The Ethics of Counting Neural Activity as Proof

摘要

In "Ethical Issues to Consider Before Introducing Neurotechnological Thought Apprehension in Psychiatry," Gerben Meynen (2019) argues "that normative reflection should be in advance of [neurotechnological] developments" (5). We agree. Meynen notes that so-called neurotechnological thought apprehension (NTA) currently has limitations, as multiple-choice designs are used and outcomes are probabilistic. He notes too that the term "thoughts" in fact covers a wide range of mental states. On these points we agree too. Yet Meynen's list of ethical issues does not take these limitations into account. His normative reflections pertain to the ideal thought experiment that is NTA, not to a realistic perspective on what information we may derive from neuro-scientific data, given the technological options we currently have and the directions in which these are developing. Meynen thereby misconstrues certain ethical issues and overlooks one that is both urgent and fundamental: How should we weigh NTA outcomes against other sources of insight into someone's psyche? Meynen discusses a much too diverse set of studies under the heading "thought apprehension," not all of which are equally likely to become relevant for (forensic) psychiatry. Experiments that are suggestive of "apprehending thoughts," such as communicating with patients in permanent vegetative state, involve instructions that limit the infinite possibilities of real-life thought to very few tractable ones. Brain-computer interfaces (BCIs) are perhaps even more suggestive, but they are not, in fact, mind-reading devices. After extensive training, BCIs pick up brain signals for the control of communication devices and robot arms. However, it is not so much the BCI that is trained to read the patient's brain correctly, but it is the patient who learns to control the BCI. The studies that are most relevant for (forensic) psychiatry aim to assist in predicting future behavior, providing information that people would not be able or willing to disclose otherwise. The studies on predicting suicidality and predicting future rearrest are cases in point. Such predictions, however, are and will remain probabilistic. More importantly, probabilities are inversely related to ecological validity of the predictions.