New capabilities of advanced neuroimaging technology have created the possibility of evaluating and predicting complex human behavior and disease in unprecedented ways. Our work to date has demonstrated a steady expansion of studies with evident social and policy implications, including studies of human cooperation and competition, moral reasoning, self-control, brain differences in violent people, genetic influences, and variability in patterns of brain development. Akin to genetic testing in the 1990s, such capabilities raise ethical issues about the conduct of research, clinical practice, and communication of information to the public. The overall goal of the present research, therefore, is to delineate the challenges introduced by these capabilities, focusing on functional magnetic resonance imaging (fMRI) as a model. Specifically, (Aim 1) in the research domain, we will identify emerging trends in human neuroimaging studies that have ethical, legal and social implications through focus groups, surveys and personal interviews with neuroimagers, stakeholders, and a multidisciplinary Advisory Board, and disseminate our findings and recommendations broadly. In conjunction, we will also publish a casebook of anomalous functional brain activation findings identified in research participants recruited to studies as healthy controls.
(Aims 2 and 3) Building on Aim 1 and the methodological promise of fMRI in two major clinical areas, we will identify the benefits and risks of functional neuroimaging in providing quantitative diagnostic confirmation of mental illness, using Major Depressive Disorder as the model. We will examine how practitioners anticipate that functional activation images will change their practice patterns and how patients anticipate that images will change their perception about their own condition. We will further identify ethical challenges in predicting subclinical disease with fMRI, using Alzheimer's Disease (AD) as the model, and consider the medical and social consequences of prediction using functional neuroimaging, predictive imaging for different clinical AD subgroups, and informed consent, access and cost, issues of privacy, counseling and education. Results of our work will reach scholars, professional and patient-advocacy groups across the neurosciences, bioethics, law and policy communities, and the media, and promote responsible communication and use of complex new information about human behavior represented by visual images of brain function.
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Racine, Eric; Karczewska, Marta; Seidler, Matthew et al. (2010) How the public responded to the Schiavo controversy: evidence from letters to editors. J Med Ethics 36:571-3 |
Racine, Eric; Dion, Marie-Josée; Wijman, Christine A C et al. (2009) Profiles of neurological outcome prediction among intensivists. Neurocrit Care 11:345-52 |
Lombera, Sofia; Illes, Judy (2009) The international dimensions of neuroethics. Dev World Bioeth 9:57-64 |
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Illes, Judy; Chin, Vivian Nora (2008) Bridging philosophical and practical implications of incidental findings in brain research. J Law Med Ethics 36:298-304, 212 |
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Illes, Judy; Lau, Patricia W; Giacino, Joseph T (2008) Neuroimaging, impaired states of consciousness, and public outreach. Nat Clin Pract Neurol 4:542-3 |
Racine, E; Amaram, R; Seidler, M et al. (2008) Media coverage of the persistent vegetative state and end-of-life decision-making. Neurology 71:1027-32 |
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