Ethics and Health Policy: Neuroethics at the Close of the Decade of Pain Control and Research
by James Giordano, PhD
 As the shift from a
fledgling attendance of just under 1,400 in 1971 to the 30,000-plus participants
(inclusive of over 5,000 non-scientific attendees) at the recent meeting of the Society
for Neuroscience in Chicago, Illinois, would indicate, there is growing interest in the
study of the brain and mind within both the scientific community and the general public.
The fields that are broadly grouped under the rubric of neuroscience provide increasingly
more information about the structure and function of neural systems and the brain, and
this certainly has been a driving force in shaping any address of pain and the challenges
and opportunities of pain medicine.
Hard Questions and Contingent Answers
In this Decade of Pain Control and Research (DCPR), neuroscience has become a focal point
for applications of genetic- and nano-technologies. The pace of neuroscientific discovery
is fueled in part by the synergy of new technology in these and other areas.
Neuroscientific advances are both being applied in medicine and integrated into the fabric
of social conduct and daily life. It becomes relatively easy to accept this information as
“fact,” and to use such facts both as contributions to, and reflections of, our
beliefs to guide—if not dictate—our understanding and activities. But given the
reality that knowledge of the brain-mind remains incomplete and contingent, the neuro
prefix seems to have become synecdoche—a figure of speech in which the part
represents the whole—for the reductionist/anti-reductionist debate in each and all of
the areas in which it is used,1 and prompts consideration of what Matthew
Crawford has called “…the limits of neuro-talk.”2
Certainly, the very same novelty that entices new and perhaps unique possibilities for
progress must equally be regarded as a source of uncertainty and should generate a
critical balance of both optimism and pessimism. Through the pace of discovery, we are
poised at the boundaries and limits of knowledge. Like it or not, we must acknowledge that
these boundaries exist, take measure of their margins, recognize the restrictions of
current knowledge, and advance our investigations and applications with prudent
precaution. Such caution need not impede the pace or progress of scientific and
technologic development, as I believe this would be antithetic to the incentives of both
philosophy and science. However, what is called for is careful reflection—upon what
we know, how we know it, and the values and beliefs that drive the quest for knowledge and
its use. Through this reflection, we confront what philosopher David Chalmers claims are
the “hard questions” of neuroscience—namely, how the brain evokes
consciousness and how our attitudes, values and actions toward selves, others, and society
are impacted by what is known about the brain and yet still unknown about the mind.3
Please refer to the Nov/Dec 2009 issue for the complete text. In the event you need to order a back issue, please click here.
— Nov/Dec 2009
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