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Anger and Forgiveness"Are You There Alone?"10 Good Questions about Life and DeathA Casebook of Ethical Challenges in NeuropsychologyA Companion to BioethicsA Companion to BioethicsA Companion to GenethicsA Companion to GenethicsA Companion to Muslim EthicsA Cooperative SpeciesA Critique of the Moral Defense of VegetarianismA Delicate BalanceA Fragile LifeA Life for a LifeA Life-Centered Approach to BioethicsA Matter of SecurityA Mirror Is for ReflectionA Mirror Is for ReflectionA Natural History of Human MoralityA Philosophical DiseaseA Practical Guide to Clinical Ethics ConsultingA Question of TrustA Sentimentalist Theory of the MindA Short Stay in SwitzerlandA Tapestry of ValuesA Very Bad WizardA World Without ValuesAction and ResponsibilityAction Theory, Rationality and CompulsionActs of ConscienceAddiction and ResponsibilityAddiction NeuroethicsAdvance Directives in Mental HealthAfter HarmAftermathAgainst AutonomyAgainst BioethicsAgainst HealthAgainst MarriageAgainst Moral 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Values and ScienceCutting to the CoreCyborg CitizenDamaged IdentitiesDeaf Identities in the MakingDeath Is That Man Taking NamesDebating ProcreationDebating Same-Sex MarriageDecision Making, Personhood and DementiaDecoding the Ethics CodeDefining DifferenceDefining Right and Wrong in Brain ScienceDefining the Beginning and End of LifeDelusions of GenderDementiaDemocracy in What State?Demons of the Modern WorldDescriptions and PrescriptionsDesert and VirtueDesire, Practical Reason, and the GoodDestructive Trends in Mental HealthDeveloping the VirtuesDid My Neurons Make Me Do It?Difference and IdentityDigital HemlockDigital SoulDignityDignityDisability BioethicsDisability, Difference, DiscriminationDiscrimination against the Mentally IllDisordered Personalities and CrimeDisorders of VolitionDisorientation and Moral LifeDivided Minds and Successive SelvesDoes Feminism Discriminate against Men?Does Torture Work?Doing HarmDouble Standards in Medical Research in Developing CountriesDown GirlDrugs and JusticeDuty and the BeastDworkin and His CriticsDying in the Twenty-First CenturyEarly WarningEconomics and Youth ViolenceEmbodied RhetoricsEmerging Conceptual, Ethical and Policy Issues in BionanotechnologyEmotional ReasonEmotions in the Moral LifeEmotions in the Moral LifeEmpathyEmpathy and Moral DevelopmentEmpathy and MoralityEmpirical Ethics in PsychiatryEncountering NatureEncountering the Sacred in PsychotherapyEngendering International HealthEnhancing EvolutionEnhancing Human CapacitiesEnoughEros and the GoodErotic InnocenceErotic MoralityEssays on Derek Parfit's On What MattersEssays on Free Will and Moral ResponsibilityEthical Choices in Contemporary MedicineEthical Conflicts in PsychologyEthical Dilemmas in PediatricsEthical Issues in Behavioral ResearchEthical Issues in Dementia CareEthical Issues in Forensic Mental Health ResearchEthical Issues in the New GeneticsEthical LifeEthical Reasoning for Mental Health ProfessionalsEthical TheoryEthical WillsEthically Challenged ProfessionsEthicsEthicsEthicsEthics and AnimalsEthics and ScienceEthics and the A PrioriEthics and the Discovery of the UnconsciousEthics and the Metaphysics of MedicineEthics at the CinemaEthics at the End of LifeEthics Case Book of the American Psychoanalytic AssociationEthics Done RightEthics ExpertiseEthics for EveryoneEthics for PsychologistsEthics for the New MillenniumEthics in CyberspaceEthics in Everyday PlacesEthics in Health CareEthics In Health Services ManagementEthics in Mental Health ResearchEthics in PracticeEthics in PsychiatryEthics in PsychologyEthics in Psychotherapy and CounselingEthics of PsychiatryEthics without OntologyEthics, Culture, and PsychiatryEthics, Sexual Orientation, and Choices about ChildrenEvaluating the Science and Ethics of Research on HumansEvilEvil GenesEvil in Modern ThoughtEvil in Modern ThoughtEvolution, Gender, and RapeEvolutionary Ethics and Contemporary BiologyEvolutionary Psychology and ViolenceEvolved MoralityExperiments in 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ShadowsOverdosed AmericaOxford Handbook of Psychiatric EthicsOxford Studies in Normative EthicsOxford Studies in Normative Ethics, Volume 7Oxford Textbook of Philosophy of PsychiatryPassionate DeliberationPatient Autonomy and the Ethics of ResponsibilityPC, M.D.Perfecting VirtuePersonal AutonomyPersonal Autonomy in SocietyPersonal Identity and EthicsPersonalities on the PlatePersonhood and Health CarePersons, Humanity, and the Definition of DeathPerspectives On Health And Human RightsPharmaceutical FreedomPharmacracyPharmageddonPhilosophy and This Actual WorldPhilosophy of BiologyPhilosophy of Technology: The Technological ConditionPhysician-Assisted DyingPicturing DisabilityPilgrim at Tinker CreekPlaying God?Playing God?Political EmotionsPornlandPowerful MedicinesPractical Autonomy and BioethicsPractical EthicsPractical Ethics for PsychologistsPractical RulesPragmatic BioethicsPragmatic BioethicsPragmatic NeuroethicsPraise and BlamePreferences and Well-BeingPrimates and PhilosophersPro-Life, Pro-ChoiceProcreation and ParenthoodProfits Before People?Progress in BioethicsProperty in the BodyProzac As a Way of LifeProzac on the CouchPsychiatric Aspects of Justification, Excuse and Mitigation in Anglo-American Criminal Law Psychiatric EthicsPsychiatry and EmpirePsychological Concepts and Biological PsychiatryPsychology and Consumer CulturePsychology and LawPsychotropic Drug Prescriber's Survival GuidePublic Health LawPublic Health Law and EthicsPublic PhilosophyPunishing the Mentally IllPunishmentPursuits of WisdomPutting Morality Back Into PoliticsPutting on VirtueQuality of Life and Human DifferenceRaceRadical HopeRadical VirtuesRape Is RapeRe-creating MedicineRe-Engineering Philosophy for Limited BeingsReason's GriefReasonably ViciousReckoning With HomelessnessReconceiving Medical EthicsRecovery from SchizophreniaRedefining RapeRedesigning HumansReducing the Stigma of Mental IllnessReflections on Ethics and ResponsibilityReflections On How We 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Neuroethics has become a much discussed topic in the last years due to the new and, in some cases, unique ethical challenges that new advances in neuroscience and neurotechnologies present us with. However, a theoretical perspective highlighting the importance of improving care for those suffering from neurological and psychiatric disorders has been neglected. Eric Racine takes the challenge to develop such a perspective in his book Pragmatic Neuroethics: Improving Treatment and Understanding of the Mind-Brain.
This book, which has an accessible style, is a an important contribution to neuroethics, since it provides a good review of the different and divergent perspectives within neuroethics, and stresses the importance of a perspective on neuroethics that encourages reflection, action, and research towards meeting the day-to-day suffering and distress that different neuro-related disorders bring for individuals and society in general.
The book is divided into two parts. The first section is the theoretical part in which the author provides background on neuroethics and pragmatism. In this first part Racine also introduces the view he endorses, namely pragmatic neuroethics. The second part of the book is a more empirically driven section, in which he discusses relevant topics in neuroethics using empirical data and real examples, such as, cognitive enhancement and public understanding.
The book begins with an overview of neuroethics. In this chapter Racine suggests four main areas of neuroethics scholarship and practice: research neuroethics, clinical neuroethics, public and cultural neuroethics, and theoretical and reflective neuroethics. In the second part of the chapter he highlights some of the salient challenges in modern neuroethics, such as, neuro-enhancement, informed consent, and issues related to "mind reading".
The second chapter reviews some of the early and current definitions, attributes, and perspectives on neuroethics. He distinguished three main ways to characterized neuroethics according to its particular perspective, namely knowledge-driven, technology driven or healthcare driven. Racine also does a review of the peer review literature, web sites, and print media to undercover the most representatives attributes related to neuroethics and the main concerns discussed.
Racine moves in chapter three, to introduce and present different waves of naturalism in bioethics, focusing in particular on pragmatic naturalism for its "commitment to interdisciplinary collaborations and its practical focus" (p.53). He suggests that neuroethics as an emergent field of study has reinitiated discussion on the importance of establishing bridges between the biological sciences and the humanities. Furthermore, he argues that a moderate pragmatic form of naturalism is a better position to start debate within bioethics.
Chapter four looks at the implications of pragmatic naturalism by addressing several critiques that have been put to neuroethics, such as: introducing detrimental specialization in biomedical ethics, having a too narrow focus, and implying a reductionist approach. Racine concludes this chapter by highlighting some of the characteristics of a pragmatic neuroethics perspective, such as, being interested not only on the organ of the brain, but also for patients and the public.
Chapter five is the start of the second section of the book and it draws attention to the importance of public understanding of neuroscience innovation and emerging interpretations of neuroscience research. Racine argues that understanding better the impact of neuroscience for our own self-understanding, fostering communication, and taking multidirectional approaches to neuroethics debates is needed in order to broaden the discussion by including public concerns and not just expert's opinions.
In chapter six, Racine touches on the issue of the increasing prevalence and importance of nonmedical uses of neuropharmaceuticals by discussing the case of performance enhancement. While discussing enhancement he introduces two different concept of morality surrounding the discussion--the praiseworthy and the acceptability frameworks of morality--and argues that they should be seen as complementary to better grasp the issues involved.
Racine moves in chapter seven to discuss different disorders of consciousness, such as, vegetative state and the minimally conscious state. He first provides the background information to distinguish between the different clinical conditions, and then he uses the case of neuroimaging to show how in an evolving neuroscience context some assumptions about these disorders will be challenged.
Chapter eight takes part of the material presented in the previous chapter and uses the case of severe brain injury to take a closer look at the existing variability and confusion within the clinical and public domain about diagnosis and prognosis of disorders of consciousness.
Chapter nine talks about the ethical implications related to the impact of neuroscience on society, human behaviour, and humanity (an area also known as social neuroscience), and tackles a number of arguments that have been made against the neuroscience of ethics. In this chapter Racine also puts forward a framework, based on pragmatic thinking and emergentist philosophies of science, for addressing the controversial relationship between ethics and neuroscience.
Racine's closing chapter summarizes the main arguments of the book and emphasizes the future challenges for neuroscience, ethics, and society. Racine hopes that Pragmatic Neuroethics can at least be a good starting point to foster multidirectional approaches and to help develop practical and pluralistic approaches for neuroethics.
Pragmatic Neuroethics: Improving Treatment and Understanding of the Mind-Brain is a welcome addition to the evolving field of neuroethics as it offers us a different perspective to understand and use neuroethics. It is not only a book addressing ethical issues that have come to the fore with new advances in neuroscience, but it also highlights what is the practical and ethical importance of actively debating these issues and using the insights gained by this process to improve patient treatment as well as to gain better understanding of the mind-brain.
© 2011 Laura Cabrera
Laura Cabrera is a PhD research student in ethics and emergent technologies in the Centre for Applied Philosophy and Public Ethics at Charles Sturt University. Laura received a BSc in Electrical and Communication Engineering from ITESM University in Mexico City, and a MA in Applied Ethics from Linköping University in Sweden. Her current research focuses on nanotechnology and neurotechnology, human enhancement, posthumanity, and the ethical dimensions of emerging technology especially those connected to medical issues and individual/social perspectives. Laura.email@example.com