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Protecting Decision-Making in the Era of Neuromodulation

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Abstract

How humans make decisions is one of the primary domains of inquiry in psychology. Our ability to make decisions leads to direct consequences in our lives and defines one aspect of autonomous function. Among clinicians and researchers, the pursuit of effective cognitive enhancements and treatments that could directly or indirectly influence our decision processes has become widespread, since many of the neural circuits that we stimulate are involved in autonomous decision-making. Given rapid scientific developments, it is prudent to consider how neuromodulation could affect a person’s ability to make choices and manage trade-offs between decision outcomes. In light of this dilemma, we offer a framework based in decision neuroscience that separates brain networks into decision-making core, volitional action, and moderating systems. This framework bridges bioethics and cognitive neuroscience to provide heuristics for the neural basis of autonomous decision-making. In doing so, we provide a general call to predict and weight risks and benefits of different degrees and kinds with regard to decision-making as increasingly precise neuromodulation techniques emerge.

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Notes

  1. Providing consent can also be a more or less rational decision. Decision-making tasks also allow us to consider various notions of “rationality” by comparing theoretically optimal strategies to real-world behavior. As some researchers have noted, in real life, forced-choice tasks are unlike many natural decisions because we can opt not to participate, either at entry during informed consent or during any portion of the task (Dhar & Simonson, 2003). For our current purposes, forced-choice tasks are simple tasks that elicit some aspects of decision-making after a subject has agreed to participate. In other words, the participant has already completed one superordinate choice in which she has opted to participate in the experimental task, rather than not.

  2. The classic distinction of cognitive versus motor systems is a heuristic that has been challenged from several cognitive-behavioral perspectives, which suggest that no clear distinction between the two is obvious (Rosenbaum, 2005). Here, the distinction is useful because we should study the representations and processes involving decision-making and motor systems to clarify their roles in decision-making.

  3. Numerous consequential perception biases also exist without direct neuromodulation; cf. (Greenwald et al., 1998; Maner et al., 2005; Ross et al., 1977; Scott & Monesson, 2009; Vuilleumier & Huang, 2009).

  4. Incidentally, this treatment is administered to the left dlPFC, which is part of the autonomous decision core.

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Authors and Affiliations

  1. Department of Psychology, Drexel University, Philadelphia, USA

    John D. Medaglia

  2. Department of Neurology, Drexel University, Philadelphia, USA

    John D. Medaglia

  3. Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA

    John D. Medaglia & Roy H. Hamilton

  4. Neuroethics Studies Program, Center for Clinical Bioethics, Georgetown University Medical Center, Washington, USA

    Andreas Kuersten

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Medaglia, J.D., Kuersten, A. & Hamilton, R.H. Protecting Decision-Making in the Era of Neuromodulation. J Cogn Enhanc 4, 469–481 (2020). https://doi.org/10.1007/s41465-020-00171-7

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