Neurotech’s brainchildren have also attracted considerable non-medical attention. Advancing from science fiction to applied science is a fast-growing, $8 billion business, with investments from commercial, military, and academic interests. While neurotechnologies may be poised to produce magic bullets for clinical medicine, the military hopes they might also fire live ammunition. (Just as S3 can reach for a cup of java with her thoughts, a soldier could similarly operate weaponries with brain-computer interfaces.)
Marketers, too, dream of a neurotechnology that could read minds to then specifically mer-chandize their hosts. And there are many mere human egos eager to have turbocharged brains that function far beyond our all-too-ordinary selves. Yet with every scientific step forward, there is also the prospect of intended and unintended missteps—of applications that are a step in space where no one should go.
The prospect of mismanaging the power of neurotechnology has spawned the field of neuroethics, bringing us face-to-face with questions about who will have access to these culture- (and ethos-) changing technologies, and to what ends they will be utilized. Psychiatrists, neurologists, and neuroscientists, therefore, will have to con-front questions of how to best apply novel neurotechnologies in an equitable and ethical way. For example, consider some of the following thornier neuroethical issues.
First, who should benefit? Memory-enhancing treatments, for example, usher in a host of questions about their applications. We may be on firm moral ground when it comes to offering cognitive-enhancing medications or other neurotechnologies to restore lost brain functions to individuals with Alzheimer disease, debilitating cerebrovascular accidents, multiple sclerosis, and other prevalent and disabling brain diseases. So, too, is the imperative to treat victims of traumatic brain injury who will need medicines or procedures to modulate or erase the traumatic memories that can sear into the brain after a disaster, in combat or from torture or abuse, leaving them “invisibly” yet severely wounded. These interventions make sense.
But should doctors prescribe cognitive enhancers to boost the functioning of a healthy brain or implant artificial neurons or stem cells to fur-ther the mental performance of those healthy from the start? Should recipients be those with debilitating illnesses—or should corporate CEOs and mediocre students (those who can afford it) attain supercharged brains?
What about the use of neurotechnology in homeland security or the corporate marketplace? Will consumers be able to ask their doctor for a nootropic or will it be available on amazon.com? Will (“when” is more likely) a black market emerge? What will be the FDA’s role in dif-ferentiating snake oil from the next truly magic pill or device? Neuroethicists will have plenty to consider.
Moreover, what principles should guide the allocation of precious and powerful resources and services in a society? Should the market forces of supply and demand determine who will get what is needed (or desired) and who will not? Ethicists, policymakers, and clinicians are familiar with these questions of “distributive justice” in which health care resources are meant to be distributed to maximize wellness and minimize misfortune. Meant is a goal, but the question remains as to how.