Ethics and Health Policy: Pain, Neurotechnology and the Treatment-Enhancement Debate
by James Giordano, PhD, Mphil; Justin Rossi, BSc; and Adriana Gini, MD
 Neuroethical
Consideration of Neurotechnology in Pain Care
In addressing the responsibility to develop and implement a neuro-ethics of pain care, it
has been stated that: “…the nature of the ‘good’ of pain care in
neurocentric contexts gives rise to several fundamental questions: Is there some threshold
of pain and suffering that can or should be validated in order to incur and/or justify
clinical intervention? Can neuroscience contribute this metric or rule? To what level(s)
might we take diagnostics and therapeutics?”1 In other words, we can, and
arguably should ask: At what point does the treatment of pain and suffering become
“excessive” and would such intervention be considered “enhancement”?
It is reasonable to assume that manipulation of neurological function—through the use
of analgesic and psychotropic drugs and certain neurotechnologies—has become, and
will continue to be, increasingly valued and publically accepted, as these techniques and
technologies improve and are made evermore commercially available. The market will both
drive and ensure that this is the case. Economic factors are such that the availability of
a given technique or technology often lend it value and establish the call for its use.
Simply put, the “if we have it; use it” maxim holds and, in many cases, there
is appreciable merit to at least considering such use. But if neuroscience has revealed
that pain is unique to each individual (i.e., reflecting how the engagement of specific
neural networks give rise to phenomenological experience) and this mitigates against a
“one size fits all” approach to pain care, then it becomes obvious that the
assessment and discernment of pain can be seen as the initiative element in both
determining the nature and impact of the subjective experience of pain and establishing a
threshold for the provision, type(s) and extent of treatment.
Please refer to the May 2010 issue for the complete text. In the event you need to order a back issue, please click here.
— May 2010
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