Junjie Yang

Deep brain stimulation (DBS) has emerged as a promising therapeutic intervention for individuals with treatment-resistant post-traumatic stress disorder (PTSD). However, the ethical acceptability of DBS as a neurointervention remains a subject of considerable debate. These concerns include the reliability of therapeutic efficacy, the evaluation of safety risks, the adequacy of informed consent processes, and the potential effects of DBS on personality, identity, agency, authenticity, autonomy, and self (PIAAAS). Moreover, current ethical assessments of DBS for PTSD may neglect cultural sensitivity, despite substantial cross-cultural differences in how therapeutic benefits are perceived, how traumatic memories are valued, and how personal change is understood, as illustrated in contexts such as the United States, Western Europe, Japan, and China. Therefore, to ensure the ethical application of DBS for PTSD, it is imperative to develop an evidence-based and culturally sensitive normative framework to guide clinical practice, striking a balance between the subjective pursuit of personal well-being and the objective demands of cultural norms.

Many countries have implemented taxes on junk food, believing this to have beneficial health outcomes. The Health Protection Argument maintains that (1) junk food is harmful to health; (2) consumers should reduce their consumption; (3) taxation is an effective means of achieving this goal, and governments should implement effective measures. Consequently, governments should tax junk food for health reasons. However, the premises in this argument are problematic. The definition of junk food and the causal relationship between junk food consumption and health outcomes remain ambiguous. Without clear health standards and justified public reasons, governments should not implement restrictive measures to reduce junk food consumption. Furthermore, the effectiveness of taxation as a policy tool, as well as the justification for prioritizing tax interventions over alternative measures, calls for closer evaluation. Therefore, the conclusion that governments should impose taxes on junk food is not sufficiently justified on health grounds.

People who have experienced traumatic events often suffer from the burden of painful memories. Recent advances in neuropharmaceuticals and neurotechnologies have enabled the modification and even erasure of traumatic memories, raising both therapeutic hopes and ethical concerns. One view argues that individuals have a moral obligation to preserve traumatic memories; therefore, erasing such memories amounts to an evasion of moral obligations and is therefore unacceptable. However, neither deontological ethics nor rule consequentialism can justify the claim that patients have an obligation to preserve their traumatic memories. In fact, memory erasure, as a transformative experience, situates individuals within a context of decision-making under uncertainty, thereby highlighting their moral obligations to themselves. Trauma survivors may seek memory erasure technologies as a way of honoring their moral obligations to their past, present, and future selves. In this sense, such interventions may be regarded as morally permissible.

People who have experienced traumatic events often suffer from the burden of painful memories. Recent advances in neuropharmaceuticals and neurotechnologies have enabled the modification and even erasure of traumatic memories, raising both therapeutic hopes and ethical concerns. One view argues that individuals have a moral obligation to preserve traumatic memories; therefore, erasing such memories amounts to an evasion of moral obligations and is therefore unacceptable. However, neither deontological ethics nor rule consequentialism can justify the claim that patients have an obligation to preserve their traumatic memories. In fact, memory erasure, as a transformative experience, situates individuals within a context of decision-making under uncertainty, thereby highlighting their moral obligations to themselves. Trauma survivors may seek memory erasure technologies as a way of honoring their moral obligations to their past, present, and future selves. In this sense, such interventions may be regarded as morally permissible.

Digital phenotyping is a novel approach to assessing individual health conditions by collecting and analysing data generated through interactions with digital devices. Although digital phenotyping is regarded as a promising tool for transforming psychiatric clinical practice, its potential to exacerbate epistemic injustice remains a central ethical concern. However, epistemic injustice in psychiatric digital phenotyping should be understood as rooted in specific forms of ignorance, which are not necessarily negative obstacles. On the contrary, phenomenological, objective and structural ignorance in psychiatric digital phenotyping can be leveraged to enhance patient epistemic empowerment and thereby help to overcome epistemic injustice.

Currently, we have developed a range of neurotechnologies to intervene in neurological and psychiatric disorders, with some of these interventions considered reversible. However, the term “reversibility,” although widely used in clinical and research contexts, remains ambiguously defined, and is often applied inconsistently in different contexts, which may pose ethical risks for patients. In fact, reversibility can be classified into three categories: ontological reversibility (including structural, functional, and psychological reversibility), methodological reversibility (including current and future methodological reversibility), and ethical reversibility (including autonomy, well-being, and harm reversibility). However, each of these forms of reversibility has inherent problems when applied in clinical settings. To ensure that patients are fully informed about the reversibility of neurotechnological interventions, we should adopt a perspective of practical reversibility to address this issue, improving the informed consent procedures for neurotechnological interventions, and clarifying the actual needs of patients regarding reversibility in terms of individual conditions, technological consequences, and value assessments.

Memory modification technology (MMT) refers to the use of neurotechnologies to intervene in memories. Many scholars have reflected on the ethical issues in MMT, but a comprehensive review of this topic has not been seen. This article presents the first scoping review study of ethical issues in MMT using a bibliometric and systematic approach. After thorough examination, 133 records of key literature are included in this scoping review. Six core ethical themes are extracted: (1) self, identity, and authenticity; (2) autonomy and informed consent; (3) welfare and happiness; (4) safety and risks; (5) responsibility and obligation; (6) social and legal justice. More detailed analyses are conducted on the moral stances and reasons held by different scholars concerning these ethical themes. As can be seen, current debates exhibit certain shortcomings, including ambiguous ethical concepts and a restricted scope of analysis. Therefore, we call for deeper reflections on the philosophical foundations, more precise definitions of ethical terms, and more comprehensive examinations of neurotechnological applications, in order to better address the ethical challenges in the future.