Our point so far has been that philosophical reflection can play a key work in the background of science, foresight, engagement, and ethics management (all key dimensions of RRI). Next, we illustrate this role by focusing on three concrete examples relevant to HBP research: neuroscientific research and its impact on human identity, neuroscientific studies on the unconscious, and neuroscientific studies of poverty.
It is often suggested that by providing knowledge of the structures and functions of the brain, not only will neuroscience enable a richer understanding of the brain and its diseases, but it will further our understanding of what sort of beings we are [27,28,29,30]. Indeed, unveiling some of the components that make us human is an explicit goal of the HBP (project that is particularly interested in addressing foundational issues) and an implicit interest in other international brain initiatives. It must be noted that the issue of whether there are species typical properties and what they are is not just of theoretical interest but of practical interest as well. The same progress in brain research that might allow considerable insights into what human beings are can also afford means to manipulate and access the brain. Some fear that such manipulation and access could make a significant impact on what humans are, and quite likely alter how people understand themselves as human [31,32,33]. Thus, to explore what is that “something” that makes humans different from other beings -what we can loosely call “human identity”- and to identify the underlying assumptions when discussing such identity should be a substantial concern to anyone making claims about the extent to which neuroscience might unveil what we are, or how neurotechnology will alter us.
But the notion of human identity generates deep questions: what does it specify? And does giving a key role to brain research in uncovering fundamental components of what human beings are betray a problematic neuroessentialism or braincentrism, (i.e. the view that the brain plays a unique role in human identity and that any meaningful approach to what we are must entail a focus on this organ) [34, 35]? It is clear that a productive approach to examining these topics requires a careful philosophical conceptual examination of both epistemological and ontological issues . Epistemologically, core questions are: what can neuroscience tell us about human identity and why? What are the limits of neuroscientific knowledge when it comes to understanding human beings? And how can we bridge the gap between the knowledge provided by neuroscience and the knowledge provided by the social and natural sciences that have done work on the same notion? From an ontological perspective, the core issues appear to be whether there is a human identity, whether such identity is to be grounded on essential or non essential traits, or whether, instead, it is to be found in a particular kind of process. [36,37,38,39,40] The issue becomes more complex when we consider that for a number of historical and religious reasons, the possession of a human identity (often discussed in philosophy in terms of “human nature”) has often been taken to mean moral superiority.
And yet, the issue of whether such human traits exist or whether the idea itself of a human identity (often discussed in philosophy in terms of “human nature”) makes sense is still debated .
Conceptual analysis of recent empirical work on the brain gives support to the view that holds human identity to be based upon a particular process: the lengthy, constant, and complex interplay between human cerebral architecture and its diverse environments [22, 41,42,43,44,45]. Indeed, in recent years, neuroscientific discourse on the brain has developed a more nuanced understanding of this organ and its relational aspects, including its relationship with the body, its many environments, and the social contexts in which it is embedded. The view of the brain as a mechanistic input-output processing device has been consistently questioned and generally abandoned [29, 41, 42]. In particular, an alternative model that sees the brain as an «autonomously active, plastic, projective» and highly selective organ heavily affected by learning and experience has greater explanatory potential [27, 42, 43, 46, 47]. The epigenetic model of neuronal development proposes that even if constrained by a genetic envelope, the human brain is able to adapt its neuronal connectivity by stabilizing or eliminating particular synapses in accordance with short- and long-term changes in its internal and external environment [41, 42]. The theory of neuronal epigenesis by selective stabilization has been used not just to explain the development of the brain, but also the acquisition of written and oral language, and the acceptance of and compliance with social and ethical rules [48, 49]. If correct, it provides grounds for endorsing a process oriented view of what humans are. Rather than looking for intrinsic universal human traits or presumptively confirming the importance of one or a group of specific behavioral or anatomical markers, it suggests that in our quest for humanity, we could focus on the constant interplay that allows for the coalescence of learning, experience, and genes and examine how dynamic interactions, and social environments impact synaptic connectivity and contribute to the formation of a variety of patterns of neural activity.
The general point is, however, that real progress in understanding what being human is and in discussing whether certain neurotechnologies will threaten humanity will only be made after rigorous conceptual analysis of the relevant philosophical and scientific notions is integrated into a comprehensive approach. In practice, expressions of fear regarding the potentially dehumanizing aspect of brain machine interfaces, robotics, or even DBS procedures can, at least partially, be explained by the prevalence of different, often muddled conceptions of human identity. Searching for conceptual clarity on what makes us human is then not just a valuable endeavour in itself but a way to responsible address and potentially manage serious concerns regarding the neuroscientific agenda itself and the implications of the products of research.
Studies on Consciousness
The investigation of consciousness in the last few years increasingly reveals the inadequacy of a limited approach to the phenomenon. Accordingly, both empirical and conceptual efforts are devoted to consciousness research within the HBP.
Several scientific and conceptual models of consciousness have been suggested, and agreement is far from being reached [50,51,52,53,54,55]. Even if the debate about their empirical and conceptual interpretation is still open, more agreement has been found regarding the role of so-called “neural correlates of consciousness” (NCC), i.e. a set of neuronal structures and functions correlating with conscious phenomena (such as wakefulness and arousal). Since their formal introduction in the scientific debate at the beginning of 1990s , the neural correlates of consciousness have been widely scrutinized from both conceptual and empirical points of view [57, 58]. Conceptually, David Chalmers defines NCC as minimal neuronal activations necessary for consciousness. . Such a general definition has been widely accepted in both philosophical and empirical contexts, even though the need for a more accurate definition of NCC has recently been suggested .
More specifically, NCC can be described in two basic ways: either as referring to a general, global state of consciousness, i.e. as neural correlates that mark the difference between being and not being conscious, or as referring to particular contents of consciousness, i.e. as neural correlates that are sufficient for a specific object to enter consciousness [59, 61].
The empirical differentiation between understanding NCC as referring to a state and understanding NCC as referring to the content of consciousness is reflected in the clinical distinction between wakefulness and awareness, i.e. between the state of vigilance and the content of conscious processing . This differentiation is also relevant to the description of the complexity of consciousness, which is not reducible to the processing of information coming from outside, but is also a sort of background state which allows processing that information .
Research on NCC provides important clues about the cerebral structures and functions involved in conscious phenomena. Yet, notwithstanding some progress in recent empirical investigations and conceptual clarifications of consciousness, we still lack an overarching theory providing a unitary picture of consciousness and related disorders. Michele Farisco and colleagues have recently formulated a new conceptual model , the Intrinsic Consciousness Theory (ICT), that starts from the predisposition of the brain to evaluate and to model the world [41, 47], i.e. from the brain’s ability to check the usefulness of the world to the satisfaction of its intrinsic needs and to develop a kind of map of the world in order to survive and thrive. Recent empirical investigation of the brain’s intrinsic activity (i.e., independent from external stimulation) and resting state activity (i.e., increasing in absence of external stimulation) contribute in describing this organ as much more than an input-ouput machine but rather as spontaneously active [65, 66].
According to ICT, these intrinsic activities of the brain are identical with consciousness, even if at a very basic level (i.e., a level of consciousness the subject is not aware of). The distinction between consciousness and the unconscious is not discrete or binary: the ability of the brain to evaluate and model the world can occur in two modalities, implicit or explicit, unaware or aware, that correspond to what we usually refer to as the unconscious and consciousness, and both are multilevel configurations of the brain along a continuous and dynamic line. This means that consciousness can be depicted as an overarching brain characteristic, which the brain retains insofar as it is intrinsically active. Thus, starting from an empirical understanding of the brain as intrinsically active and plastic, ICT distinguishes between higher cognitive functions and basic phenomenal consciousness, suggesting that the latter might characterize the brain’s intrinsic activity as such, even if at a very basic level. The necessary and sufficient conditions for consciousness are that the brain have appropriate instrinsic and resting state activities.
This new conceptual model of consciousness is conceptually parsimonious and practically relevant, specifically with reference to the assessment and care of patients suffering from disorders of consciousness. It opens the possibility that what is usually described as the unconscious, which according to ICT is an unaware modality of consciousness possibly characterized by a very basic level of phenomenality, with specific abilities and needs, might be ethically relevant as well . Morevoer, at the ethical level ICT outlines the high level of elaboration and sophistication that the unaware brain exhibits, claiming for an appropriate treatment in clinical context.
Finally, the intrinsic consciousness theory is quite relevant to the RRI goals of promoting a more ethical process and practice. If we accept the wider model of consciousness suggested by this theory we can see that allocation of resources and research priorities in the clinical context of disorders of consciousness is often unjustifiably limited to cases in which it is possible to show that there is residual awareness, while unaware abilities potentially retained by affected patients are underestimated if not ignored. But this is not inevitable: a reconceptualization of consciousness that zooms in on the brain’s retained intrinsic activity rather than on its retained reactivity to external stimulation can start a richer discussion with clear practical implications. In this way, ICT would make a positive contribution to RRI in allowing a more comprehensive ethical assessment of challenging cases like disorders of consciousness.
Neuroscientific Studies of Poverty
We focused above on two areas in which neuroscientific research may have an impact either by potentially altering our self-understanding qua humans or by enhancing our understanding of consciousness, which in turn could have significant implications on the care of patients with disorders of consciousness. Neuroscientific research may do more: it can also inspire systemic social change. The potential for this becomes evident when we focus on contemporary neuroscientific studies on the influences of poverty on cognitive, emotional, and stress regulation systems that propose to analyse how the different individual and contextual factors associated with material, emotional, and symbolic deprivation (i.e., lack of food, shelter, education, and health-care) influence neural development . These studies have important ethical and public policy implications: they should play an important role in the discussion of a number of issues such as what are the structural conditions needed for the full exercise of human rights, the overt and covert ways in which citizens’ rights can be violated, what respect for human dignity entails, the potential ways of depriving people from their identity as full citizens and of restoring such identity, and the determination of collective social responsibilities [68, 69]. The specific evidence that neuroscience brings to the analyses of poverty and its implications is then not only of great interest in itself but also relevant to policy-making. However, this evidence needs to be spelled out in detail and clarified conceptually, notably in terms of causes of and attitudes toward poverty, implications of poverty for brain development, and the possibilities to reduce and reverse these effects.
It is important to be cautious when interpreting the results of neuroscientific studies that consider contextual and cultural aspects to avoid misconceptions and stigmatization: there is notably a sizable difference between considering that neural and behavioural differences due to poverty are a deficit and considering them an adaptation. From an ethical perspective, the issue then becomes whether the consequences of poverty are related to circumstances in which no basic rights are satisfied (e.g., inadequate nutrition, housing, or access to education and health services). This is an important point considering that social attitudes to poverty differ: some consider it a result of social irresponsibility, whereas others take a more individualistic approach and explain it as a personal failure of the person afflicted. In other words, poverty is not universally regarded as a consequence of social imbalances and unequal access to social benefits. The latter, individualistic views are common in North America and South America, where the problem of poverty is much more significant than in Western and Northern Europe, where social views on poverty are dominant. It is worth noting that countries and political systems that accept the rights of access to adequate nourishment, housing, education, and health care as a shared social responsibility are also among those who have been most successful in combatting poverty, social violence, and insecurity, e.g., the Scandinavian countries (cf. World Bank Global Poverty Overview http://www.worldbank.org/en/topic/measuringpoverty#3).
The relevance of neuroscientific evidence to policy-making and legislation can be illustrated by focusing on adolescent delinquency that arises more frequently in contexts of poverty. As pointed out elsewhere , this is frequently repressed through police and judiciary means, often resulting in incarceration. However, this approach to juvenile violence simply omits compelling findings that show that adolescence is a time of “neurodevelopmental crisis.” Evidence from anatomical and functional-imaging studies has highlighted major modifications of cortical circuits during adolescence including reductions of gyrification and grey matter, increases in the myelination of cortico-cortical connections, and changes in the architecture of large-scale cortical networks—including precentral, temporal, and frontal areas . Uhlhaas and colleagues  have used Magneto Encephalography synchrony as an indicator of conscious access and cognitive performance . Until early adolescence, developmental improvements in cognitive performance are accompanied by increases in neural MEG synchrony. This developmental phase is followed by an unexpected decrease in neural synchrony that occurs during late adolescence and is associated with reduced performance. This period of destabilization is followed by a reorganization of synchronization patterns that is accompanied by pronounced increases in gamma-band power and in theta and beta phase synchrony . These remarkable changes in neural connectivity and performance in the adolescent are now being explored: awareness of their occurrence should lead to special proactive care from society. The nature of this care may include a social educative environment adapted to adolescents’ special needs, adequate physical exercise, or new kinds of therapies yet to be developed. The point is that a careful discussion of these issues is a moral priority, particularly considering that depending on the circumnstances in some countries young people can be transferred to the adult system (e.g., Canada, United States, England, Wales) and in others there is a strong political will for them to be treated as adults (Brazil, Argentina). In view of the available evidence from neuroscience, social policies that treat and punish minors as adults may arguably be not merely ineffective, but also a clear breach of human rights. In this sense, neuroscientists can play an extremely useful role, providing and reinforcing the kind of evidence needed to understand minor delinquency and how to manage it in a way that promotes the wellbeing and respects the rights of all. In doing so, they could raise awareness of a point made before: scientific work is intrinsically socially and politically relevant.
The example above illustrates the need for careful unpacking and conceptual clarification of the specific evidence that neuroscience brings to analyses of poverty and of careful ethical analysis of its implications. There are additional related issues already suggested by Sebastian Lipina and Kathinka Evers . One of them has to do with the causes and attitudes to poverty. For example, what does neuroscience concretely contribute to the debates over individualistic versus systemic or social explanations of poverty? On the other hand, what does considering the neural and behavioural differences due to poverty as a deficit rather than as an adaptation imply? A second one is related to the Impacts of poverty on brain development. The interpretation of evidence and the identification of ethical and social issues that arise might provide the means for reducing poverty’s negative impacts. We have also questions of reversibility. Which impacts of poverty can be reversed, and how? What does the concept of “reversibility” entail? The evidence available in this area raises specific ethical challenges that should also be considered in the interpretation of results and the planning of future research. Finally, there is also the important question of how to communicate scientific findings in a responsible manner so as to avoid misconceptions, hypes, misuses, or the problem of stigmatization. Scientific findings can always be misused, but the risk is greater in an area permeated with values and norms, such as that of poverty. It is not self-evident that the science of poverty will be used for poverty-alleviation: it can also be used to increase alienation from “the poor”, and deepen the stigmatization of a group that is already disrespected in societies that have created such circumstances.