Neuroplasticity, Identity, Freedom: A Contemporary Neuroethical Perspective

Introduction

The brain occupies a unique status in human life, distinguishing itself from other organs by its intimate relationship with consciousness, personal identity, memory, autonomy, and deliberative capacity. Neuroscience seeks to understand human behavior based on the structure and function of nervous systems, and one of its greatest challenges is explaining how neural circuits support adaptive behaviors and, simultaneously, how understanding neuronal functionality can contribute to preventing and treating its dysfunctions.

Interventions on the brain therefore raise profound ethical, philosophical, and social questions, requiring a reconsideration of fundamental concepts such as personhood, freedom, moral responsibility, and identity.

“For many of us it may be scary to learn about the real origins of our thoughts, emotions and personalities... our concepts of personhood, free will and personal responsibility.” (Human Brain Project, 2012, p. 53).

The accelerated development of neurotechnologies—including brain-computer interfaces, deep brain stimulation, non-invasive neuromodulation, and neural signal interpretation algorithms—has significantly amplified these concerns. In 2025, UNESCO approved the first international recommendation specifically dedicated to the ethics of neurotechnologies, recognizing the urgent need to protect human dignity, personal autonomy, mental privacy, and social justice in the development of these technologies (UNESCO, 2025).

Given this scenario, it becomes essential to develop an ethical framework capable of guiding the development, financing, use, regulation, and dissemination of new neurotechnologies. In line with the bioethical tradition, a model structured around three fundamental axes is proposed here: principles, virtues, and fundamental interests.

I. Neuroethics: principles, virtues, and fundamental interests.

At the heart of neuroethics lies a particularly challenging reality: neurotherapies arise from the need to alleviate or eliminate suffering caused by neurological and psychiatric disorders. However, this need is confronted with scientific uncertainty regarding the benefits and risks of these interventions, as well as with an incomplete understanding of the overall mechanisms of brain function (Levy, 2007).

The traditional division of bioethics into principlism, casuistry, or virtue ethics proves, in isolation, insufficient to assess the specificity of neuroscientific intervention. The unique status of the brain demands an integrated articulation of these models.

The Nuffield Council on Bioethics has identified five fundamental interests that should guide the ethical evaluation of neurotechnologies:

• Security protection, taking into account the risks associated with the expected benefits.

• Promoting autonomy . Neurological interventions fundamentally affect autonomy. Neuroethics also aims to support people's ability to make their own decisions while preserving their identity.

• Privacy protection . Data protection permeates the entire ethical framework in scientific research. In the case of neuroscientific techniques, some devices may collect sensitive personal data.

• Promoting equity , both in terms of access to innovative products and in terms of social stigma and discrimination.

• Promoting public understanding and trust in new neurotechnologies.

These interests must be matched by practical virtues:

• Innovation – expressed through technological advancement, identifying ways to provide greater access to therapies.

• Humility – expressed in the recognition of the limitations of current knowledge and the ability to use technologies to alleviate the damage caused by brain disorders.

• Responsibility – expressed in the consistency of research and clinical practices, avoiding exaggeration in communication about its potential uses.

• These virtues should be exemplified in the professional practices of all those involved in the therapeutic process, in the financing, use, regulation, and promotion of new neurotechnologies.

Despite this challenge, neuroplasticity, in itself, is not a bioethical issue. It is, however, an inherent capacity of neuronal functionality and, in this sense, ceases to be a purely neurological issue and takes on neuroethical dimensions.

Neuroplasticity refers to the nervous system's ability to modify its structure and function in response to experience, environment, and clinical intervention. While this characteristic is intrinsic to brain function, its technological manipulation raises significant ethical questions.

In the therapeutic field, neuroplasticity finds applications in pathologies such as Parkinson's disease, Alzheimer's disease, treatment-resistant epilepsy, and refractory depressive disorders. Techniques such as deep brain stimulation have demonstrated important clinical benefits, but simultaneously raise questions related to informed consent, decisional autonomy, and preservation of personal identity.

In particularly vulnerable patients, obtaining informed consent can prove especially complex, requiring enhanced ethical review protocols.

Although based on common bioethical challenges related to scientific research and safeguarded in the Additional Protocol to the Convention on Human Rights and Biomedicine on Biomedical Research, especially in articles 6, 7 and 8 [1] .

Despite this common basis, these two types of intervention have very different bioethical implications: the therapeutic dimension and the enhancement dimension.

a) Neuroplasticity and therapy

From a therapeutic perspective, neurological potentiation is characterized as a functional and direct intervention, while also being based on a structural conception of neuronal functioning and therefore entailing broad changes in the quality of life of patients. These broad-spectrum interventions raise underlying ethical questions by challenging principles such as Autonomy, Beneficence, and Dignity. This is, in fact, the great debate in the field of neurological intervention: by intervening in brain function, we act on an organ that has functions of coordination and regulation of the Self.

In a state of latent vulnerability resulting from a neurological problem, such as Alzheimer's or Parkinson's disease, any type of therapeutic intervention must take into account the issue of informed consent. In these types of diseases, it will always be difficult to know to what extent we are dealing with a patient with a minimum capacity to consent, even though they are conscious and generally react badly to any indication that may compromise their autonomy. At the same time, deeper implications are observed that point to the principle of beneficence. Advances in neurotherapies call into question the distinction between the principle of Beneficence and that of Non-maleficence. In other therapeutic areas, we can, with some clarity, perceive the difference between the two principles, following the doctrine of Beauchamp and Childress.

In the case of neurotherapies, this distinction is attenuated to the point where an intervention in a specific function can have radical consequences in the domain of autonomy. One of the paradigmatic cases is that of functional surgery: no tissue is destroyed or removed; instead, a stimulator is placed on each side of the brain, in a cell nucleus located deep within it, to which electrical stimuli generated by a battery placed under the skin in the chest are delivered. This stimulus alters the functioning of that nucleus and allows for the control of symptoms. Although the symptoms are controlled, there is a profound ethical question related to the autonomy of the patients.

b) Neuroplasticity and cognitive enhancement

Beyond its therapeutic dimension, neuroplasticity has paved the way for the development of neurocognitive enhancement strategies . This phenomenon includes transcranial stimulation, neurofeedback, cognitive psychopharmacology, and brain-computer interfaces.

The central issue lies in the growing ability to modify cognitive functions in healthy individuals, going beyond the traditional medical goal of treating disease.

According to Lighthart et al. (2023), this reality gave rise to the contemporary debate on so-called neurorights , including:

• cognitive freedom;

• mental privacy;

• mental integrity;

• psychological continuity.

The possibility of collecting, storing, and interpreting neural data demands new models of ethical and legal governance.

Conclusion

Neuroplasticity and a new theory of the spirit: a proposal

The objectives of this strategy are, therefore, to explore the social and ethical dimensions of research and to promote the involvement of policymakers and the general public.

The responsibilities of research have been debated for many years, both by policymakers and by the scientific community itself.

The common perception is that, so far, the debate has failed to influence the overall direction of the project or the surrounding political framework. Neuroscientists, physicians, and philosophers have contributed to a wide range of proposals, variously referred to as constructive technology assessment, interactive technology assessment, real-time technology assessment, upstream public engagement, and technology appreciation.

To implement these proposals, it is essential to develop a set of strategies based on consensus conferences, citizen juries, stakeholder workshops, deliberative surveys, and public dialogue, in order to ensure that the assessment of ethical and social implications becomes an essential component of technological development processes.

“ This is a sign that leading scientists increasingly recognize the right of public to participate in decisions about the applications of science – avoiding the risk that public 'mistrust' will hamper the introduction of valuable technologies ” [2] .

The immediate cause for the lack of a consensual theory of the spirit lies in the current state of neuroscience research and the lack of a comprehensive understanding of the role of neuronal activity in the process of thought emergence.

Given this context, and for a sustainable bioethical debate, we propose a strategy that articulates assertiveness (essentially related to the "state of the art" and current knowledge in neuroscience) and predictability (related to future hypotheses based on the agenda of the research process). The point of contact between these two vectors is made through the precautionary principle and a prudent attitude in decisions and in the proposal of a new theory of mind to be developed.

The greatest difficulty in presenting ethical proposals in neurostimulation situations lies in the lack of a coherent and robust explanation of how the human brain enables a person to know and represent objects through the mediation of neuronal sensory possibilities. Objects of all kinds, real or ideal, that are external to the individual. An idea is prior to and external to its cognition by the knowing person.

The difficulty of explaining sensory cognitive awareness is compounded by the even greater difficulty of explaining self-awareness, reflective awareness, or self-consciousness.

From among the many proposals, we have selected only a few, in summary. It is certain that no author is satisfied with the explanation of the mind that they present.

In the words of W. Boyd, no theory - whether based on neural correlates of consciousness, information processing, intentionality, phenomenology, higher-order representation, theoretical modeling, neural workspaces models, sensorimotor contingency theories, introspection of “lived experiences,” embodied cognition, or other views - is yet sufficient.

Wolf Singer views self-awareness as a temporal rather than a spatial unit. Therefore, the anatomical “correlate” should not be sought in brain structure, but in brain function that ensures neuronal synchronization. Given the extraordinary structural and functional complexity of the brain, as well as the already known mechanisms of self-organization, the focus should be placed on the overall brain function, which persists over time, from birth to death, and generates the illusion of self-awareness.

Joseph LeDoux, starting from the established fact that brain function depends on synaptic connections between neurons, considers self-awareness to be an emanation or emergence of synchronized synaptic activity. This statement is acceptable with regard to sensory cognitive awareness, but it is merely hypothetical with regard to self-awareness.

J.P. Changeux, in his book "L'Homme de vérité," adopts a concept, later developed with Dehaene, of self-awareness as a neuronal "workspace." Without going into detail, it can be said that in this conception, the thalamo-cortical connections that are built with sensory stimulations from the outside create a network of preferential neurons and synapses that stabilize in the form of what is called procedural memory. Each new stimulus is confronted with the existing network, which can reject or modify it. This pre-representation would be the neuronal workspace. Its constant and increasingly effective activity throughout life would create the illusion of self-awareness as the seat of the autonomy of the self. While a good explanation for cognition, it does not fulfill the scientific requirement of a consistent explanation of self-awareness.

Christof Koch, the most imaginative of current neuroscientists, recalling his years of work with Francis Crick, insists that the question must be resolved by presenting a theory that explains how and why the physical world is capable of generating "phenomenal" experience, that is, cognition. His theory, presented in a diffuse way, starts from information theory, which he defines as the reduction of uncertainty, to conclude with the concept of integrated information, which introduces a precise measurement of the extent of consciousness, the PHI, which quantifies the reduction of uncertainty in a given system. Creatures, animals or humans, with a high PHI will be better able to adapt to the surrounding world and find the best solutions. This theory is abstract and lacks any biological or structural foundation. Koch states: "Integrated information theory is in its infancy."

The difficulty in grounding an ethical analysis of any and all interventions on the brain lies in the fact that, lacking a sound theory on the brain-mind relationship, the ethicist must work with global and very general notions. Accepting that the brain is necessary for the expression of cognitive consciousness, for the valuation of perceptions, attributing meaning to them, and for the structuring of human decisions, they will use this platform to conduct analyses of individual and, primarily, social ethics.

At stake is the personal ethical responsibility of the neuroscientist when acting on brain structures to obtain a specific effect, and also the social ethics that require evaluating these activities from the perspective of the benefit to society of the expected results. It is a case-by-case ethics rather than an ethics of philosophical reflection.

As Judy Illes summarizes, " The new breed of so-called neuroethicists must lead the way in drawing from bioethics, genetics, and other disciplines to meet the unique challenges that are raised by the opportunity to study and probe the brain. To succeed, neuroethicists must keep up with the pulse of neuroscience, and pursue an ethically coherent agenda based on the needs of the neuroscience community and its interface with society ."

Neuroplasticity represents both an extraordinary therapeutic opportunity and an unprecedented anthropological challenge. The future of neuroscientific research will depend on the ability to articulate scientific innovation, moral responsibility, and the protection of human dignity.

References

Boyd, G. W. (2012). The body, its emotions, the self, and consciousness. Perspectives in Biology and Medicine, 55 (3), 362–377.

Changeux, J.-P. (2002). L'Homme de vérité . Odile Jacob.

Human Brain Project. (2012). Ethics and society report .

Koch, C. (2012). Consciousness: Confessions of a romantic reductionist . MIT Press.

LeDoux, J. (2003). Synaptic self . Penguin.

Levy, N. (2007). Neuroethics: Challenges for the 21st century . CambridgeUniversity Press.

Ligthart, S., Ienca, M., Meynen, G., et al. (2023). Minding rights: Mapping ethical and legal foundations of neurorights.

Singer, W. (2007). Understanding the brain. EMBO Reports, 8 (Special Issue), S16–S19.

UNESCO. (2025). Recommendation on the ethics of neurotechnology . Paris: UNESCO.

[1] General provisions

Article 3 – Primacy of the human being

The interests and welfare of the human being participating in research shall prevail over the sole interest of society or science.

Article 4 – General rule

Research shall be carried out freely, subject to the provisions of this Protocol and the other legal provisions ensuring the protection of the human being.

Article 5 – Absence of alternatives

Research on human beings may only be undertaken if there is no alternative of comparable effectiveness.

Article 6 – Risks and benefits

1. Research shall not involve risks and burdens to the human being disproportionate to its potential benefits.

2. In addition, where the research does not have the potential to produce results of direct benefit to the health of the research participant, such research may only be undertaken if the research entails no more than acceptable risk and acceptable burden for the research participant. This shall be without prejudice to the provision contained in Article 15 paragraph 2, sub-paragraph ii for the protection of persons not able to consent to research.

Article 7 – Approval

Research may only be undertaken if the research project has been approved by the competent body after independent examination of its scientific merit, including assessment of the importance of the aim of research, and multidisciplinary review of its ethical acceptability.

[2] File name: HBP-PS D16.2 State of the art review EPFL 120125.docx, pg. 62.