Neurosciences is multidisciplinary sciences which is mainly concern with the study of the structure and function of the brain system. This area of study is quite relatives new in Malaysia compared to western countries that have been involved in this area of study for quite some long time ago. Advances in neurosciences raise ethical, social and legal issues in relation to the human person and the brain. Ethical problems resulting from brain research have induced the emergence of a new discipline termed neuroethics.
Neuroethics focuses on ethical issues raised by our continually improving understanding of the brain and by consequent improvements in our ability to monitor and influence brain function. Since neurosciences is a young field that is growing in Malaysia, thus the neuroethics in Malaysia is also not really well established as not many journals can be found and there is no spesific neuroethics guidelines that has been documented for Malaysia. So, all the journals that have been used in this article are mainly written from other countries and intentionally can advance our understanding of autonomy in neuroethics precisely.
Before the autonomy in neuroethics is discussed further in detail, the organisation and division of the information throughout this article as following.
THE HISTORY AND EMERGENCE OF NEUROETHICS
In biology field, bioethics is common for those people in that field. Bioethics is a broad field that links the biological sciences with ethical concerns. There are many subfield under the bioethics such as biomedical and medical ethics. The biomedical ethics focuses on issues related to basic and clinical research and medical ethics deals with issues in the healthcare setting.
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One of the most important core in biomedical and medical ethics is respect for the individual. The respect for individual involves elements of making an informed decision regarding participation clinical research or access to health care. The emergence of the biomedical and medical ethics has led to current approaches to the ethics of human experimentation and respect for autonomy in neurosciences field. New ethical issues build on this legacy and coined as neuroethics. Neuroethics intersects with biomedical ethics in that broadly defined is concerned with ethical, legal and social implications of neuroscience research findings, and with the nature of the research itself (Bird & Mitcham, 2005 as cited in Bird & Illes, 2006).
Drawing on the history of ethics in neurosciences, it have a long and fascinating history. It became interests of natural philosophers, physicians, researchers, as well as laypeople from past till nowadays. As such, the history of the neurosciences along with the recent history of neuroethics had incorporates wide perspectives from multidisciplinary area such as the history of philosophy and theology, the history of science and medicine, along with social, political, and cultural histories (Stahnisch, 2015). Overall, the history of ethics in neurosciences can be relate starting from the history of biomedical ethics in which attention to the ethical implications of biomedical research in the late 1900s and advancement in molecular biology due to certain events marked its emergence in the public sphere and consequently played a vital role in shaping ethics in neuroscience. The chronology emerging of neuroethics are describe as below.
• After World War II, as is well known, a trial commenced in Nuremberg, on December 19, 1946, of Nazi doctors and a code was defined in which the judges, all Americans, clearly emphasized a view of medical research and technology: science should never transform or consider human beings as an instrument to be employed for scientific purposes. In actual fact, documents exist providing evidence that a few decades other than the Nuremberg Code, the International Code of Medical Ethics, the Code of the British Medical Association, and the World Medical Association’s Declaration of Helsinki had laid out ethical principles regarding research with human subjects.
- 1960s
- 1970s
- 1980s
- 1990s
- 2002
CONCEPT OF AUTONOMY IN NEUROETHICS
Nowadays, autonomy is one of core concept in bioethics, after it was recognized as one of vital principle in bioethics after the principles of nonmaleficence and beneficence, were recognized. Autonomy carries a general definition where it is a concept representing an individual’s control state of his or her own thoughts and action which can be motivated by ‘internal forces from within’ such as judgment and decision and it is not ‘external forces’ from the surrounding (xxxxx). Based on the ‘Ethics Explainer: Autonomy’ article, autonomy in terms of ethical principle, has a clear purpose which is to protect every person’s choice, rights and independence against the control of any organizations, authorities or other people. This basically means that autonomy lets an individual be his or her own ruler. Baruch Spinoza, a philosopher had also mentioned that an individual is independent, only if he or she is living with free consent under the entire guidance of reason. Despite being used in various contexts, autonomy is most often an important element in philosophical, political and medical fields.
Autonomy in Neuroethics: Metaphysical Views versus Moral and Political Views
In the neurosciences field, there are some debate over the concept of autonomy where some neuroscientists believe that notion of autonomy has associated with the metaphysical concept (free will) or in other words is Personal Autonomy, while some of them are supporting autonomy in moral and political philosophy. Although views in the concept of autonomy are differ, it is widely appreciated as a valuable aspect of personhood (Roskies & Adina, 2016). The metaphysical concept of free will is centred towards oneself as has abilities to make own decision meanwhile the moral and political philosophy includes moral aspects on an individual’s ability to make own decision and take account of social structures and political institutions where the persons are belong. These two views are elaborate in detail in the next following section that include operational definitions of both Metaphysical views and Political views as well several distinctions were drawn between these two views.
Metaphysical Views or Personal Autonomy
Most views on Personal Autonomy renders concept of free will even though some neuroscientists reject it and believe that Personal Autonomy is independent concept from free will. However, in this article, Personal Autonomy is regarded as the same concept of free will in decision making. As a human, we live together in some area together with other people in a community and in the Personal Autonomy context, they declare that everybody in the community has the right to live autonomously and ought to be allowed to govern themselves. Due to this declarations, they deny and reject anyone to control an individual’s activity and no one has the authority or exercise any power over his or her activity unless he or she authorizes it.
So, Metaphysical views or Personal Autonomy defines autonomy as a trait that individuals can exhibit relative to any aspects of their lives, not limited to questions of moral obligation (Dworkin 1988 as cited in Roskies & Adina, 2016). In metaphysical philosophy, the concept of autonomy generally discussed about free will, fatalism, determinism, and agency. According to Waldron (2005), personal autonomy will evokes a person is in charge of his or her life, capable of making judgments and decisions by following his or her own desires and it is not an immoral idea, but it has relatively little to do with morality.
However this views have some limitations that arisen from some questions such as what factors influences on a person’s decision, intention, or how capable a person is able to make own self-decision and as the number and variety of these accounts indicate, the distinction is extremely elusive. These arguments become threats to Personal Autonomy: since they cannot find consensus about to what extent influences on our behaviour prevent us from governing ourselves.
Moral and Political Views
The Moral and Political views in autonomy is come recently as modern and contemporary philosophy in ethics. However, the idea of moral and political views of autonomy came from a moral philosopher from German named Immanuel Kant. In Kant’s view, key to understand and to justifying the authority in making judgments and decision making are the moral requirements that have over it. Moreover, in this view, a person is autonomous in the moral sense when he is not guided just by his own conception of happiness, but by a universalized concern for the ends of all rational persons (Johnson, 2004). This conception of autonomy contrasts with theories of personal autonomy in which decisions and do not give weight to the self-desires and wishes.
Specifically some philosophers or researchers have tried to make comprehensive explanations on moral and political views on autonomy in neuroethics. One definition that have been found in an article define the moral and political views of autonomy as and implicitly grounded in the legal and political system where a person act autonomously endorses decisions and acts in accord with internal motivational states, shows commitment to them in the absence of undue coercion and compulsion, and could be a reasonable and rational person continue to do so after a period of informed critical reflection (Dubljevic, 2013).
at least in the strictest sense of the term. Our analysis of the degree to which neurobiological insights conform with the concept of autonomy was intended to be grounded in the real world of day-to-day decision making. We sought to delineate the contours of the issues and to initiate a debate about how autonomy should be viewed in light of neurobiological evidence.
Consensus Concept of Autonomy in Neuroethics
Empirical data from the neurosciences call into question the extent to which decisions made by healthy human adults are autonomous. At the moment, contemporary neuroscience practise has been tremendously influenced by bioethics’ western ideas and it is assumed by most, that autonomy is a universal value of human existence (Rathor, Azarisman & Hasmoni, 2016). According to the World Health Report from the year 2000, the World Health Organization (WHO) considered autonomy as a “universal” value of human life against which every health system in the world should be judged. Personal autonomy and self-determination in Western bioethics prevail in all sectors of social and personal life of individuals which is a concept that is unacceptable to some cultures in which studies should be conducted on these to determine autonomy as a universal value of human existence and also its scope in neurosciences fields. From my opinion, I support the idea that we make autonomous decisions is secure as long as the capacity to do so is preserved that is proposed by Dubljevic (2016) but the term of “capacity”is more appropriate to take account neurobiological factors that is what our brains actually do when they make decisions seems more practically relevant than just what capable of doing.
However, I believed that moral and political views in autonomy serve important roles in the context of our country, Malaysia for person autonomous. It is because the basis for ascription of moral and legal responsibility differs in some societies across the world. Malaysia has some legal system that is based on religious Islam. In terms of autonomy in the medical field, Islam emphasizes purely on bioethical decision making which must be carried out within a framework of values derived from Islamic law in which morality in Islam are absolute and are of divine origin where health prevention and disease promotion is a major point to consider in religious aspect. On the other hand, the concept of autonomy in Western culture focuses more on individualism over the community, self-reliance over one’s dependence, personal satisfaction, and self-actualization. In any situation that may occur, the people will still have the right to do whatever they wish with their bodies because it is their based on their own choice.
In the discussion on neuroscience and autonomy, based on the research studies that have been conducted revolving around the term ‘autonomy’, it can beconclude that the right of autonomy vital in betterment of human lives because it involves the inner thoughts of an individual, as one can achieve personal satisfaction through making own decisions which are respected by others. This automatically can increase the individual’s positive well-being. This ethical principle may look like a small factor in one’s life, but it brings a whole new meaning to the person despite the influence of other external factors. As a suggestion, future research can take initiative to create the context for psychological need fulfilment based on the right of autonomy in different situations. So, further research may bring a more specific dimension on how one may bring positive consequences to all while having the rights to self-govern and future research may as well examine moral principles to allow us to evaluate and understand not only the effect of the types of moral norms on the individual, but also the morality of ideologies which comes from the surrounding especially in Malaysia.
IMPLICATIONS OF AUTONOMY IN NEUROETHICS
Neuroethics is just another branch of applied ethics under the bioethics domains and its scope is broader, encompassing about to give consent or to refuse the permissibility or advisability of using neurotechnologies to study about brains that makes us unique individuals, that gives us our personality, memories, emotions, creative abilities, and etcetera. A remarkable conference event conferences on the topic which sponsored by The Dana Foundation, neuroethics was defined by William Safire as ‘the study of the ethical, legal, and social questions that arise when scientific findings about the brain are carried into medical practice, legal interpretations, and health and social policy (http://ccnmtl.columbia.edu/projects/neuroethics/index.html retrieved on 2 December 2018). It is clear that rapid emerging of brain technology and scientific research, neuroethical issues need to be addressed urgently and this paper will discuss the implications of autonomy in neuroethics in four domain of neurosciences along with case study to as example.
Autonomy in Neuroethics . (2022, Apr 23). Retrieved from https://paperap.com/autonomy-in-neuroethics/
