Tuesday, January 6, 2015

Neuroscience and Human Rights

Last month, I had the privilege of attending the International Neuroethics Society Meeting in Washington, DC, made possible by a travel award from the Emory Neuroethics Program. This year's meeting featured panelists from diverse backgrounds: government, neuroscience, ethics, law, engineering, public health, and others. Each participant and attendee offered her unique perspectives on topical issues in neuroethics.

As I listened to many thought-provoking presentations and discussions, a question kept arising in my mind: to what extent should scientists engage with issues of social justice if their research findings support changes in public policy? As a "war on science" continues to be waged by members of the U.S. Senate and Congress (see Senator Coburn's 2014 "Wastebook," and the recent NPR Science Friday response by targeted scientists) and the American public lags in scientific literacy (A NSF report this year found that 1 in 4 Americans think the sun orbits the earth), this question carries a particular sense of urgency. Isn't science supposed to support human flourishing and maximize our well-being, as the American Association for the Advancement of Science puts it, "for the benefit of all people?" How accountable should scientists be in ensuring that this actually happens, beyond the scope of their laboratories?

My reflections on these questions were ignited by a fascinating example of how neuroscience can inform policy, provided by Katy de Kogel of the Dutch Ministry of Justice. Dr. de Kogel spoke of recent shifts in Dutch criminal law that reflect neuroscientific consensus: the neural substrates that support decision-making are not fully "online" in the developing, adolescent brain. In contrast to United States legal code, which specifies that individuals above the age of 18 be prosecuted as adults, thus barring them from legal protections offered to minors, Dutch courts have incorporated scientific understanding of neurodevelopment into their criminal code by advancing the age at which individuals are tried as minors: from 18 to 22 years of age. Criminal research findings support this change, as minors housed in adult detention centers tend to have higher rates of recidivism than those detained in juvenile centers. In my view, this is a refreshing and somewhat unexpected example of how society can benefit from advancements in neuroscience. We often think of science producing technological or medical innovations that improve our lives, rather than ancillary benefits like this that are impossible to foresee at the outset of a project.

Katy de Kogel of the Dutch Ministry of Justice (Courtesy of Dr. Gillian Hue)

The next panel discussion, themed "Neuroscience and Human Rights," provided another example of how neuroscience and society can intersect. One of the participants, Dr. Mariana Chilton of Drexel University, presented her research on food insecure communities here in the United States. Food insecurity is defined by the USDA as "a household-level economic and social condition of limited or uncertain access to adequate food." Dr. Chilton's talk highlighted the striking prevalence of food insecurity among American children: an astonishing 21.6%, according to a 2014 report by the non-profit organization, Feeding America. She continued by pointing out overwhelming epidemiological evidence linking early-life malnutrition and its associated psychosocial stressors to adverse health outcomes in adulthood. These negative outcomes include, but are certainly not limited to, impairments in social skills, language development, emotional self-regulation, and problem-solving abilities derived from neurodevelopment deficits that come along with macro- and micronutrient deficiencies. With billions of dollars spent annually on psychiatric medications and innumerable losses in productivity due to mental health issues such as Attention Deficit Hyperactivity Disorder (ADHD) and depression, I wondered whether the rising prevalence of childhood malnutrition could be a key mechanism by which our national public mental health crisis has arisen? (For context on the American mental health crisis, the CDC estimates that only 17% of US adults are considered to be in a state of optimal mental health.)

Dr. Chilton's presentation continued with a neuroethically-minded suggestion that inadequate US policies to support childhood nutrition and healthcare constitute a human rights violation. First off, she cites the 1989 United Nations Convention on the Rights of the Child (UNCRC), which asserts that "the child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth," which support the child's right "to the enjoyment of the highest attainable standard of health," as outlined in Article 24 of the Convention. Secondly, Chilton points out that contemporary findings from developmental neuroscience and maternal and child health epidemiology unequivocally demonstrate that nutritional deficiencies do not support the "highest attainable standard of health" for children, as advocated by the UNCRC. The implication is that with such a large proportion of American children undernourished, publicly-funded programs such as the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the Supplemental Nutrition Assistance Program (SNAP), and the National School Lunch Program (NSLP), may be inadequate to fully address their needs. Therefore, the inalienable human rights of the child to flourish are, in my estimation, jeopardized by US policy (or lack thereof). As an aside, I was astonished to learn that of the 194 United Nations member states to sign the treaty, only 3 countries have failed to ratify it: Somalia, South Sudan, and the United States.

Dr. Mariana Chilton speaking at the "Neuroscience and Human Rights" Panel (Courtesy of Dr. Gillian Hue)

By suggesting that human rights can serve as a rationale for changes in US social policy, Dr. Chilton contributes a novel and persuasive approach to political arguments around issues like access to food, housing, and early education. Arguments against empirically-validated government programs that support childhood nutrition and health often helicopter around the respective economic and political views of their proponents, with both sides of the political divide overlooking human rights concerns. One example of this is the justification provided by Rep. Paul Broun (R-GA) in 2011 for his proposed 10% cut in federal funding for WIC, by suggesting that the measure would "save us from spending hundreds of millions of dollars we don't have," and that WIC is "seemingly designed to hold a section of the population in limbo rather than helping them grow out of poverty." I concede Rep. Broun's obvious point that budget cuts would save money; however, there is extensive empirical support for the beneficial effects of the WIC program on short- and long-term health outcomes. While more efficient approaches to support childhood nutrition may exist, such as reducing healthcare costs for families and increasing the federal minimum wage, political rhetoric and discourse on public health policies should consider their implications for human rights.

Returning to my original question on the extent to which scientists should engage in conversations with policymakers and the public, I would argue that they do in fact have an ethical responsibility to do so. While it may not be the responsibility of scientists to advocate for specific policies per se, I personally think that they and their academic institutions have an ethical responsibility, as publicly-funded entities, to communicate their research findings and particularly its broader implications to the public. Unfortunately, one of the biggest obstacles that even the most well-intentioned, socially-engaged scientist faces is the lack of time or incentive to get involved. As NIH and NSF pay-lines continue to decline, scientists spend more of their valuable time competing for grant funding, and the institutions within which scientists serve continue to weigh a researcher's "success" by grant and publication record, rather than activities like civic engagement. I challenge colleges and universities to refine their science faculty evaluation to be more in accord with the goals of the AAAS. For example, how has Dr. X "provided a voice for science on societal issues," or "promoted the responsible use of science in public policy?" I think most scientists would support such a change.

As Dr. Chilton demonstrated at INS 2014, neuroscientific research findings can be incorporated into human rights arguments for updating US social policies and legal statutes. Knowing what they know about human health and disease, some scientists may be particularly well-positioned to advocate for social change. It is incumbent upon the public and their elected officials to honestly ask themselves, for example, whether they are taking adequate measures "to combat disease and malnutrition…through the provision of adequate nutritious foods and clean drinking-water," as stated in the UNCRC. Whether these discussions are initiated by neuroscientists who understand that the adolescent neocortex is underdeveloped and therefore lacks impulse control, or those who understand that early-life deprivation has profound, persistent effects on the human capacity to flourish, someone must speak and act for members of society who are not empowered to do so for themselves.


Want to cite this post?

Kohn, J. (2015). Neuroscience and Human Rights. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2015/01/neuroscience-and-human-rights.html

No comments: