tDCS for Memory Enhancement: Analysis of the Speculative Aspects of Ethical Issues.
tDCS for Memory Enhancement: Analysis of the Speculative Aspects of Ethical Issues.
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DOI：
10.3389/fnhum.2016.00678
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发表时间：
2016
影响因子：
2.9
通讯作者：
Racine E
中科院分区：
文献类型：
--
作者：
Voarino N;Dubljević V;Racine E
经颅直流电刺激（tDCS）是一种很有前途的提高认知和身体机能的技术。人们感兴趣的主要领域之一是增强健康人的记忆功能。由于tDCS在生活方式和认知增强方面的应用较早，市场上出现了一些重要的伦理问题，特别是因为到目前为止，还没有官方的指导方针或评估程序来解决这些问题。本文的目的是回顾在伦理学和神经科学文献中发现的与tDCS用于记忆增强相关的伦理问题，并评估这些问题的现实程度和科学依据。为了评估每个问题的合理性或推测性，我们应用了Racine等人对生物伦理学中“知情和反思”的推测所描述的方法框架。这个框架可以简洁地表述为以下要求：(1)明确承认事实性假设并确定其价值；(2)跨学科文献对这些假设的验证；(3)采用广阔的视角，支持对规范性问题进行更全面的反思。我们确定了与tDCS用于记忆增强的开发相关的四个主要考虑因素：安全性、自主性、公平性和真实性。为了评估与这些问题相关的危害的严重性和可能性，我们分析了道德问题背后的假设，以及每个问题的证据水平。我们确定了七个不同的假设：流行程度、社会接受程度、功效、意识形态立场（生物保守主义vs.自由主义）、滥用的可能性、长期副作用，以及提供完整而清晰的信息。我们的结论是，关于通过tDCS增强记忆的伦理讨论有时会涉及不当的猜测，更密切地关注科学和社会事实将带来更细致入微的分析。目前，最现实的关切与安全和违反知情同意而侵犯用户自主权有关，因为对私人用户的潜在即时和长期健康风险仍然未知或没有得到很好的界定。必须向研究参与者和tDCS产品或相关服务的消费者提供有关这些风险的清晰和完整的信息。更广泛的公共教育倡议和警告也值得那些正在建造自己的tDCS装置的人了解。
Transcranial direct current stimulation (tDCS) is a promising technology to enhance cognitive and physical performance. One of the major areas of interest is the enhancement of memory function in healthy individuals. The early arrival of tDCS on the market for lifestyle uses and cognitive enhancement purposes lead to the voicing of some important ethical concerns, especially because, to date, there are no official guidelines or evaluation procedures to tackle these issues. The aim of this article is to review ethical issues related to uses of tDCS for memory enhancement found in the ethics and neuroscience literature and to evaluate how realistic and scientifically well-founded these concerns are? In order to evaluate how plausible or speculative each issue is, we applied the methodological framework described by Racine et al. for “informed and reflective” speculation in bioethics. This framework could be succinctly presented as requiring: (1) the explicit acknowledgment of factual assumptions and identification of the value attributed to them; (2) the validation of these assumptions with interdisciplinary literature; and (3) the adoption of a broad perspective to support more comprehensive reflection on normative issues. We identified four major considerations associated with the development of tDCS for memory enhancement: safety, autonomy, justice and authenticity. In order to assess the seriousness and likelihood of harm related to each of these concerns, we analyzed the assumptions underlying the ethical issues, and the level of evidence for each of them. We identified seven distinct assumptions: prevalence, social acceptance, efficacy, ideological stance (bioconservative vs. libertarian), potential for misuse, long term side effects, and the delivery of complete and clear information. We conclude that ethical discussion about memory enhancement via tDCS sometimes involves undue speculation, and closer attention to scientific and social facts would bring a more nuanced analysis. At this time, the most realistic concerns are related to safety and violation of users’ autonomy by a breach of informed consent, as potential immediate and long-term health risks to private users remain unknown or not well defined. Clear and complete information about these risks must be provided to research participants and consumers of tDCS products or related services. Broader public education initiatives and warnings would also be worthwhile to reach those who are constructing their own tDCS devices.