On the current neuroenhancement use of transcranial direct current stimulation by healthy individuals—A non-fictional snap-shot: Commentary on Lapenta et al. 2014.

Hildt, Elisabeth

doi:10.3922/j.psns.2014.011

Cited by 4 publications

(16 citation statements)

References 8 publications

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“…Table 1 (below) identifies seven distinct assumptions: prevalence, social acceptance, efficacy, ideological stance (bioconservative vs. libertarian), potential for misuse, long term side effects, and the delivery of complete and clear information. These are regularly featured in the literature to support the existence of ethical issues associated with tDCS (e.g., Hamilton et al, 2011; Hildt, 2013, 2014; Cabrera et al, 2014; Pustovrh, 2014; Schutter, 2014). For example, the existence of coercion that would impede autonomy (one of the four major issues) is contingent on a rather strong acceptance of tDCS (an example of an assumption) and significant prevalence of the use of tDCS for memory enhancement.…”

Section: Methodological Guidepost 1: Acknowledging Assumptions More Ementioning

confidence: 99%

“…One of the first ethical preoccupations linked to the use of tDCS for enhancement purposes relates to safety (Cabrera et al, 2014; Hildt, 2014; Pustovrh, 2014). As tDCS is considered non-invasive and used in research settings on numerous people with only benign and transitory side effects, this device is usually considered to be relatively safe (Bikson et al, 2016).…”

Section: Methodological Guidepost 1: Acknowledging Assumptions More Ementioning

confidence: 99%

“…However, additional unexpected risks could appear in cases of use outside of controlled laboratory settings, especially considering the potential repetitive and long-term use by healthy subjects facilitated by the online availability of tDCS (Hildt, 2014; Pustovrh, 2014) and risks associated with “transfer” of this technology to pediatric and other vulnerable populations (see e.g., Davis, 2014). Concerns about safety are related to the lack of knowledge and scientific uncertainty regarding unexpected or long-term side effects of tDCS enhancement uses (Hildt, 2013; Lapenta et al, 2014).…”

Section: Methodological Guidepost 1: Acknowledging Assumptions More Ementioning

confidence: 99%

“…However, the mechanisms of action of tDCS likely involve different synaptic and non-synaptic effects on neurons and non-neuronal (e.g., glial) cells and tissues within the brain (Brunoni et al, 2011). Compared to other neurostimulation devices (such as TMS or DBS), tDCS devices are relatively small and affordable (about 80 dollars when purchased online), easily portable (battery operated) and less risky (only minor side effects in healthy adults reported to date; Hildt, 2014; Pustovrh, 2014; Bikson et al, 2016). Long-lasting effects appear to modulate longer-term protein synthesis, beyond a mere short-term electronic phenomenon associated with neurotransmission.…”

Section: Memory Enhancement With Tdcsmentioning

confidence: 99%

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tDCS for Memory Enhancement: Analysis of the Speculative Aspects of Ethical Issues

Voarino

Dubljević

Racine

2017

Front. Hum. Neurosci.

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Transcranial direct current stimulation (tDCS) is a promising technology to enhance cognitive and physical performance. One of the major areas of interest is the enhancement of memory function in healthy individuals. The early arrival of tDCS on the market for lifestyle uses and cognitive enhancement purposes lead to the voicing of some important ethical concerns, especially because, to date, there are no official guidelines or evaluation procedures to tackle these issues. The aim of this article is to review ethical issues related to uses of tDCS for memory enhancement found in the ethics and neuroscience literature and to evaluate how realistic and scientifically well-founded these concerns are? In order to evaluate how plausible or speculative each issue is, we applied the methodological framework described by Racine et al. (2014) for “informed and reflective” speculation in bioethics. This framework could be succinctly presented as requiring: (1) the explicit acknowledgment of factual assumptions and identification of the value attributed to them; (2) the validation of these assumptions with interdisciplinary literature; and (3) the adoption of a broad perspective to support more comprehensive reflection on normative issues. We identified four major considerations associated with the development of tDCS for memory enhancement: safety, autonomy, justice and authenticity. In order to assess the seriousness and likelihood of harm related to each of these concerns, we analyzed the assumptions underlying the ethical issues, and the level of evidence for each of them. We identified seven distinct assumptions: prevalence, social acceptance, efficacy, ideological stance (bioconservative vs. libertarian), potential for misuse, long term side effects, and the delivery of complete and clear information. We conclude that ethical discussion about memory enhancement via tDCS sometimes involves undue speculation, and closer attention to scientific and social facts would bring a more nuanced analysis. At this time, the most realistic concerns are related to safety and violation of users’ autonomy by a breach of informed consent, as potential immediate and long-term health risks to private users remain unknown or not well defined. Clear and complete information about these risks must be provided to research participants and consumers of tDCS products or related services. Broader public education initiatives and warnings would also be worthwhile to reach those who are constructing their own tDCS devices.

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Section: Methodological Guidepost 1: Acknowledging Assumptions More Ementioning

confidence: 99%

Section: Methodological Guidepost 1: Acknowledging Assumptions More Ementioning

confidence: 99%

Section: Methodological Guidepost 1: Acknowledging Assumptions More Ementioning

confidence: 99%

Section: Memory Enhancement With Tdcsmentioning

confidence: 99%

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tDCS for Memory Enhancement: Analysis of the Speculative Aspects of Ethical Issues

Voarino

Dubljević

Racine

2017

Front. Hum. Neurosci.

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“…One particular area of discussion has centered on the home (or Bdo-it-yourself^; DIY) use of transcranial direct current stimulation (tDCS; Dubljević et al 2014;Hildt 2014;Lapenta et al 2014;Maslen et al 2014;Fitz and Reiner 2015;Wexler 2017), a technique that provides low levels of electrical stimulation to the brain. Scientists, clinicians, and ethicists have warned about the potential dangers and unintended consequences associated with the home use of tDCS (Cabrera et al 2013;Iuculano and Cohen Kadosh 2013;Sarkar et al 2014;Brem et al 2014;Steenbergen et al 2016), which is an experimental research technique (e.g., it does not have FDA approval or clearance in the USA; Fregni et al 2015;Wexler 2016a).…”

Section: Introductionmentioning

confidence: 99%

Who Uses Direct-to-Consumer Brain Stimulation Products, and Why? A Study of Home Users of tDCS Devices

Wexler

2017

J Cogn Enhanc

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Despite the attention garnered by the home (or Bdo-it-yourself^) use of tDCS (transcranial direct current stimulation), little is known about the population of actual users. The present study aimed to provide a comprehensive examination of those who purchase tDCS devices: who they are, how they learn about tDCS, and why and how they stimulate. A link to an online survey was sent to those who had purchased a tDCS device from seven different companies selling tDCS devices to the public as of June 2016; data was analyzed from 339 participants, the majority of whom reported residing in North America. The typical respondent was a wealthy, highly educated, liberal, fortysomething male living in the USA who reported being an early adopter of technology. Nearly three quarters of respondents reported using tDCS for cognitive enhancement, one-quarter for restoration, and approximately 40% for treatment; many participants selected a combination of usage indications. Notably, approximately one third of participants utilize tDCS to self-treat depression. Most who use tDCS for treatment find the technology to be effective, whereas most who use it for non-treatment purposes (i.e., only enhancement and/or restoration) find it to be ineffective. Approximately 40% of those who purchase tDCS devices either quit using the device (mostly due to lack of efficacy) or have never used the device (mostly due to lack of guidance). Participants depart from established scientific protocol particularly with regard to frequency of stimulation, with 8.4% reporting self-administering 100+ sessions of tDCS. With regard to side effects, a small subset of users (n = 10) reported serious skin burns. This study provides an empirical foundation on which to base policy recommendations and offers a fact-based perspective on a bioethical debate that has too-often been one step removed from reality.

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DIY brain stimulation: On the difficulty of measuring effectiveness and its ethical implications

Lin

2020

Developments in Neuroethics and Bioethics

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On the current neuroenhancement use of transcranial direct current stimulation by healthy individuals—A non-fictional snap-shot: Commentary on Lapenta et al. 2014.

Cited by 4 publications

References 8 publications

tDCS for Memory Enhancement: Analysis of the Speculative Aspects of Ethical Issues

tDCS for Memory Enhancement: Analysis of the Speculative Aspects of Ethical Issues

Who Uses Direct-to-Consumer Brain Stimulation Products, and Why? A Study of Home Users of tDCS Devices

DIY brain stimulation: On the difficulty of measuring effectiveness and its ethical implications

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