Hall Wayne, Carter Lucy, Morley Katherine I
Office of Public Policy and Ethics, Institute for Molecular Bioscience, The University of Queensland, St. Lucia, Qld, 4072, Brisbane, Australia.
Addict Behav. 2004 Sep;29(7):1481-95. doi: 10.1016/j.addbeh.2004.06.001.
The increasing evidence that many addictive phenomena have a genetic and neurobiological basis promises improvements in societal responses to addiction that raise important ethical and social policy issues. One of the major potential benefits of such research is improved treatment of drug addiction, but in order to do the research required to realize this promise, it will be necessary to address ethical doubts raised about the capacity of addicted persons to give free and informed consent to participate in studies that involve the administration of drugs of dependence. Neuroscience research on addiction promises to transform the long running debate between moral and medical models of addiction by providing a detailed causal explanation of addiction in terms of brain processes. We must avoid causal models of addiction being misinterpreted as supporting simple-minded social policies, e.g., that we identify the minority of the community that is genetically and biologically vulnerable to addiction and hence can neglect social policy options for reducing addiction, including drug control policies. Causal accounts of addiction supplied by neuroscience and genetic research may also be seen to warrant the use of pharmacotherapies and drug vaccines under legal coercion. Neuroscientists also need to anticipate the ethical issues that may arise if the knowledge that they produce delivers interventions that enhance human cognitive and other capacities. Advances in neuroimaging that enable us to identify "addicts" or predict future risk of addiction will raise concerns about invasion of privacy, third-party use of neuroimaging data, the powers of courts to coerce defendants to undergo such tests, and consumer protection against the overinterpretation of test results. Given the strong public and media interest in the results of their research, neuroscientists and geneticists have a moral obligation, and a professional interest, to minimize popular misunderstandings of their work in the media that may rebound to its detriment.
越来越多的证据表明,许多成瘾现象具有遗传和神经生物学基础,这有望改善社会对成瘾问题的应对措施,但也引发了重要的伦理和社会政策问题。此类研究的一个主要潜在益处是改善药物成瘾的治疗,但为了开展实现这一前景所需的研究,有必要解决人们对成瘾者是否有能力自由且知情地同意参与涉及使用成瘾药物的研究提出的伦理质疑。关于成瘾的神经科学研究有望通过从大脑过程的角度提供成瘾的详细因果解释,来改变关于成瘾的道德和医学模式之间长期存在的争论。我们必须避免将成瘾的因果模型误解为支持简单化的社会政策,例如,我们认定社区中的少数群体在遗传和生物学上易成瘾,因此可以忽视减少成瘾的社会政策选择,包括药物管制政策。神经科学和基因研究提供的成瘾因果解释也可能被视为在法律强制下使用药物疗法和药物疫苗的正当理由。神经科学家还需要预见,如果他们所产生的知识带来能够增强人类认知和其他能力的干预措施,可能会出现的伦理问题。神经成像技术的进步使我们能够识别“成瘾者”或预测未来的成瘾风险,这将引发对侵犯隐私、神经成像数据的第三方使用、法院强制被告接受此类测试的权力以及消费者保护以防测试结果被过度解读等问题的担忧。鉴于公众和媒体对他们研究结果的浓厚兴趣,神经科学家和遗传学家有道义上的责任,也有职业上的利益,尽量减少媒体对他们工作的普遍误解,因为这种误解可能会对其造成不利影响。