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Deep Brain Stimulation, Historicism, and Moral Responsibility

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Abstract

Although philosophers have explored several connections between neuroscience and moral responsibility, the issue of how real-world neurological modifications, such as Deep Brain Stimulation (DBS), impact moral responsibility has received little attention. In this article, we draw on debates about the relevance of history and manipulation to moral responsibility to argue that certain kinds of neurological modification can diminish the responsibility of the agents so modified. We argue for a historicist position - a version of the history-sensitive reflection view - and defend that account against a rival, relational view of responsibility. We conclude that DBS can, under certain conditions, diminish responsibility, and explore the circumstances under which this might be so. We conclude by suggesting that philosophical debates about moral responsibility, manipulation, and history have greater practical relevance than is sometimes thought, and that attention to practical cases can help inform and deepen this body of scholarship.

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Notes

  1. Fischer and Ravizza might try to account for such cases in other ways, claiming that while certain attitudes, such as blame, admit of degrees, moral responsibility itself does not [10]. We think this would get things backwards: what explains why blame is ascribed to agents in degrees is that they are, to varying extents, responsible. Accordingly, we largely agree with the amendments suggested by Coates and Swenson [11].

  2. While our view suggests this claim about responsibility, it does not entail it. The general claim that responsibility can be enhanced because it being responsible for some action partially consists in exercising one’s relevant capacities in performing that action also needs to be qualified. For example, in some cases, the mechanisms for enhancing responsibility could, for historicist reasons, in fact undermine it. This is especially likely in cases of coercive enhancement, for reasons we will see later.

  3. There are other, non-invasive methods for stimulating the brain, including transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). However, these methods have less dramatic effects on personality and cognition than DBS. Pharmacological interventions, e.g., SSRIs, can also gradually reshape dispositions, mood and character. Because most psychoactive drugs affect chemicals and compounds active in the neurotransmitters of many brain areas, they are often less targeted than direct intervention upon a particular region of the brain.

  4. Appleby, et al. report in a meta-analysis that these make up between 1.9–3.1 % of all reported DBS-related adverse events. They also note that cognition worsened after DBS in 12 % of cases. Severe variants of these kinds of impairments may diminish a person’s responsibility [5].

  5. Smeding also reports a second, similar case. A Parkinson’s patient (aged 61), who was beginning to experience declines in memory and motor function, underwent bilateral STN stimulation. Before surgery, he was “easy to go on with”. Afterwards, the patient “started using aggressive vocabulary” and “became increasingly irritable…He drove too fast and violated traffic rules, while he used to be a conscientious driver.” However, “the patient himself had no complaints.” One week after switching off stimulation, “all behavioral alterations had resolved” and “his bad manners had disappeared” [18].

  6. Some people receiving DBS come to feel alienated from aspects of their psychological lives. This reaction often seems to include an acute sense that a new characteristic produced by the modification is not authentically ‘their own.’ [20, 21].

  7. For example, Gary Watson suggests that considering the brutal childhood of a cold-blooded killer may make him appear less-than fully responsible, despite his cruelty. He may remain responsible enough for severe punishment, but his upbringing reduces his blameworthiness. One explanation for the latter is that it matters how the agent acquired his vicious character [22].

  8. For example, while a drunk driver may have little control over her actions in driving, we judge her responsibility in terms of the kind of agency she exercised when she set out to drink. If she drank heavily, expecting to drive, her history is inculpatory. However, if she was force-fed alcohol and strapped behind the wheel, we do not hold her as responsible, although her driving itself is equally voluntary. [23].

  9. Christman does not state the full conditions for competence. Here, we include only some necessary conditions. Perhaps there are others, but nothing turns on it for our purposes.

  10. See note 5 above.

  11. Some studies suggest that memories can be manipulated, perhaps even implanted, by neurological procedures [31].

  12. For helpful comments we would like to thank two anonymous reviewers for this journal. Disclaimer: The views expressed are the authors’ own. They do not represent the position or policy of the National Institutes of Health, US Public Health Service, or the Department of Health and Human Services.

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Authors and Affiliations

  1. Department of Philosophy, New York University, 5 Washington Place, New York, NY, 10003, USA

    Daniel Sharp

  2. Department of Bioethics, National Institutes of Health, 10 Center Drive, Building 10, Room 1C118, Bethesda, MD, 20892-1156, USA

    David Wasserman

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Sharp, D., Wasserman, D. Deep Brain Stimulation, Historicism, and Moral Responsibility. Neuroethics 9, 173–185 (2016). https://doi.org/10.1007/s12152-016-9260-0

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