The body-to-head transplant (BHT) planned to be undertaken later this year at China’s Harbin Medical University by neurosurgeons Sergio Canavero and Xiaoping Ren has attracted considerable attention and criticism. The intended operation gives rise to philosophical queries about the body–brain–mind relationship and nature of the subjective self; technical and ethical issues regarding the scientific soundness, safety, and futility of the procedure; the adequacy of prior research; and the relative merit, folly, and/or danger of forging new boundaries of what is biomedically possible. Moreover, that this procedure, which has been prohibited from being undertaken in other countries, has been sanctioned in China brings into stark relief ways that differing social and political values, philosophies, ethics, and laws can affect the scope and conduct of research. Irrespective of whether the BHT actually occurs, the debate it has generated reveals and reflects both the evermore international enterprise of brain science, and the need for neuroethical discourse to include and appreciate multicultural views, values, and voices.

Diagnostic classification systems in psychiatry have continued to rely on clinical phenomenology, despite limitations inherent in that approach. In view of these limitations and recent progress in neuroscience, the National Institute of Mental Health (NIMH) has initiated the Research Domain Criteria (RDoC) project to develop a more neuroscientifically based system of characterizing and classifying psychiatric disorders. The RDoC initiative aims to transform psychiatry into an integrative science of psychopathology in which mental illnesses will be defined as involving putative dysfunctions in neural nodes and networks. However, conceptual, methodological, neuroethical, and social issues inherent in and/or derived from the use of RDoC need to be addressed before any attempt is made to implement their use in clinical psychiatry. This article describes current progress in RDoC; defines key technical, neuroethical, and social issues generated by RDoC adoption and use; and posits key questions that must be addressed and resolved if RDoC are to be employed for psychiatric diagnoses and therapeutics. Specifically, we posit that objectivization of complex mental phenomena may raise ethical questions about autonomy, the value of subjective experience, what constitutes normality, what constitutes a disorder, and what represents a treatment, enablement, and/or enhancement. Ethical issues may also arise from the (mis)use of biomarkers and phenotypes in predicting and treating mental disorders, and what such definitions, predictions, and interventions portend for concepts and views of sickness, criminality, professional competency, and social functioning. Given these issues, we offer that a preparatory neuroethical framework is required to define and guide the ways in which RDoC-oriented research can—and arguably should—be utilized in clinical psychiatry, and perhaps more broadly, in the social sphere.

Neuroscience and neurotechnology are increasingly being employed to assess and alter cognition, emotions, and behaviors, and the knowledge and implications of neuroscience have the potential to radically affect, if not redefine, notions of what constitutes humanity, the human condition, and the “self.” Such capability renders neuroscience a compelling theme that is becoming ubiquitous in literary and cinematic fiction. Such neuro-SciFi (or “NeuroS/F”) may be seen as eidolá: a created likeness that can either accurately—or superficially, in a limited way—represent that which it depicts. Such eidolá assume discursive properties implicitly, as emotionally salient references for responding to cultural events and technological objects reminiscent of fictional portrayal; and explicitly, through characters and plots that consider the influence of neurotechnological advances from various perspectives. We argue that in this way, neuroS/F eidolá serve as allegorical discourse on sociopolitical or cultural phenomena, have power to restructure technological constructs, and thereby alter the trajectory of technological development. This fosters neuroethical responsibility for monitoring neuroS/F eidolá and the sociocultural context from which—and into which—the ideas of eidolá are projected. We propose three approaches to this: evaluating reciprocal effects of imaginary depictions on real-world neurotechnological development; tracking changing sociocultural expectations of neuroscience and its uses; and analyzing the actual process of social interpretation of neuroscience to reveal shifts in heuristics, ideas, and attitudes. Neuroethicists are further obliged to engage with other discourse actors about neuroS/F interpretations to ensure that meanings assigned to neuroscientific advances are well communicated and more fully appreciated.

Ongoing developments in neuroscientific techniques and technologies—such as neuroimaging—offer potential for greater insight into human behavior and have fostered temptation to use these approaches in legal contexts. Neuroscientists are increasingly called on to provide expert testimony, interpret brain images, and thereby inform judges and juries who are tasked with determining the guilt or innocence of an individual. In this essay, we draw attention to the actual capabilities and limitations of currently available assessment neurotechnologies and examine whether neuroscientific evidence presents unique challenges to existing frameworks of evidence law. In particular, we focus on (1) fundamental questions of relevance and admissibility that can and should be posed before the tests afforded in Daubert v. Merrill Dow Pharmaceuticals or Frye v. U.S. are applied and (2) how these considerations fit into the broader contexts of criminal law. We contend that neuroscientific evidence must first be scrutinized more heavily for its relevance, within Daubert and Federal Rule of Evidence 702, to ensure that the right questions are asked of neuroscientists, so as to enable expert interpretation of neuroscientific evidence within the limits of their knowledge and discipline that allows the judge or jury to determine the facts at issue in the case. We use the analogy provided by the Daubert court of an expert on the phases of the moon testifying to an individual’s behavior on a particular night to ensure that we are, in fact, asking the neuroscientific expert the appropriate question.

Here we have a case in which (1) the outcome(s) for the patient do not comport with the projected—or initially defined—outcomes of the research study, and (2) these outcomes represent cognitive and behavioral effects that are positively interpreted by the patient, but not by the patient’s immediate family. The 6Cs approach, which frames the technique or technology—and its effects—within defined considerations of domains and dimensions, can be used as part of a multistep approach to addressing issues arising from the use of neurotechnology.1 The approach recommends that the medical team consider the following domains and dimensions when engaging neuroethical analyses:

• • The capacities and limitations of current neuroscience and technology (neuroS/T), and the capacity of the patient

• • The consequences incurred by neuroS/T on recipients, families, and society in the short, intermediate, and long term

• • The character of the recipient (e.g., patterns of cognition, emotion, and behavior) affected by neuroS/T

• • The continuity of research and clinical care

• • The contexts of need and value that influence the use or nonuse of neuroS/T

• • Consent through provision of the most information possible 2

An integrated and principled neuroethics offers ethical guidelines able to transcend conventional and medical reliance on normality standards. Elsewhere we have proposed four principles for wise guidance on human transformations. Principles like these are already urgently needed, as bio- and cyberenhancements are rapidly emerging. Context matters. Neither “treatments” nor “enhancements” are objectively identifiable apart from performance expectations, social contexts, and civic orders. Lessons learned from disability studies about enablement and inclusion suggest a fresh way to categorize modifications to the body and its performance. The term “enhancement” should be broken apart to permit recognition of enablements and augmentations, and kinds of radical augmentation for specialized performance. Augmentations affecting the self, self-worth, and self-identity of persons require heightened ethical scrutiny. Reversibility becomes the core problem, not the easy answer, as augmented persons may not cooperate with either decommissioning or displacement into unaccommodating societies. We conclude by indicating how our four principles of self-creativity, nonobsolescence, empowerment, and citizenship establish a neuroethics beyond normal that is better prepared for a future in which humans and their societies are going so far beyond normal.

Neuroscience affords knowledge that can be leveraged in the ontological valuation of individuals, groups, and species. Sociocultural sentiments, norms, and mores may impede embracing such knowledge to revise moral attitudes, ethics, and policies. We argue that the practices of neuroethics will be valuable in that they ground ethico-legal discourse in (1) naturalistic philosophy; (2) the current epistemological capital of neuroscience; (3) the issues, problems, and solutions arising in and from neuroscientific research and its applications; and 4) the use of neurocentric criteria—such as painience—to define and resolve ethical decisions regarding attitudes toward and treatment of nonhuman animals.