 In high school, middle school and high school, they learn other sciences, we hope. They learn geology. They know sedimentary rock is different from igneous. But neuroscience is not, last time I looked, which was a few years ago, but not that long ago, because I'm working with the Philadelphia School District. We have a new neuroscience course for grades 11 and 12. But in general, there is no standard neuroscience taught in schools. The AP biology curriculum does not have a section on neuroscience. So that's a problem. I mean, I think we need a basic level of literacy, you know, you could say the same of probably all sciences, but it's kind of strangely missing in the knowledge base of the sort of average educated person. Okay. The next one is ownership. What I'm talking about is who decides what technologies get made and distributed and, you know, precisely what applications they're adapted to. Traditionally, medical advances in neuroscience were funded in this country by NIH and other countries by the equivalent organizations. Basic neuroscience, you know, maybe a little bit still at NIH, National Science Foundation, again, other nations have their equivalent organizations. But research and development on non-medical applications of neuroscience are by and large not publicly funded, okay? So that means the people developing these technologies are not answerable to anybody. If we want to know things like how effective are they? What are the side effects? You know, they don't have to tell us. If we think, well, you know, new forms of computer gaming through brain interfaces will be even more gripping on the attention of our teenagers. I mean, that's going to be a big incentive for companies to develop that, but the public, the society, that's not really in its interests to have that application, right? So I think the ownership question is going to be very important going forward because it will determine what gets developed for what purposes. And right now, without any public funding, it's all up to, you know, sort of the, you know, private enterprise, which is not necessarily, you know, evil, but I think a more kind of diverse ecosystem of, you know, supporting the development of these technologies would be good. Finally, I just want to say, I think there's a kind of nihilism that can creep into our thinking about ourselves and our world and humanity. The more we internalize this idea that we are a pack of neurons, right? We're a pack of neurons. We can, you know, make them work better for us in certain ways by taking this pill. We can activate certain sets of neurons to perform better in that way by putting electrode there. All of these technologies, and in general, just the fascination that our culture now has with seeing ourselves as essentially, you know, fancy biophysical mechanisms, fancy computational networks is hard to reconcile with traditional notions of, you know, meaning and personhood and certainly religious ideas about, you know, soul and body. And I think, I mean, I do think there is, you know, I think it makes it a little bit easier to fall into a kind of nihilistic perspective on the world where, you know, it doesn't really matter. It's just a bunch of matter in a certain configuration. That's my two sense of philosophy in the end. So in some, where have we gotten? Well, I hope what I have presented to you is, you know, neuroscience is not giving us French pills and it's not controlling our brains. But it is actually here and now able to do certain things that affect our lives and perhaps the way we think of each other, these are the nihilism point, and, you know, clearly is on a trajectory to do more and more of that. The issues raised by these developments are, you know, not utterly unique and new under the sun, but I think they do raise some interesting new issues and I am going to, I think, end there. Yes. And thank you very much. A very good question. Can you generalize all the results to another geographical area, another environment, another culture that is comparative studies? Can you repeat the first part of your sentence, your question? Yeah. Yeah, that's a really interesting question. There are people working on neuroethics in very different cultures, in Asia, for example, I mean really all over the world, and I couldn't really tell you what is being learned about the differences. I suspect there are differences. Yeah, I'll just leave it there, but I think that's a good point. I mean, are there certain differences that you would predict or expect based on different cultures, for example? For example, the culture, you mentioned a different religion that can have another impact in the result, and you can compare with another society, the Western or the other. I'm sorry, my, so which of the neuro-science? The values, society, culture, religion, in another different society, for example, for Asia or for the inter-country to compare with here, the developed country or the developed country. No, I think it would be very, very interesting, and I mean, you could imagine very different attitudes toward enhancement, cultures that are, I mean, American culture is very individualistic, and it's considered to be a good trait to try to get ahead, right? Look for an edge, work harder and work longer, and distinguish yourself. But certainly in many Eastern cultures, they're less individualistic and more, I don't know, what's the word, sort of communal in their approach to, you know, judging behavior good or bad, and so some of the enhancement practices might be viewed differently because of that. I don't know, it's very, very interesting. Thanks for an interesting talk on a complicated topic. Getting back to your paper on the meta-analyses, it looked like all the individual findings were not statistically significant from what you showed, and that it was only after you manipulated the data that you'd find something significant. So is that just a product of just the meta-analysis? Well, I could try to go back and find the, but I mean, so what the individual studies show is, the effect size they found, and the, yeah, let me add that problem set, I'm going to read that whole history book today, but of course that's a non-trivial help, right? So widely used, probably more effective for improving your motivation to work than your ability to work for normal, healthy subjects, nevertheless, you know, a factor in normal undergraduate life and other kinds of students, other kinds of professionals, careers like, you know, everything from doctors to long-distance truck drivers. Now, there are other medications more recently, more recently on the market, and more recently used for enhancement, for example, Modafinil, a trade-name provigil, and there's some similar kinds of medications out now as well, that were originally developed as treatments for narcolepsy. They will, however, make somebody who has been normally, well, they will make somebody who does not have narcolepsy able to function with minimal cognitive decline and actually feeling pretty good with extreme sleep deprivation, okay, easily skip a night's sleep, maybe more, and some normal healthy adults who are adequately rested claim that it helps them concentrate and also gives them a little motivational boost, and there's some evidence from, you know, well-designed studies that's consistent with that. So this is obviously the boon to people who want to work, ridiculous amounts of time, right? I mean, this is the ultimate time management, you know, fix. Just get another eight hours of time by not sleeping. Okay. Obvious downsides to that, you know, it doesn't protect you from the long-term effects of sleep deprivation on your immune system, you know, nervous system, and so forth, but extremely helpful in the breach. For this reason, the U.S. military, many other nations, militaries, use this medication with their normal healthy soldiers, right? But, you know, in the middle of a battle, you can't say, oh, it's 11 o'clock, time to go to sleep, you know. So this is, you know, basically another kind of brain enhancement, performance enhancement to work better or longer that we are seeing more and more normal healthy people use. There are medicines being developed for memory dysfunction, and here's just a screen grab from a website from Memory Pharmaceuticals showing that among the indications that they're working to address various disease states, nothing especially striking there, but age-associated cognitive decline, okay? That's by definition a normal healthy person, right? You know, when you get into your 60s, actually, before that, you start to remember less well. Wouldn't it be nice to have a molecule that reversed that, gave you the memory you had when you were in your 30s? Is there upfront about this being one of the goals? So again, this is not a pill that makes you able to speak French, okay? This is not a silly dream. This is something that a well-financed company is aiming towards. There are other kinds of enhancement that you might want to use yourself or on somebody else. For example, oxytocin is a hormone. It's a neuropeptide that, in this study that this data graph is from, increases a person's, a normal healthy person's generosity when they're playing an economic game relative to placebo. There are, you know, the effects of oxytocin remain to be completely understood. There are certainly cases where it has the opposite effect, but this is a chemical pathway that powerfully modulates people's trust and generosity. And that could be an interesting, you know, it'd be really nice to find the knob, wouldn't it, that you can adjust that up and down. Oxytocin has various problems that make it very inconvenient to dose with. I will, however, say, for those of you who are saying, okay, she's getting a little close to that French pill. What's his name? Tom Insel's advisor, Larry Young. Larry Young tells me that whenever he goes to conferences that have large numbers of psychiatrists at them when he's speaking at those conferences, he is always approached by practitioners who say, you know, this is great stuff. I use it with some of my patients. They get a compounding pharmacy to mix something up and it has to be inhaled through the nose. But there you go. This is now happening, maybe a little fringy, but it's now happening and clearly has great potential. This article, a little out of date now, what is this, 2009, exemplifies the search for other molecules that don't have to be snorted, that can be taken orally and cross the blood-brain barrier, that will modulate that same system. So it's not just cognition and work performance. It's some of our nearest and dearest interpersonal emotions as well. And finally, while we're talking about altering normal healthy brains, not necessarily nice brains, but medically normal and healthy, there is the prospect for brain interventions within their criminal justice system. There is a tradition of therapeutic justice in our society and many others where the goal of the sentence is not just retributive punishment and is not just, you know, as a system of incentives to dissuade people from breaking the law, but also to try to turn them around, rehabilitate them, make them better. We already give anti-androgen medication to sex offenders to decrease their sex drive. This is clearly a kind of brain intervention. And we know that SSRIs, other serotonergic drugs, are at least somewhat effective in combating impulsive violence and also because of the well-known side effect that limits the use of SSRIs for other indications, namely the sexual dysfunction that they frequently have as a side effect, they can also be useful for sex offenders. Okay, so again, is this like science fiction, Fringy? Well, I hope I've indicated by these examples that we are already seeing these things put into practice. And excuse me, and that there are, you know, at different stages, right, a few kooky psychiatrists. I hope I'm not offending anybody here if they actually use oxytocin. Let me just say a few, you know, non-traditional psychiatrists using oxytocin, but also the military, you know, all kinds of professionals using stimulants and, you know, the search for memory enhancing enhancement for older people. Is this science fiction? Well, I think those other examples I presented indicate that it's not, but interestingly, the American Academy of Neurology, you know, has created a committee to study what medicines their members should prescribe for normal, healthy patients who come to them saying, I want cognitive enhancement. Okay, they've already published a statement saying there's no legal or moral reason not to provide that for, you know, a competent patient asking for it. And now they are trying to synthesize the literature to see what they should actually be prescribing. Okay, conclusion. No, this is not the French pill. Okay, another newer approach to brain enhancement involves devices that involve current passing through the brain and changing brain function and therefore mental function. Transcranial magnetic stimulation uses magnetic field to induce the current in the brain. Transcranial direct current stimulation simply runs an electrical circuit, you know, through the brain, basically two electrodes and your brain completes the circuit with something like a 9-volt battery in between. These methods are, you know, widely used for research, used in some limited cases, TMS is approved for clinical use in certain very specific cases, you know, depression that has certain characteristics. And TDCS, because it is kind of low-tech and you can get yourself a 9-volt battery and some electrodes is used quite a bit by private, you know, do-it-yourselfers, do these things work? Do they actually, and we can ask the same question about them that we ask about, you know, Adderall, does it really make you smarter, better performing or do you just think you are? TDCS has been the focus of a lot of controversy in just the last couple of years. There have been a number of meta-analyses, mostly concluding that it doesn't do anything. This was the most kind of sweeping negative, there's nothing here, you're all fooling yourselves, study by Horvath et al. published in, I don't know, I think 2015. It, without taking you too much through like inside baseball, it had a lot of problems with it, this study. It's probably not, if you really want to give the technique a chance to show you what it can do, their methods of meta-analysis probably didn't give it maximum opportunity. Other people have done other meta-analyses, concluded basically the same thing, sometimes down very small effects. Right now, I think published online, not yet in print, internal cognitive neuroscience, my colleagues and I have a meta-analysis, we had to get into the act. We just focused on working memory and whether TDCS can enhance working memory because as you probably know, working memory enhancement is considered the key to enhancing general intelligence. It may or may not be a good assumption, but it's a widely made assumption and that's why there are all these working memory training programs around. Anyway, what we found was kind of like everybody else, not much of an effect. You can see this is what we call a forest plot that the diamond at the very bottom shows the sort of aggregate effect size taking into account all the different studies weighted by the power of their design. And you can see, you know, maybe like 0.2 effect, Cohen's D at 0.2. Let me say that this finding, weak as it is, has to be further qualified by evidence of publication bias using funnel plots. But again, we won't do inside baseball here, I think depending on the exact analysis that you do of these data, it hovers right around being just significant at the famous 0.05 level or not. One analysis that seems a little more promising, wait a minute, this is the same image. Oh, Dorn, no, no, it's not, excuse me. Okay, I just superimposed another forest plot. The smaller table on top is studies that used transcranial direct current stimulation to enhance working memory training. So I've already told you there's a lot of effort to train working memory ability. And of course the gold standard is, you know, you get far transfer, even near transfer would be nice, to different working memory tasks. It looks, and these are plotted up there, the effects of just on the effectiveness of training, how effective is training with TDCS versus without. And there I want to say, okay, we've got a little bit of an effect and it doesn't go away when you correct for publication bias. So I think in fact, and so this covered articles I think through the end of 2014, a few other things have come out in the meantime showing positive effects of TDCS on working memory training and training on other things. So my guess, here's what the T-leaves are kind of lining up to indicate right now. Again, if we've learned anything from this whole replicability crisis in neuroscience and psychology, it's don't draw any firm conclusions based on a small number of studies. But it looks as if this very low-tech, very safe method of TDCS can be very effective at boosting the effects of training or practice. So that really could have a big payoff. And not that they waited to see whether there was evidence that it could have a big payoff or not, but certainly some companies are getting into the act already, marketing such things. So again, you know, is this just silly science fiction? Well, you know, the investors in SYNC, T-H-Y-N-C, who invested, I can't remember the figure, many millions of dollars in selling this device. It's a beautifully designed TDCS advice, but they hired designers away from Apple to make it look really sleek. That's, you can have your own streamlined, beautiful, transcranial current stimulator that looks like that, or you can go to focusfoc.us, which also sells, you know, consumer to be used at home. Breed stimulation. And if you want to talk about the foundation of this, I'd be really interested to do that in the discussion section later. It's a strange story, but basically the FDA has basically said, oh, that's okay, you just sell it and we're not going to bother you. So these things are not science fiction and fringe. And in fact, there are even, you know, research and development attempts, obviously nothing that's being sold the way you think is, to alter people's psychology with multiple implanted electrodes and chips in the brain. This is the DARPA subnets program, which stands for Systems-Based Neurotechnology for Emerging Therapies. And they are making a very serious attempt to come up with systems of implanted electronics that will help to both diagnose, but more importantly, treat, and they say maybe even cure, psychiatric illness. So this is not here and now, and maybe what DARPA does is by definition science fiction, I don't know, but it's certainly something that our government is investing in. So that's my little, you know, bicycle tour of ways of altering human brain function, not for medical purposes, with maybe the exception of subnets, but for sort of pleasure and profit. Now let's just talk briefly about brain imaging. This is another technology that started out, of course, for medical practice and medical research, but is now being used for many, many other reasons, non-medical, and stands to, you know, affect the way we live our lives and the way our society works. This is a company with a wonderful name, NOLI MRI. And as you might guess, what it offers is brain-based lie detection. There's another company that until recently did the same thing. The company hasn't gone out of business, but it stopped offering the lie detection service, and that was called CEPHOS. And these methods, they're not currently used in the courtroom in the U.S. They're used for private matters, you know? Honey, I really was working late at the office, and I'll get into a scanner to prove it. But they have also tried to get into the courtroom. They've been turned down every time. The closest they got was a federal criminal case a few years ago, maybe two years ago, of a doctor who was accused of lying, committing Medicare fraud. And he claimed that he didn't realize that what he was doing was wrong. He didn't deny that he had filed certain claims for certain things, but he said he really hadn't done it knowingly committed fraud. And he got the people at CEPHOS to give them some scans, and they wanted to offer that as evidence in defense in his trial. And what's called a Daubert hearing was held, where Daubert hearings are to see if a certain scientific method meets the Daubert criteria for being admitted into a trial, and they got very close. And I'll tell you, it was a day and a half process. I actually went, it was neuroethics tourism, and really, like, fascinating, fascinating to see just all of the interactions between the attorneys and the judge and the expert witnesses. Basically in the end, the judge, too fam, said, you know, this is not ready for prime time. You haven't really satisfied the Daubert criteria. But, you know, here's what you would need to do if you want to do that. Basically set out a little blueprint for them. They may or may not be pursuing that now. But clearly this is one way in which neuro-technology imaging has been, you know, looked to to solve a societal problem. How great it would be if we actually knew when people were lying about high-stakes things. But then again, think about how disastrous it would be if we got that wrong in high-stakes things, right? Put people in jail, let people go free, you know. Okay, another use of neuroimaging in the legal system that has already made it into trials and looks, I think, much more promising, and from what I know probably still not really ready, despite the fact that it has been used, is imaging pain. An awful lot of legal cases involve pain. And of course, where's the objective evidence that somebody is in pain, right? It's very hard, if not impossible. Well, it is impossible to tell for sure, right? It's a problem of other minds, essentially. Well, it turns out that pain has a certain, what's called neural signature. I think now even the person who proposed that phrase realizes that it implies things are simpler than they really are. But there certainly are pretty strong correlates of pain on fMRI that, and even on structural MRI for chronic pain, that tell a lot. Now, do they tell you enough with enough certainty to decide important cases? That's the question. But as I said, already in use. Of course, there's neuromarketing, like neurosense, people using both brain imaging and I think this is also neuro-sense, which is an EEG-based method. There are also fMRI methods for neuro-marketing. Certainly, if any mental state is pretty reliably related to patterns of brain activation, it's the I Want It mental state, right? Reward system activity. So neuro-marketing on the face of things is somewhat plausible. It's pretty easy to predict what advertising messages, products, designs, whatever appeal to people. One of my colleagues from Penn, Emily Falk, in the Annenberg School of Communications, uses neuroimaging in a very similar way to study the effectiveness of public service announcements for improving health behaviors, quitting smoking, et cetera. And she can predict, by looking at a sample of people in the scan or looking at different anti-smoking ads, she can then predict what a population will respond to, which ads they will be most motivated by. So she does very clever experiments where she has different ads then actually shown on air with different phone numbers to call to get further information. And she can show that depending on the amount of nucleosacumbens activity, also medial frontal activity associated with self-related processing, the more you're identifying and thinking of yourself when you're watching this ad, the more you're likely to call when you see that ad. And the number of responses logged, the number of calls logged to the different phone numbers, bears that out. So clearly, neuromarketing and neurocommunications are onto something. And let me also say that it's not so clear with neuromarketing because the people who do this, they're doing it to make a buck themselves. They're not gonna be good, you know, Carl Popper, let's try to falsify our claims. But Emily contrasts, she pits the imaging-based prediction against the best you can do with behavioral methods and shows that the imaging actually goes beyond that. Okay. So in education, you can again find improved prediction of in this case, when a child is gonna be ready to learn to read using various approaches to fMRI, or to MRI, what am I looking at here? fMRI, behavior, classificate, okay, yes. So DTI doesn't do much for us. But you can see that BX is the sort of state-of-the-art behavioral assessment of when somebody's ready to learn to read. And you can see that pattern analyses of fMRI data, machine learning methods, significantly outperform the best behavioral methods. Not sure how practical it is at this point. You know, we're not gonna scan every kid on their first day of kindergarten, but, you know, this is translational research and clearly has something to offer in the future. And I seem to have mixed up my slide order. This is just another neuro-marketing company. You know, one thing I didn't mention that I would like to is in India, the courts do admit a kind of EEG evidence of... It's not exactly lie detection. Well, it's a form of detection of deception called guilty knowledge detection. So they present the defendant with details of the crime, examine their EEG activity, and infer whether that person had first-person knowledge of the crime. And that has been used in a number of murder cases to convict people. There's, like, no evidence of its validity online, which is a little distressing. Okay. And this is... Okay. So, oh, gosh, I am so sorry. I feel like my slides are a little screwed up. We're skipping that neuroscience worldview. But hopefully, you've now seen a bunch of ways of altering the brain, reading information from the brain that shows, yeah, there is some grist here for a field called neuroethics. There are some really new kinds of things that we're doing with neuroscience in society in general. What about the ethical issues that it raises, anything new? Well, I think the problem with this question, is there anything new here, is that you always have to answer, if you're honest, you answer it yes and no, right? Because nothing is new under the sun. Whatever happens, you can find some precedent that has some relevant form of similarity to it. Okay. And also, you can always insist that, well, this is really new, because it's different in this way. So I think what we have to ask is, not are the ethical, legal, and societal implications of neuroscience, the LCs of neuroscience, are they totally different from issues that have been discussed before in bioethics, but rather, are they substantially new? Do they, you know, do they differ in some substantial way? I think sometimes people who do neuroethics get danced into a corner that they really shouldn't let themselves get into by the challenge, what's really new here, right? Okay. So what is new here? Well, newness, uniqueness, always arguable, right? And in addition, I think this kind of categorical distinction is this qualitatively different from anything before. It's not especially important for understanding the issues or certainly for trying to make policy and how to deal with it. So let us move on and say, you know, I think a lot of the LCs, ethical, legal, and societal implications, are familiar. So with brain imaging, there are clearly issues of privacy that arise, you know, now, you know, to the extent that we can read various traits of a person from a brain image, you know, how much more does your amygdala, if you're a white person, how much more does your amygdala activate when shown a photograph of a black face than when shown a photograph of a white face, right? I mean, we know from enough research now that I would say this is pretty reproducible that the higher you score on implicit racism, the more that amygdala activation differs. Okay, so now, you know, I just say, John, come into my scanner, or I say, ah, applicants for the police academy, we are testing your memory for faces because, of course, an officer of the law must be a good witness and be able to remember who he is seen. Just lie here, look at these faces, we're going to show them to you later, see if you remember them. Some of the faces are white, some of the faces are black. We can look and see how your amygdala behaves, right? I mean, that might be a good kind of information to have, I don't know. But it certainly would be an intrusion into, you know, somebody's psyche that they might not feel, they might even be ashamed of what their amygdala is doing right now. So clearly there are privacy issues, not without plenty of precedent, most notably in genetics, okay? But unlike genetics where certainly disease vulnerability for certain diseases may have a pretty detectable genetic signature, psychological traits don't. I mean, it isn't like you can, you know, look for the gene or the, you know, complex trait, whatever, and, you know, say with any certainty how smart versus dumb, how authoritarian versus whatever the opposite of that, you know, pick your personality trait. But with brain imaging, you know, you can account for more of the variance at this point. It appears based on research so far. So there are certainly privacy issues. There's also hucksterism issues. You know, it will only charge you, you know, $8,000 to be scanned to prove to your wife that you are faithful, you know. Okay. Brain enhancement certainly has safety issues which, you know, may or may not really belong in a list of neuro or bioethical issues, but might. Freedom, however, you know, should you be free to put whatever chemicals you want into your brain? Should you be free to, you know, do better on your test because you studied super intensively with the help of Adderall? Some universities already have it in their honor code that that is a violation of the honor code. You are not supposed to get help in your schoolwork from chemicals. Fairness. You know, is it fair? I mean, that's why it's in the honor code, presumably. Is it fair to the kids who don't study with Adderall, you know, to be taking Adderall? Can a, you know, can a boss say, listen, everybody else in the office is pulling an all nighter once a week? You know, it's fantastic. You know, I'm getting six work days a week out of them. So how about it? Would you like to, you know, join the ranks of the super productive? In fact, he doesn't even have to say, please take ProVigil. He can just say, look at what all these other people are doing. That's fantastic. You know, there's lots of applicants who can do the same and not even mention the drug. Okay. So there are a lot of issues of freedom and fairness. Breaking out medicalization and agency, because I think they're a little less pragmatic and a little more philosophical. You know, is it a problem if we, you know, if we give a medical, if we give a medicine to change some psychological issue, to make you more focused and conscientious, to make you more loving and trusting in a relationship? Are we medicalizing effort and lack thereof? Are we medicalizing, you know, affection and trust issues? I don't know. And agency, you know, shouldn't you get ahead at work through your own agency, not by chemical crutch? That doesn't really, that question is just a question that I think can be asked. I'm not taking any particular side on it. So, but these are, you know, medicalization and agency are also things that we see in bioethics. I think it's worth saying, though, there are always new wrinkles with these, you know, new technologies. And I also want to emphasize that differences in degree can be just as important practically as differences in kind, right? I mean, you could say, yeah, but look, people drink coffee to study and, you know, so Adderall isn't any different. Why don't those universities lighten up and just not make it an honor code issue? But the thing is, Adderall or ProVigil can keep you studying and focused so much longer than coffee can that, you know, yeah, maybe it's not different in kind, it's only different in degree, but that is an important difference in degree, I would argue. Okay. Finally, there are some new issues for neuroethics, and this is pretty much where I'm going to end up. You know, one is neuroscience literacy. So neuroscience has really rapidly been taken up into so many different sectors of human life, right? I mean, we've got, you know, the marriage counselors, you know, going to oxytocin. We've got, you know, well, I mean, you go to a parent-teacher meeting and chances are good, the teacher is going to give you some brain babble, whether it's sensible or not. A lot of neuroeducation is, I think, pretty weak. But, you know, all the different examples I cited are cases where, you know, 20 years ago we were trying cases in court, fighting battles on land in the air, educating people, trying to be productive at work, all these different, you know, without the products of neuroscience helping, and now they are, and it looks like they're poised to enter more and more aspects of our life, and yet most people know nothing about neuroscience. And, you know, in high school, students are, you know, middle school and high school, they learn other sciences, we hope. They learn geology, you know, they know sedimentary rock is different from igneous, but neuroscience is not, last time I looked, which was a few years ago, but not that long ago, because I'm working with the Philadelphia School District. We have a new neuroscience course for grades 11 and 12, but in general there is no standard neuroscience taught in schools. The AP biology curriculum does not have a section on neuroscience. So that's a problem. I mean, I think we need a basic level of literacy, you know, you could say the same of probably all sciences, but it's kind of strangely missing in the knowledge base of the sort of average educated person. Okay. The next one is ownership. What I'm talking about is who decides what technologies get made and distributed and, you know, precisely what applications they're adapted to. Traditionally, medical advances in neuroscience were funded in this country by NIH and other countries by the equivalent organizations. Basic neuroscience, you know, maybe a little bit still at NIH, National Science Foundation, again, other nations have their equivalent organizations. Research and development on non-medical applications of neuroscience are by and large not publicly funded. Okay. So that means the people developing these technologies are not answerable to anybody. If we want to know things like how effective are they, what are the side effects, you know, they don't have to tell us. If we think, well, you know, new forms of computer gaming through brain interfaces will be even more gripping on the attention of our teenagers. I mean, that's going to be a big incentive for companies to develop that, but the public, the society, that's not really in its interests to have that application, right? So I think the ownership question is going to be very important going forward because it will determine what gets developed for what purposes. And right now, without any public funding, it's all up to, you know, sort of the, you know, private enterprise, which is not necessarily, you know, evil, but I think a more kind of diverse ecosystem of, you know, supporting the development of these technologies would be good. Finally, I just want to say, I think there's a kind of nihilism that can creep into our thinking about ourselves and our world and humanity. The more we internalize this idea that we are a pack of neurons, right? We're a pack of neurons. We can, you know, make them work better for us in certain ways by taking this pill. We can activate certain sets of neurons to perform better in that way by putting an electrode there. All of these technologies, and in general just the fascination that our culture now has of seeing ourselves as essentially, you know, fancy biophysical mechanisms, fancy computational networks is hard to reconcile with traditional notions of, you know, meaning and personhood and certainly religious ideas about, you know, soul and body. And I think, I mean, I do think there is, you know, I think it makes it a little bit easier to fall into a kind of nihilistic perspective on the world where, you know, it doesn't really matter. It's just a bunch of matter in a certain configuration. That's my two sense of philosophy in the end. So in some, where have we gotten? Well, I hope what I have presented to you is, you know, neuroscience is not giving us French pills and it's not controlling our brains. But it is actually here and now able to do certain things that affect our lives and perhaps the way we think of each other, these are the nihilism point and, you know, clearly is on a trajectory to do more and more of that. The issues raised by these developments are, you know, not utterly unique and new under the sun, but I think they do raise some interesting new issues and I am going to, I think, in there, yes, and thank you very much. A very good talk. Can you generalize all the results to another geographical area, another environment, another culture, that is comparative studies? Can you repeat the first part of your sentence, your questions? Yeah, if there is any comparative study in another society, in another geography, in another different... Yeah, that's a really interesting question. There are people working on neuroethics in very different cultures, in Asia, for example, I mean really all over the world. And I couldn't really tell you what is being learned about the differences. I suspect there are differences. Yeah, I'll just leave it there, but I think that's a good point. I mean, are there certain differences that you would predict or expect based on different cultures, for example? For example, the culture, you mentioned a different religion that can have another impact in the result and you can compare with another society, the Western or the other. I'm sorry, my... So, which of the... The value of society, culture, religion in another different society, for example, for Asia or for the inter-country to compare with here, the developed country or the developed country? No, I think it would be very, very interesting. I mean, you could imagine... Yeah, I mean, you could imagine very different attitudes toward enhancement cultures that are... I mean, American culture is very individualistic and it's considered to be a good trait to try to get ahead, right? Look for an edge, work harder and work longer and distinguish yourself. But certainly in many Eastern cultures, they're less individualistic and more... I don't know what's the word, sort of communal in their approach to judging behavior good or bad. And so, some of the enhancement practices might be viewed differently because of that. I don't know, it's very, very interesting. Thanks for an interesting talk on a complicated topic. Getting back to your paper on the meta-analyses, it looked like all the individual findings were not statistically significant from what you showed and that it was only after you manipulated the data that you'd find something significant. So is that just a product of just the meta-analysis? Well, you know, I could try to go back and find the... But I mean, so what the individual studies show is the effect size they found and the confidence interval around it. Yeah, yeah. So here's the thing, if you have a bunch of things, a bunch of studies, all going in the same direction non-significantly, a meta-analysis will decide that there's an effect there, right? Because what are the chances that... But if all the studies show that it's not significant, then can you make a claim that there is significance even by putting them together in a meta-analyses? Strangely enough, you can. And it's because significant versus not significant is not simply like a zero versus one kind of outcome. And then the question comes up, is it really clinically or real world significant? I mean, that's the other issue. Yeah, yeah, yeah, yeah, exactly. So if it's a tiny effect, even if it's statistically significant, if it's tiny, who cares, right? I think that's a very fair comment. I also think it's the case that tiny effects kind of, you know, if they are in play day in, day out, can snowball, can lead to, in the end, substantial advantage? I mean, especially in sort of winner-take-all contexts where only one person gets that fellowship or something like that. But, you know, in general, I mean, working memory training programs, behavioral kind of studies, the effect sizes are small. But, you know, people have the faith that, and maybe it's just a faith, I don't know, that just, you know, amping up your sort of basic cognitive processes that you bring to bear on learning new skills, performing different tasks. If you're able to consistently just bring a little more cognitive juice to that, that in the long run, the benefits might be substantial. It's an empirical issue, and nobody has really looked to see how much, you know, that much improvement in, say, working memory translates into for things that we would really care about. So following up on that, I'm getting the impression that a cup of coffee or a ham sandwich wouldn't have done just as good? Yeah, I mean, you know, there were no coffee and sandwich conditions in these studies, but had there been, yeah. And actually, there have been, the military has run some studies of modafinil pitted against, I think, amphenamine and caffeine. And at least for some measures, their equivalent, so the coffee, is effective. But not for everything. Hi, Dr. Farah. Nice talk. I just have a question regarding, like, the effects of nootropics and performance and the ethics of that, considering, you know, that there's certain genetic endowments that certain individuals might enjoy over others. Say for instance, if kids who are in poverty showed to be leveled off with kids who grew up in enriched households, would that somehow justify the use of nootropics in those instances? Or should we still say that, no, it's not a level playing field. When we've seen the effect of enriched upbringings and inequality and the effect that that has on academic achievement. Yeah, yeah. Yeah, I mean, that's a great question. You're touching on something that's near and dear to my heart, which is the effects of, you know, childhood socioeconomic status on later cognitive ability. You also mentioned genetics, and that's a, you know, mostly separate issue. You know, as for, you know, might, let me try to reword your question and tell me if that's still basically the question you're asking. If it turns out that we could close the achievement gap between poor kids and well-off kids with a drug like, whatever, drug X, would that be a good thing to do? Would people who are against using drug X for enhancement say, well, that's okay, you can do that? I think that's a conversation you could have. I do think you're going to freak a lot of people out by talking about drugging poor children. And, you know, I think as a practical matter, we're so far away from knowing what could be helpful for, you know, really knowing, like, what is it about growing up poor that, you know, that changes kids' abilities. But I think as a sort of, you know, distant future thought experiment, it's an interesting one. Certainly the differences within the normal population in whatever abilities you want to talk about are partly genetic. We know that from, you know, twin studies and so forth. And so if somebody is against improving your abilities by using drugs or think or whatever, you know, you could ask them, well, look, you know, why is it okay for John to be better at these things just because he got the right genes in the genetic lottery, but it's not okay for me to be better at it because I have an electrode on my head. But, you know, just sort of to the point, you know, the comp T study with, like, people with a subtype allele versus the other, some people just tend to perform better exams than others, and they have something to do with dopamine concentrations, and if that could be altered somehow by no tropics, that would bring the genetic element. And I think you would also argue for, like, the exceptions, right, we have some people from this advantage background, so you don't expect to reach those upper echelons of achievement, and yet they do. And we somehow use that as an example of, like, well, he did it without any advantage, you should too. Right, right, right. And it's sort of, I don't know. Agreed. Since you mentioned you're involved with education, could I just ask about neuroliteracy, because it seems like, as well as formal public, it's kind of critical to any broad-based discussion about this, and yet most people seem to get their understanding from the movies. So how do you feel about the prospect of getting people better informed about these issues that you've been talking about? Yeah, well, I mean, like, I wish I felt more optimistic. You know, there's, I mean, you know, education in general has lots of room for improvement in our country, and science education even more so. I think neuroscience education faces an additional barrier because most science teachers do not know any neuroscience, right? I mean, if you're a science teacher, you presumably majored in science or math in college. You know, you probably took a class, you know, you've probably taken one chemistry class at least, one physics class at least, biology, maybe you took an environmental studies class, and so forth. You probably did not take a neuroscience class. They probably weren't even offering a neuroscience class unless you graduated in, like, the last, you know, five or ten years. So one of the problems that we found in Philly introducing this course into the schools is that there's a real barrier for the teachers to teach it. They're eager to, and we've actually, we've actually taught them, but that, you know, you can't scale that up very easily. So I think that's a real problem, yeah. Hi, I wanted to ask you what you think we've learned, if anything, from how these issues have played out in traditional psychology. So we have a longer history of using behavioral interventions and assessments, you know, the same issues, misusing them, using them in legal situations where they probably shouldn't have weren't ready for prime time. Yeah. You know, as you know in clinical psychology we have our own ethics about first do no harm, but what have we learned from that and how would that apply, and what's different, I know the issue is this new, but what's different about using behavioral measures to enhance from using psychotropics to enhance? Yeah, yeah. I mean, that's a great, great question or a set of questions. I mean, specifically in regard to legal contexts, I heard a wonderful talk at the Society for Neuroscience meeting this past year by Judge Jed Rakoff, who gave a talk on neuroscience in law and took an historical approach and basically talked about how, you know, first the law was entranced with psychoanalytic thinking and, you know, looked for, you know, evidence of, you know, psychodynamic things that would, I can't remember the details, and the judges were clearly very influenced by that. And then, you know, there was the next phase of psychology and I do apologize for not remembering more, I need that company to hurry up and make the memory pill, maybe behaviorism or something like that. And, you know, when he recounted all of the sort of blunders and really unfortunate decisions that were made by people thinking they were being guided by the latest, most relevant science and basically said, like, you know, let's learn from past mistakes and go very cautiously into the age of neuro law. And I'm told if you, we're not at neuroscience, I don't know if you caught this talk, it's very, very good as one of the neuroscience and society talks, but I'm told that Jed Rakoff, R-A-K-O-F or FF has an article in a recent New York review of books that sounds from what somebody was telling me like, you know, basically the talk. And so I recommend that to anybody who's interested. But yeah, in general, I have to say one of, you know, as I said, I have a love-hate relationship with neuroethics and, you know, one occasion when my hate feelings are, you know, riled up is when people ignore the similarity between some of the issues with neuroscience and more traditional behavioral methods. You know, the neuroscience, you know, the exciting new neuroscience developments are only of interest, only worth thinking about in terms of their impact on society if they can do something above and beyond what behavioral methods already do. And that's why I think Emily Faulk's work is great. John Gabrielli, who did the reading prediction work, because they say, what's the best we can do with traditional methods? Let's see if we can do better with the brain. But also, you know, we have a tendency to kind of think of the brain as this, I don't know, like, ah, it's in the brain, so it must be true, it must be objective, whatever. And of course, it's not inherently more true or more objective than any other kind of data about a person, so yeah, thank you for raising that really good point. I'm afraid we should wrap up, but please, during the thank you.