The Ethics of Neuromodulation for Consciousness Exploration

In 1641 Rene Descartes sat, ball of wax in hand, pondering the flexibility of material states and how such impermanence spoke to an object’s essence. Hundreds of years later, cognitive neuroscientists are probing into the recesses of the human brain, assessing its task-dependent states, and forming hypotheses regarding the underpinnings of its malleability. Just like Descartes’ transforming wax, the human brain is in a state of constant flux. Observed endogenously, this metamorphic phenomenon of the brain is known as consciousness. In a seemingly relentless pursuit, philosophers and scientists alike have been enthralled by the ever so evasive conceptualizations of consciousness. However, despite valiant efforts, a truly satisfying, all-encompassing theory has yet to emerge. Scientists’ hardships in this arena are entirely understandable. For, how does one yield a true understanding of something that is inherently numinous and ephemeral? Certainly the sophists grew tired of mere mind mulling on such topics and socially evolved into scientists. Scientists, in succession, have turned to sophisticated technologies for insights into the critical cortical loci necessary for conscious awareness. However, is it possible to understand all the components of an object and be immediately privy to a comprehension of its emergent properties? The scientific community’s quest for an understanding of consciousness thus far is reminiscent of the story of the blind men trying to explain what an elephant is by each touching different parts. While recent advances in neuroimaging have allowed for researches to capture the spatio-temporal signature of brain activity during a plethora of mental states, brain mapping still remains unsatisfactory in its attempts to grasp consciousness.

Perhaps philosophy and science alone are incapable of providing the exploratory tools necessary for a succinct understanding of consciousness. In a non-mutually exclusive third branch of consciousness exploration reside the psychonauts; a nomenclature given to those who use a variety of methodologies to both achieve and describe altered states of consciousness. Conceivably, psychonautic experiences may be able to compliment the rigorous approaches currently employed by scientists and philosophers and yield a harmonious explanation for the universe’s greatest mystery. It will be the focus of this paper to elucidate plausible and safe methodologies for the merging of philosophy, science, and psychonautics while subsequently addressing the ethical dilemmas that arise from such a hypothetical collaboration. At first, this paper will speak to the neuroscientific correlations of brain structure with altered conscious states. Subsequently, this paper will address the potential for the recreation of those conscious states by the use of neuromodulatory devices. Lastly, it will lay forth the potential repercussions and ethical issues associated with such practices.

Since the advent of phrenology, it appears as though mankind’s desire to understand the functioning of the brain has taken manifest as a brain-mapping effort that that seeks to correlate localized regions of the brain with specific modules of function. Galen of Greece (210 BC) was the first to correlate structure and function with his focus on the pineal gland’s role in producing ““psychic pneuma”, a fine, airy substance which he described as “the first instrument of the soul”(Rocca, 2003). Since, ancient, medieval, and renaissance philosophers continued to suggest that the pineal gland provided the “seat for the soul”. Currently, a vast array of neuroscience methods, including direct recordings, neuroimaging, and behavioral testing after localized brain damage, have allowed researchers to relate various brain structures with various behaviors. For example, the hippocampus has long been associated with the acquisition of new memories (Squire, 1992), the prefrontal cortex in cognitive control (Miller and Cohen, 2001), and the superior parietal cortex with spatial attention (Yantis et al., 2002). However, the reported existence of complex brain networks, where multiple cortical regions are activated in unison for particular genres of task states, has gained significant traction as a theory for dynamic cognitive function (Bullmore and Sporns, 2009; Sporns et al., 2004). Such theories seems to suggest that the concurrent, temporally locked activation of a multitude of brain regions gives rise to the emergent phenomenon of consciousness, whereby different collections of brain regions result in different states of consciousness.

Research into the more ethereal states of consciousness has followed in similar suite to the rest of neuroscience’s ventures. That is, studies, while small in number, have pinpointed the different brain regions correlated with being in a state of meditation (Short et al., 2010; Lazar et al., 2000), trance (Peres et al., 2012), psychedelic states (Carhart-Harris et al., 2012), and sleep (Horovitz et al., 2008). These studies have paralleled the biochemical pursuits that attempt to identify the neurotransmitters whose presence in the brain is modulated by the ingestion of particular substances. For example, dopamine release has been affiliated with the use of cocaine (Ritz, 1987); serotonin with the use of lysergic acid diethylamide (LSD) (Nichols, 2004). Curiously, particularly potent psychedelic experiences, like those accomplished by drinking ayahuasca, rely on the ingestion of dimethyltriptamine (DMT), a compound found endogenously in mammalian species (Franzen and Gross, 1965). Furthermore, for the first time, DMT, and its precursors have been found in the pineal gland of rodents (Barker et al., 2013). This parallels the findings that dopamine is stored and released by specific brain areas, such as the pars compacta portion of the substnatia nigra (Geffen, 1976).

Attempts to establish double-dissociations for the supposed responsibilities of brain areas in particular cognitive functions has led researchers to implement neuromodulatory tools that can selectivity potentiate and deactivate particular brain regions. Subsequent alterations in behavior in relation to the external modulation of cortical regions allow researchers to make claims that follow the format of “if region X is potentiated, then subject’s perform Y% better at task T”. Techniques such as transcranial direct-current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) have been used with great success to confirm the significance of a brain region’s involvement with particular behavioral tasks (for a review see Levasseur-Moreau et al., 2013).

However, in accordance with the brain-network theories illustrated previously, it would seem as though the simultaneous stimulation of multiple sites would be necessary to invoke a subjective change in conscious state. TMS has been shown to alter the functional connectedness of brain networks with the stimulation of single nodes within that network (Pascual-Leone et al., 2000). Yet, the network activation is not a perfect rendition of the endogenously induced conscious state. Furthermore, the limitations of both TMS and tDCS (e.g their lack of spatial specificity and inability to modulate cortical regions deeper than 1.5cm of cortex) prevent the faithful activation of particular networks. Perhaps this is the reason behind why rTMS has highly variable evidence on inducing changes in conscious states such as depression (Loo and Mitchell, 2005) and no studies have been published reporting shifts in consciousness that parallel those reported by psychonauts. Fortunately, recent technological developments such as low intensity focused ultrasound pulsation (LIFUP) allow for far more acute spatial resolution (2mm) compared to rTMS (5cm) and tDCS. Additionally, LIFUP has the potential to practically stimulate any region in the brain since it can focus on brain regions greater than 15cm past the skull (Bystritsky et al., 2011).

It can be theoretically postulated that if we can both identify networks of regions in the brain that are correlated with particular cognitive states and also precisely modulate brain activity, then we should be able to recreate particular conscious states exogenously. For example, if a subject were to ingest psilocybin and undergo an fMRI scan during the transition from normal waking consciousness to a psychedelic state, similar to Carhart-Harris et al. (2012), then a time-course of their brain activity would elucidate the transient activity of critical brain networks responsible for inducing the alteration in consciousness. Then, a precisely positioned array of LIFUPs aimed at the key nodes of interest could then reproduce the time-course of brain activity, remaining faithful to the spatial regions of interest and their fluctuations. Furthermore, LIFUP could be used to modulate the release of state-related neurotransmitters that have their locus in particular brain regions. If the adage that “the brain creates the mind” is coherent, then it should follow that this apparatus arrangement would recreate the psychedelic state that was initially experienced by the subject.

Of principal notation, this proposed use of mechanical means to induce psychedelic states has the incredible benefit of removing the chemical ingestion component of psychedelic experiences. Many psychonauts suffer the consequences of ignorance towards a particular substance’s exact contents, their source, and the dosage. Such gaps in knowledge lead to unwanted side effects and potential overdoses. Furthermore, the mere act of ingesting chemicals can cause incredible discomfort (e.g ayuhausca requires a purge; psilocybin results in stomach uneasiness; THC causes dry-mouth). The removal of the need to insert chemicals into the body is an insurmountable advantage of noninvasive stimulation that mirrors psychedelic states. Interestingly, it could be the case that some of the mental side effects of many psychedelics (e.g anxiety) have the potential be eliminated by tailoring the patterns of spatio-temporal LIFUP activations in a way that excludes brain regions responsible for such side effects. Additionally, the effects of such a stimulation procedure are potentially transient; it could be the case that the effects only persist during stimulation. As such, a psychedelic experience could last as long as the user desires. This comes in stark contrast to the unavoidable duration of substance-induced psychedelic experiences.

While such machine-induced mental states are hypothetically feasible, its actual implementation mandates both more reliable imagining methodologies and more robust neuromodulation devices. Nonetheless, the benefits, detriments, and ethics of such a concept are worthwhile topics of debate. The first points of discussion should be in regards to the concepts brought forth in the introduction of this paper: Does a mind in a psychedelic/altered state offer a more profound insight into the operations of natural phenomena (particularly that of consciousness)? Scientific documentations of behavioral reports following intravenous administration of DMT speak to subject’s revelations regarding consciousness:

Some subjects emerged from the intoxication with new perspectives on their personal and/ or professional lives. One said, “It changed m e. My self- concept seemed small, stupid and insignificant after what I saw and felt. It’s made me admit that I can take more responsibility; I can do more in areas I never thought I could. It’s so unnatural and bizarre you have to find your own source of strength to navigate in it.” Another “saw clearly how the personal self and consciousness are just slowed down and less refined versions of ‘pure consciousness.’ (Strassman et al., 1994)

Perhaps such shifts in perspective could help scientists to approach research questions from new angles. Imagine a coffee break that consists of a five-minute psychedelic journey for an “inspiration jolt” before tackling a seemingly unsolvable problem. Scientists routinely value the input of fresh perspectives, as seen by the incredible success of employing video game players to “solve puzzles for science” (www.fold.it/portal). In an exemplary showcase, Francis Crick admitted to the effects of LSD in aiding his unraveling the structure of DNA, a discovery that won him the Nobel Prize (Rees, 2004). Hereby, it seems as though psychedelic states can issue thought-evoking and perspective-changing state of consciousness that may be of benefit to scientific discoveries.

Thus, it seems as though mechanically induced states of consciousness are theoretically conducive to creativity whilst void of the prolonged length of inebriation and potential pharmaceutical side effects. However, the potential benefits of psychedelics continue into their ability to aid psychotherapists achieve breakthroughs with their patients. For example, both LSD and psilocybin have been used to help terminally ill patients cope with the inevitability of their death (Richards, 1972; Grob et al., 2011). MDMA has been used to treat post-traumatic stress disorder with a 75% success rate (Bouso et al., 2008). Additionally, Psilocybin has been used to effectively increase “emotional insight” in psychotherapy (Carhart-Harris et al., 2012a). Eliminating the chemical side effects and tailoring the mechanical activations to not include brain-regions involved in the mental side effects of psychedelic states could increase the efficacy of these methods.

Unfortunately, substances initially developed for the sake of science and therapy has continually been met with illicit use. The frightening epidemic of oxycodone use is but one example of substance abuse that stems from pharmaceutical development. Therefore, the development of new technologies that could theoretically be used to alleviate pain, suppress consciousness, and other elicit other unforeseen effects should be treated with caution in order to avoid maladaptive practices. For example, at-home tDCS devices such as the Foc.us (http://www.foc.us/) have been reported to enhance the cognitive abilities of gamers. However, the long-term side effects of tDCS and its non-focal nature make it potentially dangerous and addictive. For, if a gamer sees improvements in their gameplay, then what is to stop them from increasing the voltage? Better yet, what incentive is there for them to ever stop using the device? This begs to ask the question: does the creation of publically available neuromodulation devices that can induce psychedelic states just create an easier way for people to become dependent on such systems?

Technically, the answer to the last question is “yes”. Just as the availability of a new substance creates an unlimited potential for its use, the introduction of a technology that could alter minds is equally likely to be recruited. However, humans have a seemingly insatiable and uncontrollable appetite for consciousness exploration as seen by the extensive history of trepanning and ayahuasca brews. Thereby it seems as though the development of such proposed neuromodulatory technologies is inevitable and its use most likely rampant. Thus, the legal ramifications that surround the use of such devices should be relatively lax, especially in light of the recent results of Portugal’s decision to decriminalize all drugs. Portugal’s drug use, crime rate, and national sickness decreased substantially after it’s nationwide decriminalization of drugs: “The data show that, judged by virtually every metric, the Portuguese decriminalization framework has been a resounding success” (Greenwald, 2009). Thereby, it seems as though the true problem with drug-use is legislation. Seeing as drug-use is concerned with perturbations of consciousness, it should follow then that the true problem with altered states of consciousness is legislation. Consequently, legislation should be put in place that exerts little to no regulations on the use of this hypothetical technology for consciousness exploration.

Furthermore, it should be considered unethical for legislatures to ban “states of consciousness”, since, with this technology, there would be no possibility for “possession” charges other than the possession of the device (which could easily be skirted around in the same way that “bongs” are sold for tobacco use only). Thus, preventing the use of this technology would be akin to a direct ban on states of consciousness, which seems highly unethical. For, are we not free to modulate ourselves as we see fit? It would appear that in the physical domain, there are no daunting restrictions. For example, body-builders routinely use weights to alter their physical appearance; chiropractors use electricity to increase muscle tone in their patients; plastic surgeons essentially rely on physical modifications. A society that regulates mental explorations that have absolutely no effect on the well being of the population at large should be considered dystopian. Unfortunately, current legislature in the majority of the world regulates the possession of illicit substances with penalties as severe as death. Regulations concerning the possession and use of substances that are conducive to violence (e.g bath salts) have a utilitarian benefit in their restrictions and are justified. However, such penalties seem outlandish for drugs that affect only the user. The proposed technologies should be governed under a legislation that finds a balance between allowing the safest possible administration of consciousness alterations while preventing the creation of states of consciousness that promote violence. Governments should even go so far as to encourage the use of technologies that act as safe alternatives to users that currently rely on physical chemicals. Such encouragement would be an inspiring extension on Portugal’s needle exchange program, which reduced the nation’s rate of infection, AIDS, and more.

In summation, it would appear as though there is feasibility for a technology that can mimic the conscious states experienced by those who use psychedelic substances. Such possibility is created by a small leap of theory that draws from recent advances in neuroimaging (e.g fMRI) and neuromodulation devices (e.g LIFUP). As a result, users can achieve the desired inspirational effects of psychedelics and simultaneously remove a majority of the potential for chemical induced harm. Such affects can aid scientific discoveries, decrease crime, and increase health. Lastly, the legislature of such technologies should be treated with relative leniency so as to optimize the utilitarian outcomes of this beneficial technology.

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