Brain Research: Blueprints of a New Era

Brain science has been one of the central topics in the scientific world in the last decade. The development of several new technologies has allowed scientists to reach a superior level in research methods.

Such technologies - particularly brain scanning techniques (PET, fMRI, CT, etc.) - have enabled experts to perform procedures which were thought to be in the realm of science fiction in a near past. In the verge of an advanced era in the perception and manipulation of the human mind, an ethical discussion was raised in the Old continent.

Meeting the ‘Meeting of Minds’

“Meeting of Minds - European Citizens' Deliberation on Brain Science, was a unique exercise involving the general public in a discussion on cutting-edge science. Citizens from nine European countries will suggest what they think should be done with our new-found knowledge of the brain. They will debate the ethical, social and legal implications with international experts. The citizens’ conclusions on the use of new technology, medicines and techniques will be offered to policy-makers at the European, national and transnational level.” (www.meetingmindseurope.org)

Breaking through Brain Research

The outcome of the meeting of minds was one of the most elaborate displays of democratic decision-making in history. 126 citizens, 9 countries, 12 organisations and another dozens of professionals from several areas: resulting in over 100 recommendations that are being analysed by stakeholders in the fields of brain research and politics. The meeting’s organisation committee recognised several ‘new’ areas in brain research which are becoming increasingly relevant in our daily lives, and designed most recommendations based on probable outcomes from these areas.

Brain Stimulation

The initiative to solve psychiatric problems derived from common mental health disorders, such as OCD, has provided the background for neuro-surgeons to endeavour in “tinkering at people’s brains”. Innovative procedures, such as the insertion of electrodes that emit mild currents to communicate with the patient via a wireless system, are part of this area. Issues? The definition of normality: how are medical treatments going to affect different social groups and who should, and should not, be treated.

Brain Scanning Technologies

Functional Magnetic Resonance Imaging (fMRI) has been used to identify patterns of cognitive behaviour in the human brain. Scientists have attempted to use it for lie detection and even to recognise which areas of the brain are being used when a stimuli is provided. Scientists have even attempted to scan several different people in order to define a ‘normal’ brain structure. Issues? Privacy and a patient’s right to refuse treatment are the major concerns which result from this type of research.

Regulatory Drugs

Several drugs have been developed to treat patients with brain disorders, such as compliance and conduct disorders. The ability to provide a ‘quick fix’ to particular behaviours has induced research in this area. Issues? Again the definition of normality: there is a concern on whether some conditions are in fact disorders that should be treated. With further development of research, such drugs could be used for social control.

Cognitive Enhancers

In the last decade cognitive enhancers have been a central topic of discussion in brain research. Drugs which improve memory, alertness and other cognitive functions have been developed, and drug companies are prepared to market them to the general public. Issues? There are several concerns about the non-regulation of such drugs, which could become a quick fix for ‘mental problems’. This culture would play a role in decreasing the importance of preventive treatment.

Genetic Profiling

Increased research in the brain’s structure and functioning is giving scientists the opportunity to relate the genetic structure of individual’s with the possible development of particular brain conditions. Such procedure could allow the recognition of pattern which would predict the incidence of mental health diseases prior to the actual development of the disease. Issues? The burden of knowing the future for an individual that is likely to develop a mental health disease.

Themes and Final Recommendations

The project’s meeting on January produced more than 100 recommendations in six different areas of brain research. Following are some of them:

Regulation and Control

- Increase the transparency of public funding allocation mechanisms and its links to solving social issues.
- Extend the reach of ethical oversight to non-experimental research.
- Prevent the misuse of human beings for experimental research.
- Make disclosure of privately-funded brain research activities into a legal requirement.
- Increase transparency of ongoing research to align public funding.
- Increase public funding for fundamental research.
- Minimise bureaucratic barriers to encourage collaborative research.
- Strengthen legal regimes on discrimination against persons with mental conditions, particularly in their workplaces.

Normalcy versus Diversity

- Foster greater inter-disciplinary knowledge to improve thinking about norms
- Take into consideration that diversity is “normal” and positive for the development of society, the arts and science.
- Counteract a “social pressure” for medical treatment.
- Do not treat patients if they do not wish it.
- Offer a broad range of treatment options and support, provide alternatives to medical treatment and complementary medicine or combine various approaches.
- Put more emphasis on prevention.
- Reinforce communication between patients and specialists in charge.
- Reallocate resources in favour of basic research.
- Give high priority to brain research.
- Ensure that the increased knowledge that brain science provides is also applied in other fields such as teaching, learning, thinking, and creativity.
- Do not allow enhancing drugs for people who have to pass exams.
- Definitions should be flexible as society moves on.

Public Information and Communication

- Promote broadcasting of scientific documentaries during viewer-friendly hours.
- Start a “Brainpedia” similar to the general Wikipedia encyclopedia in the internet.
- Mobilize medical students and create opportunities for them to go public in order to enter a permanent discussion with practitioners, organizations, and citizens.
- Keep the medical press independent of pharmaceutical industries.
- Promote the information flow between experts.
- Encourage a more interdisciplinary approach.
- Introduce or improve communicative skills in the education for medical doctors in order to improve the doctor-patient relationship and the quality of information.
- Establish more direct information links between experts and patients. Scientists should be discouraged to publish immediately every new development in research in popular media.

Pressure from Economic Interests

- Introduce incentives for pharmaceutical companies to conduct fundamental research.
- Initiate foundations that support patients with rare diseases.
- Foster independent information about drugs that are positioned as consumer products.
- Keep the ban on advertising for prescription drugs.
- Require that sources of financing are listed with every academic contribution.

Equal Access to Treatment

- Make efforts to ensure equal access regardless of age, gender, ethnicity, economic capacity and social status.
- Make sure that people are well informed about treatments and non-medical alternatives in order to avoid exclusion from services.
- Extend the understanding of necessary treatment to prevention and create respective institutions and programs.
- Incorporate citizens and patients’ organizations in decision making on allocation of resources.
- Target mental health care to particular groups (elderly, ethnical groups, socially weak groups…) to increase efficiency.

Freedom of Choice

- Create interdisciplinary support teams for patients and their families.
- Improve the geographical distribution of diagnosis and treatment units for patients and their families.
- Set up a multidisciplinary group to define “unbearable psychological suffering”. The established criteria should serve as a foundation for laws on euthanasia independent of public opinion, one group emphasized.
- Guarantee equal access to treatment as a self-evident precondition for choice.
- Carefully prioritise public funds. Conduct a clear information policy on the costs of prophylactic measures, check-ups, and treatments.
- Don’t streamline research along political, financial or materialistic deliberations but keep it open in all scientifically relevant directions (blue sky research).

The Next Steps

“Since January 2006 the partner organisations have launched different types of initiatives at both national and European level to disseminate results and provide policy advice to relevant stakeholders and policy makers. Such initiatives include presentations in relevant fora such as national parliaments and scientific conferences, and the organisation of policy advice workshops. Willing citizens can play a key role during these events.” (www.meetingmindseurope.org).

Will the international efforts to overlook brain research work? The process is on its way, and time will tell. If the implementation of the several proposed recommendations is effective through the political, medical and social layers of participant EU countries – it may be time to consider how scalable this project could be.

As the knowledge of brain functioning and particular interactions between neural networks is increasingly expanding, a discussion could arise from the very heart of mental health: how much impact can brain research provoke in the several mental health disciplines? Will learning paradigms shift – or will brain research support contemporary theories? The blueprints of a new era are under development – and the next steps will be promising.

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