Philosophical and ethical issues at the forefront of neuroscience and genetics: an overview for psychiatrists

This review has touched upon some of the major ethical issues surrounding emerging technologies in neuroscience and genetics. Although at first glance these issues may seem somewhat peripheral to the clinical practice of psychiatry, we suggest that they may have unanticipated effects upon the care of patients with mental illness. Certainly, the philosophical issues surrounding free will are of tremendous consequence to persons who commit crimes while suffering severe symptoms of mental illness. In addition, the opening up of a lucrative new "enhancement" market for the sale of new therapies could divert commercial resources away from the development of therapies for mental illness, although it is also possible that some enhancements will have secondary benefits as treatments for disease. Social acceptance of enhancement therapies could have a beneficial, normalizing effect on public attitudes toward those who receive mental health treatment. On the other hand, a moral backlash against enhancements as "quick fixes" that deprive individuals of authenticity could have a secondary effect of increasing the stigma of mental health treatment. For all of these reasons, it has become increasingly important for psychiatrists to be informed about and active participants in the public conversation about neuroethics. Psychiatric patients appear to have much at stake in these ethical debates, and psychiatrists have valuable expertise to offer as professionals with intimate knowledge of the human mind, its limitations, and its potential.