Theoretical Neurobiology of Consciousness Applied to Human Cerebral Organoids.

Organoids and specifically human cerebral organoids (HCOs) are one of the most relevant novelties in the field of biomedical research. Grown either from embryonic or induced pluripotent stem cells, HCOs can be used as in vitro three-dimensional models, mimicking the developmental process and organization of the developing human brain. Based on that, and despite their current limitations, it cannot be assumed that they will never at any stage of development manifest some rudimentary form of consciousness. In the absence of behavioral indicators of consciousness, the theoretical neurobiology of consciousness being applied to unresponsive brain-injured patients can be considered with respect to HCOs. In clinical neurology, it is difficult to discern a capacity for consciousness in unresponsive brain-injured patients who provide no behavioral indicators of consciousness. In such scenarios, a validated neurobiological theory of consciousness, which tells us what the neural mechanisms of consciousness are, could be used to identify a capacity for consciousness. Like the unresponsive patients that provide a diagnostic difficulty for neurologists, HCOs provide no behavioral indicators of consciousness. Therefore, this article discusses how three prominent neurobiological theories of consciousness apply to human cerebral organoids. From the perspective of the Temporal Circuit Hypothesis, the Global Neuronal Workspace Theory, and the Integrated Information Theory, we discuss what neuronal structures and functions might indicate that cerebral organoids have a neurobiological capacity to be conscious.

ChatGPT in society: emerging issues.

We review and critically assess several issues arising from the potential -large-scale- implementation or deployment of Large Language Models (LLMs) in society. These include security, political, economic, cultural, and educational issues as well as issues concerning social biases, creativity, copyright, and freedom of speech. We argue, without a preconceived pessimism toward these tools, that they may bring about many benefits. However, we also call for a balance assessment of their downsides. While our work is only preliminary and certainly partial it nevertheless holds some value as one of the first exploratory attempts in the literature.

Infosphere, Datafication, and Decision-Making Processes in the AI Era.

A recent interpretation of artificial intelligence (AI) (Floridi 2013, 2022) suggests that the implementation of AI demands the investigation of the binding conditions that make it possible to build and integrate artifacts into our lived world. Such artifacts can successfully interact with the world because our environment has been designed to be compatible with intelligent machines (such as robots). As the use of AI becomes ubiquitous in society, possibly leading to the formation of increasingly intelligent bio-technological unions, there will likely be a coexistence of a plethora of micro-environments wrapped and tailored around humans and basic robots. The key element of this pervasive process will be the capacity to integrate biological realms in an infosphere suitable for the implementation of AI technologies. This process will require extensive datafication. This is because data is the basis of the logical-mathematical codes and models that drive and guide AI. This process will have huge consequences on workplaces, on workers, as well as on the decision-making processes required for the functioning of future societies. In this paper we will offer a comprehensive reflection on the moral and social implications of datafication as well as a set of considerations about its desirability, which will be informed by the following insights: (1) full protection of privacy may become structurally impossible, thus leading to undesirable forms of political and social control; (2) worker's freedom may be reduced; (3) human creativity, imagination, and even divergence from AI logic might be channeled and possibly discouraged; (4) there will likely be a push towards efficiency and instrumental reason, which will become preeminent in production lines as well as in society.

Human Brain Organoids: Why There Can Be Moral Concerns If They Grow Up in the Lab and Are Transplanted or Destroyed.

Human brain organoids (HBOs) are three-dimensional biological entities grown in the laboratory in order to recapitulate the structure and functions of the adult human brain. They can be taken to be novel living entities for their specific features and uses. As a contribution to the ongoing discussion on the use of HBOs, the authors identify three sets of reasons for moral concern. The first set of reasons regards the potential emergence of sentience/consciousness in HBOs that would endow them with a moral status whose perimeter should be established. The second set of moral concerns has to do with an analogy with artificial womb technology. The technical realization of processes that are typically connected to the physiology of the human body can create a manipulatory and instrumental attitude that can undermine the protection of what is human. The third set concerns the new frontiers of biocomputing and the creation of chimeras. As far as the new frontier of organoid intelligence is concerned, it is the close relationship of humans with new interfaces having biological components capable of mimicking memory and cognition that raises ethical issues. As far as chimeras are concerned, it is the humanization of nonhuman animals that is worthy of close moral scrutiny. A detailed description of these ethical issues is provided to contribute to the construction of a regulative framework that can guide decisions when considering research in the field of HBOs.

Minding Rights: Mapping Ethical and Legal Foundations of 'Neurorights'.

The rise of neurotechnologies, especially in combination with artificial intelligence (AI)-based methods for brain data analytics, has given rise to concerns around the protection of mental privacy, mental integrity and cognitive liberty - often framed as "neurorights" in ethical, legal, and policy discussions. Several states are now looking at including neurorights into their constitutional legal frameworks, and international institutions and organizations, such as UNESCO and the Council of Europe, are taking an active interest in developing international policy and governance guidelines on this issue. However, in many discussions of neurorights the philosophical assumptions, ethical frames of reference and legal interpretation are either not made explicit or conflict with each other. The aim of this multidisciplinary work is to provide conceptual, ethical, and legal foundations that allow for facilitating a common minimalist conceptual understanding of mental privacy, mental integrity, and cognitive liberty to facilitate scholarly, legal, and policy discussions.

Human cerebral organoids: the ethical stance of scientists.

BACKGROUND: Human cerebral organoids (HCOs) offer unprecedented opportunities to study the human brain in vitro, but they also raise important ethical concerns. Here we report the first systematic analysis of scientists' stance within the ethical debate. METHOD: Twenty-one in-depth semi-structured interviews were analyzed through a constant comparative method to highlight how the ethical concerns filter in the laboratory. RESULTS: The results suggest that the potential emergence of consciousness is not yet seen with concern. However, there are some features of HCO research that need to be better accounted for. Communication to the public, the use of terms such as "mini-brains", and informed consent appear to be the most pressing concerns of the scientific community. Nonetheless, respondents generally showed a positive attitude toward the ethical discussion, recognizing its value and the necessity of constant ethical scrutiny over scientific advancements. CONCLUSIONS: This research paves the way for a better-informed dialogue between scientists and ethicists, highlighting the issues to be addressed whenever scholars of different backgrounds and interests meet.

Consciousness in a Rotor? Science and Ethics of Potentially Conscious Human Cerebral Organoids.

Human cerebral organoids are three-dimensional biological cultures grown in the laboratory to mimic as closely as possible the cellular composition, structure, and function of the corresponding organ, the brain. For now, cerebral organoids lack blood vessels and other characteristics of the human brain, but are also capable of having coordinated electrical activity. They have been usefully employed for the study of several diseases and the development of the nervous system in unprecedented ways. Research on human cerebral organoids is proceeding at a very fast pace and their complexity is bound to improve. This raises the question of whether cerebral organoids will also be able to develop the unique feature of the human brain, consciousness. If this is the case, some ethical issues would arise. In this article, we discuss the necessary neural correlates and constraints for the emergence of consciousness according to some of the most debated neuroscientific theories. Based on this, we consider what the moral status of a potentially conscious brain organoid might be, in light of ethical and ontological arguments. We conclude by proposing a precautionary principle and some leads for further investigation. In particular, we consider the outcomes of some very recent experiments as entities of a potential new kind.

A Balance of Rights: The Italian Way to the Abortion Controversy.

The U.S. Supreme Court's Dobbs ruling triggered a global debate about access to abortion and the legislative models governing it. In the United States, there was a sudden reversal of federal guidance about pregnancy termination that is unprecedented in Western and high-income countries. The strong polarization on the issue of abortion and the difficulty of finding a point of compromise lead one to consider the experiences of countries that have had different paths. Italy stands as a candidate for being a partially alternative model because it allows abortion up to 12 weeks, but without considering it a subjective right. The legislation in place since 1978 aims to balance the interests of the fetus and those of the woman. An issue often raised concerning Italian law is that of conscientious objection granted to doctors. Many gynecologists declare themselves objectors, and this makes access to abortion more difficult in some regions of Italy. After discussing this issue and envisaging different ways to deal with it, the article concludes by highlighting new dilemmas about a possible divorce between the law and medical ethics in different directions and offers some avenues to begin setting up a response.

Dealing with Criminal Behavior: the Inaccuracy of the Quarantine Analogy.

Pereboom and Caruso propose the quarantine model as an alternative to existing models of criminal justice. They appeal to the established public health practice of quarantining people, which is believed to be effective and morally justified, to explain why -in criminal justice- it is also morally acceptable to detain wrongdoers, without assuming the existence of a retrospective moral responsibility. Wrongdoers in their model are treated as carriers of dangerous diseases and as such should be preventively detained (or rehabilitated) until they no longer pose a threat to society. Our main concern in this paper is that Pereboom and Caruso adopt an idiosyncratic meaning of quarantine regulations. We highlight a set of important disanalogies between their quarantine model and the quarantine regulations currently adopted in public health policies. More specifically, we argue that the similarities that Pereboom and Caruso propose to substantiate their analogy are not consistent-despite what they claim-with the regulations underlying quarantine as an epidemiological process. We also notice that certain quarantine procedures adopted in public health systems are inadequate to deal with criminal behaviors. On these grounds, we conclude that Pereboom and Caruso should not appeal to the quarantine analogy to substantiate their view, unless they address the issues and criticism we raise in this paper.

Memory Modulation Via Non-invasive Brain Stimulation: Status, Perspectives, and Ethical Issues.

While research to improve memory or counter decay caused by neurodegenerative diseases has a fairly long history, scientific attempts to erase memories are very recent. The use of non-invasive brain stimulation for memory modulation represents a new and promising application for the treatment of certain disorders [such as Post-Traumatic Stress Disorder (PTSD)]. However, numerous ethical issues are related to memory intervention. In particular, the possibility of using forms of non-invasive brain stimulation requires to distinguish treatment interventions from the enhancement of the healthy. Furthermore, a range of important societal and legal concerns arise when manipulating memories. In this short contribution, we address some of the most significant ethical, social, and legal implications surrounding the application of memory-modulation techniques and offer a series of reflections and considerations, which we hope can be of use to guide -and perhaps regulate- their potential, future implementation in society.

What if some patients are more "important" than others? A possible framework for Covid-19 and other emergency care situations.

BACKGROUND: The Covid-19 pandemic caused situations where, in some hospitals, there were more patients in need of urgent treatment in intensive care units (ICU) than were available. In particular, there were not sufficient ventilators or critical care resources for all patients in danger of dying from respiratory failure or other organ failures. DISCUSSION: As the "first come, first served" criterion was not considered adequate, more nuanced and fairer clinical criteria were proposed to assess whom to treat first. One type of patients that has not been considered in the literature so far is that of "important patients", individuals that many people might consider worthy of priority treatment for the contribution they made or might make to society as a whole. In this article, we discuss the moral insights behind the possible treatment of "important patients" and suggest a supererogatory solution of voluntary renunciation/withdrawal. Details of the proposal are explained, and potential objections are addressed.

Crystal Ball Health Policies: A Case Against Preventive Testing For Alzheimer's Disease.

After the recent approval of a new drug for the treatment of Alzheimer's disease, the first in almost twenty years, it is useful to consider what are the real possibilities to make a preclinical diagnosis of dementia and to treat its symptoms. The scientific community widely agrees that the drugs available today can only slow down the progression of the disease; it, therefore, seems helpful to warn against encouraging the spread of preventive testing. In fact, faced with the prospect of drugs that promise to act in the first stage of Alzheimer's, there might be an incentive to invest in the research on biomarkers and even healthy adults could be encouraged to increasingly resort to such prediction tests. Our claim, however, is that such massive use of biomarkers would eventually make things worse for many individuals and for society as well. A few examples are given to illustrate this risk. Therefore, our proposal is to limit access to prediction testing until truly effective treatments for Alzheimer's are available.

The "One Health" approach in the face of Covid-19: how radical should it be?

BACKGROUND: The 2020-2021 coronavirus (Covid-19) pandemic is just the latest epidemic event that requires us to rethink and change our understanding of health. Health should no longer be conceived only in relation to human beings, but in unitary terms, as a dimension that connects humans, animals, plants, and the environment (holistic view, One Health). In general, alterations occurring in this articulated chain of life trigger a domino effect. METHODOLOGY: In this paper, we review the One Health paradigm in the light of the Covid-19 pandemic and distinguish two approaches within it that might be dubbed the Prudent one and the Radical one. Each approach is structured in three levels - epistemological, medical, and ethical. RESULTS: In this way, we show how we humans can better address the pandemic today and how, in the future, we can treat the whole living system better, by renouncing our anthropocentric perspective on health. CONCLUSION: We hold that the Prudent approach can be very helpful, and we discuss the medical and ethical issues related to it. We also consider the Radical view and the epistemological turn it requires compared to the Prudent one.

COVID-19 and Biomedical Experts: When Epistemic Authority is (Probably) Not Enough.

This critical essay evaluates the potential integration of distinct kinds of expertise in policymaking, especially during situations of critical emergencies, such as the COVID-19 pandemic. This article relies on two case studies: (i) herd immunity (UK) and (ii) restricted access to ventilators for disabled people (USA). These case studies are discussed as examples of experts' recommendations that have not been widely accepted, though they were made within the boundaries of expert epistemic authority. While the fundamental contribution of biomedical experts in devising public health policies during the COVID-19 pandemic is fully recognized, this paper intends to discuss potential issues and limitations that may arise when adopting a strict expert-based approach. By drawing attention to the interests of minorities (disenfranchized and underrepresented groups), the paper also claims a broader notion of "relevant expertise." This critical essay thus calls for the necessity of wider inclusiveness and representativeness in the process underlying public health policymaking.