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Neurobioética 2017

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Ric C

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Transcript of Neurobioética 2017

acarrara@legionaries.org
http://acarrara.blogspot.com
Neuro
manía

Neuro
fobia

Neuro
crÍtica

THE HUMAN BRAIN PROJECT

THE BRAIN INITIATIVE

2014: Año Europeo del Cerebro

2015: HANDBOOK OF NEUROETHICS
reduccionismo

vs
Integración
3. ¿Algunas
preguntas?

NEUROscienze
: UNA STORIA LUNGA QUANTO L'ESSERE UMANO

Edwing Smith
Imhotep
"primo neurobioeticista":
alcmeone di crotone

e la "teoria cerebro-centrica" (
540-500 a.C.
)
scribonio Largo
65 d.C.
origine remota della dbs
Galeno 129-206
Andreas Vesalius 1516-1564
la conoscenza dell'anatomia
di una struttura ci conduce a comprendere meglio la sua fisiologia
Thomas Willis
Cerebri Anatome (1664)
XIX secolo
Gall vs Flourens
“localizzazionisti” vs “antilocalizzazionisti”
Phineas
Gage

(1848)
Broca
e
Wernicke
teoria cellulare
Camillo
Golgi
(1843-1926)
Santiago
Ramón y Cajal
(1852-1934)
psicofarmacologia
: squizofrenia e clorpromacina (
1950
)
Neurocentrismo contemporaneo:
neuroimmagini
Angelo
Mosso
(1846-1910)
narrativa
neuroetica

la constitución de las
sociedades científicas acerca el cerebro
a partir de los años 40-50…
1989
: “
neuroethicist
” Neurologic Clinics, R. E. Cranford
1991
: Patricia S. Churchland

1993: A. A. Pontius
2002
: Neuroethics: mapping the fiel - DANA Foundation
William Safire
: «Welcome to the first symposium on one specific portion of that two-century-long growing concern: neuroethics – the examination of what is right and wrong, good and bad about the treatment of, perfection of, or unwelcome invasion of and worrisome manipulation of the human brain»
Adina Roskies
NEJM 1999
neuro-antropología
: La
persona Humana

Walter Glannon:
Brain
,
Body
, and
Mind
. Neuroethics with a Human Face

INDUZIONE DI UN
COMPORTAMENTO
PEDOFILO compulsivo (adquired pedophilia) AD OPERA DI UN
TUMORE
orbito-frontales

Jan

Revolutionary Prosthetic
Andrew B. Schwartz
Nature 442, 164-171 (13 July 2006):
Neuronal ensemble control of prosthetic devices by a human with tetraplegia

“Although the
mind
has a neurobiological underpinning, the mind is not reducible to the
brain


There is much
more
to the human mind and human behavior than the mobilization of distinct sets of nerve cells…
The
mind
consists of qualitatively new properties not exhibited by physical properties of the
brain
. These include the property of representing the body anD events from the external environment to the brain and making them meaningful to us...
It is also questionable whether the first-person phenomenological feel of subjective experience can be entirely captured by third-person descriptions of brain function. The human mind expresses itself through a chain of molecular events and processes. But the mind is more than just a function of molecules.”
...emerge una preoccupazione di fondo...
la
questione antropologica
mayo 2014
Vol.17,n.6,junio 2014
El
cerebro
es el convidado de cualquier
humanismo
...
José Delgado: (
1965
)
nEURO
CENTRISMO
Neuro
manía VS
NEURO
FOBIA
una
reflexión
sistemática e informada acerca de la
neurociencia
y de la
interpretación
de la misma neurociencia que incluye las ciencias correlativas de la mente, es decir, la psicología en todas sus formas, la psiquiatría, el desarrollo de la así llamada inteligencia artificial... objetivo de comprender todas las implicaciones de esta reflexión interdisciplinar
para la auto-comprensión humana
y los peligros y perspectivas de las aplicaciones al ser humano del desarrollo neurocientífico y neurotecnológico

NOT
ONLY
BRAIN...

Neuro
bio
Ética
Neuro-genómica
2015
a new and neglected area of ethical concern -
neuro-ethics
..........
2015
neuroethics as a
brain-based philosophy
...Thus yet
another hybrid word
is finding its way into current discussions:
neuroethics
...
...other increasingly fashionable hybrid word, '
neuroethics
'...
...it is in response to these prospects that the term '
neuroethics
' has been invented, and it is to
neuroethics
itself that finally i turn...
...a new term has appeared in the
bioethical
and
philosophical
literature:
neuroethics
...
2006
2011
Recent advances in the brain sciences have dramatically improved our understanding of brain function. As we find out more and more about
what
makes us tick, we must
stop and consider the ethical implications of this new found knowledge
.
Will having a new biology of the brain through imaging make us less responsible for our behavior and lose our free will? Should certain brain scan studies be disallowed on the basis of moral grounds? Why is the media so interested in reporting results of brain imaging studies? What ethical lessons from the past can best inform the future of brain imaging?
These compelling
questions
and many more are tackled by a distinguished group of contributors to this,
the first-ever volume on neuroethics
. The wide range of disciplinary backgrounds that the authors represent, from neuroscience, bioethics and philosophy, to law, social and health care policy, education, religion and film, allow for profoundly insightful and provocative answers to these questions, and open up the door to a host of new ones. The contributions highlight the timeliness of modern neuroethics today, and assure the longevity and importance of neuroethics for generations to come.
The past two decades have seen unparalleled developments in our knowledge of the
brain
and
mind
. However, these advances have forced us to confront head-on some significant
ethical issues regarding our application of this information in the real world
—whether using brain images to establish guilt within a court of law, or developing drugs to enhance cognition. Historically, any consideration of the ethical, legal, and social implications of emerging technologies in science and medicine has lagged behind the discovery of the technology itself. These delays have caused problems in the acceptability and potential applications of biomedical advances and posed significant problems for the scientific community and the public alike—for example in the case of genetic screening and human cloning. The
field
of
neuroethics
aims to
proactively anticipate ethical, legal, and social issues at the intersection of neuroscience and ethics, raising questions about what the brain tells us about ourselves, whether the information is what people want or ought to know, and how best to communicate it
.
uno
specifico ambito d'indagine
...di
ciò che apprendiamo su noi stessi e sul nostro "funzionamento"
, grazie principalmente (ma non esclusivamente) alle
neuroscienze
...
un nuovo genere di antropologia
...
...un
ponte
fra le scoperte delle
neuroscienze
e i sistemi dei
valori
umani, all'
interfaccia
con psicologia, filosofia, antropologia, etica normativa, scienze giuridiche e sociali, economia...

una disciplina che si prefigge di
leggere l'uomo, nella sua individualità e globalità, alla luce della neurobiologia
documentata delle neuroscienze...
2010
2010
2011
la centralità delle
"
neuroscienze dell'etica
"
2005
'
neuro
bio
ethics
'
http://www.neurobioethics.org/
(1) the study of
neurological bases of
moral cognition, sense and action

(2) the
field of study
that addresses the moral issues that arise in and from neuroscientific research and the clinical practices
and
social effects/implications that evolve from these investigations

(3) the
reciprocal interaction(s)
between neurological research/clinical practices and other ethically relevant areas of biomedical sciences (e.g. the effects/implications of genetic research on neurological care; use of nanotechnology in neurological research and practice, etc.)
Contemporary neuroethics necessitates consideration and appreciation of an
underlying natural philosophy
, that grounds neuroscience (and its constituent disciplines) and the humanities. Toward this, a number of operational definitions are introductory to an explanation of neuroethics...

Natural
: 1: the inherent character or basic constitution of a person or thing 2: a controlling force in the universe or the sum of such forces in an individual 3: a kind or class usually distinguished by fundamental or essential characteristics
Philosophy
: 1: a discipline comprising as its tasks: metaphysics, logic, epistemology, ethics, engaged in study or pursuit of field/practice 2: a search for a general understanding by chiefly speculative rather than observational means
Science
: an area of knowledge that is an object of study, particularly as concerning general laws; usually as obtained through specific rational methods

Ethics
: a system of beliefs, attitudes and practices reflective of a metaphysical appreciation engaged in moral decision making; a ‘binding’ set of beliefs and faith in such beliefs
Neural/Neuro
: pertaining to or derived from the structure, function (or concept) of nerves, and/or nervous systems, such as brains.
From this, we can consider
two
viable definitions of "
neuroethics
":

1) Inquiry and investigation into the
neural basis
of moral thought, intention and behavior

2) Inquiry and investigation into the moral, ethical and policy-related issues arising in, and from neuroscientific research and its clinical applications

Both of these definitions involve
a solid foundation of the facts of neural function
, the realities of science, medical practice, and social impact, and from this
(a.) recognize the exigencies and issues that are inherent and arise, (b.) the moral obligations and responsibilities involved with these issues, and (c.) how various ethical systems may be utilized to address and resolve these issues, questions and problems. This allows us to construct a
normative and applied neuroethics
"...from the ground up", as schematically illustrated below.
i. Introducción - contexto
1. (Neuro)Ciencia vs Filosofía 1.1. c. p. snow -p. STRATA
1.2. La respuesta de la Filosofía
2. Neuromanía vs Neurofobia
2.1. neuro-manía
2.2. neurofobia.
¿Quién tiene miedo del cerebro?
Ralph f. jozefowicz
3. Tripartición
1. "neurocentrismo"
1.1. Del
ADN
a la
neurona
1.2.
Neuro
genetica y
Neuro
genómica
Neurociencia(s)
gran familia de disciplinas biomédicas relacionadas con la neurología, que estudia el
funcionamiento
del sistema nervioso; en particular, el cerebro. Junto a las especialidades tradicionales (neurología, neurocirugía, psiquiatría, psicología), hoy en día son cada vez más importantes nuevas disciplinas - como la neurogenética, la neurobiología, la así llamada neuroimagen - que se están abriendo nuevos escenarios para el estudio y la investigación, inimaginable hace sólo unos pocos años, del
desarrollo
, la
estructura
y la
función
del sistema nervioso
Excursus
El estatuto epistémico de las neurociencias
1974
ii. neurociencias:
una narrativa histórica
1. PREMisas
1.1. TERMINOLOGIA
associazione
Mediazione
Correlazione
Connessione causale
Causazione
Meccanismo
Processo
Stato cerebrale
Stato mentale

1.2. Modelo “cerebro trino”
1952 Paul D. MacLean
1.3.
bottom-up / top-down
bottom
up
top
down
2013
2003
2015
2690-2610 a.c. !!!
bottom
up
bottom
up
bottom
up
Leonardo da Vinci
1452-1519
- controllo della muscolatura da parte del midollo spinale
- presenza di nervi pari nelle strutture craniali
- controllo della voce da parte del
cervello
stesso e il fatto che il cervello controllasse i quattro umori che catalizzavano il funzionamento del nostro corpo e della nostra personalità somatica e psichica
1021
ibn al-haytham
1390
mansur: primo atlante
anatomico a colori
aree cerebrali
-
funzioni mentali
afasie
bottom
up
1861
1874
top
down
1874 richard caton
1897 charles s. sherrington
1909 korbinian broadman
1921 otto loewi
acetilcolina
1951 wilder penfield
1953 caso h.m.
1995 caso "elliot"
Antonio damasio
2008 jill price
brain-to-text
5 principios
mente-cerebro
http://faculty.washington.edu/chudler/hist.html
Eric H. Chudler, Ph.D.
http://faculty.washington.edu/chudler/ehc.html
2008
2006
2011
2015
http://peh-med.biomedcentral.com/articles/10.1186/s13010-016-0037-1
similarly, entire school systems in the USA taught "new math" (also criticized as too soon by mathematician Klein) in kinder garden and began literacy instruction with the "whole word" or "sight reading" method. The latter is actually a picture recognition ability, mediated by a different brain system than alphabetical letter by letter reading. (e.g. children could "read" cat but not "caterpillar").
Millions of USA school children were taught a method for which their brain was not yet mature, contributing to millions of "functionally dyslexics". Neurologically uninformed authorities were experimenting with young children without respecting given anatomical neuro-developmental facts and without consent at those times
.
It was said pointedly: "Behaviorists resent the central nervous sytem:"
Thus, neurological facts were neglected and at that time, there was no neurology-base warning on potentially dire effects.

Kind regards
Anneliese Alma Pontius
MD, Associate Clinical Professor (ret.), Harvard Medical School

PS Please feel free to ask further questions.

I am glad you asked: when I wrote those articles four decades ago,
behaviorism
reigned in the USA, which
neglected neurological facts
. For example newborns have no anatomical maturity to enable them to walk, and the
neurologically uninformed authors
of "Walking in the newborn" (Zelazo PR et al. (Science 1972;176:314-315) mistook the innate stepping reflex for independent walking, requiring myelination of the pyramidal tract at about 8 months of life) as detailed in my paper (
AA Pontius: Neuro-ethics of 'walking. Perceptual & Motor Skills. 1973;37:235-245
). Zelazo et al. recommended "walking" exercises in newborns, believing that "subtle forces in society "deprives the one-week olds and "erodes the self-rewarding activities underlying the infant's curiosity". My letter to the Science Editor, supported by neuropathology professor
Paul I Yakovlev
was rejected as being "too late", while another author-supporting letter was accepted weeks later by an anthropologist's irrelevant examples.
Neuroethics, in my lexicon, is
a distinct portion of bioethics
, which is the consideration of good and bad consequences in medical practice and biological research. But the specific ethics of the brain science hits home as research on no other organ does. It deals with our consciousness – our sense of self – and as such is central to our being. What distinguishes us from each other beyond our looks? The answer: our personalities and behavior. And these are the characteristics that brain science will soon be able to change in significant ways
Let’s face it: one person’s liver is pretty much like another’s. Our
brains
, by contrast, give
us
our intelligence, integrity, curiosity, compassion, and – here’s the most mysterious one – conscience. The brain is the organ of individuality
the hastings center
1969
....2017
Behariorism
, July 11,2013
Dear Professor Alberto Carrara:

Thanks for your interest in my work on "neuro-ethics", beginning
1973
and for your questions why I wrote "
new and neglected area of ethical concern - neuro-ethics
", what was its context at those times and why I used the term "neglected" this
new field of ethics
.
contesto
1962
LeefmannJ,LevalloisCandHildtE (
2016
)
Neuroethics 1995–2012. A Bibliometric Analysis of the Guiding Themes of an Emerging Research Field
. Front.Hum.Neurosci.10:336.
doi: 10.3389/fnhum.2016.00336
https://www.routledge.com/The-Routledge-Handbook-of-Neuroethics/Johnson-Rommelfanger/p/book/9781138898295
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