Elsevier

Brain and Cognition

Volume 50, Issue 3, December 2002, Pages 341-344
Brain and Cognition

Editorial
Neuroethics: An emerging new discipline in the study of brain and cognition

https://doi.org/10.1016/S0278-2626(02)00522-5Get rights and content

Abstract

The vision for the special issue in Brain and Cognition is rooted in the need to bring to the foreground the state of scientific knowledge in research and clinical neuroimaging ethics. To this end, the issue highlights a broad range of relatively unexplored ethical challenges in functional neuroimaging with MR, alone or in combination with other neuroimaging modalities, from imaging the central nervous system of the fetus in utero through neural activation patterns associated with cognition and behavior in childhood and in adulthood. Theoretical, practical, and ethical considerations at the heart of imaging healthy research subjects and cognitively compromised patients are explored.

Introduction

The 1990s represented a decade of profound accomplishment in the neurosciences. Significant strides in understanding basic brain and behavior relationships were made, new approaches for diagnosing and treating relentless neurodegenerative diseases were realized, and revolutionary new capabilities in medical imaging, biotechnology, and genetic medicine were achieved. These same accomplishments have also given rise to thorny moral and ethical quandaries not previously faced by our discipline. From questions concerning new kinds of information about personality, decision-making and emotional judgment, to questions about whether we should grow or harvest stem cells for the benefit of prolonging life in the neurologically ill, a new discipline of “neuroethics” has been born.

This special issue represents a first attempt to bring to the foreground the state of scientific knowledge in biomedical ethics and functional neuroimaging with MRI, only one of, but an important dimension in neuroethics today. The exponential growth of basic and clinical functional magnetic resonance imaging research (Illes, Kirschen, & Gabrieli, 2002) has defined MR technology as one of the most powerful tools in modern neuroscience. With functional MRI (fMRI), regional brain activation associated with mental events occurring over a few seconds can be studied noninvasively with a resolution of 1–4 mm. It is faster and less invasive than positron tomography (PET), and although slower than electroencephalography (EEG), it has far greater spatial resolution (see e.g., Moseley & Glover, 1995). Taking functional mapping to yet another level, diffusion tensor imaging (DTI) with MR allows the integrity of white matter tracts to be traced in an unprecedented way. With extraordinary promise, therefore, we are now seeing fMRI studies that probe into our deepest thoughts, define our engagement in complex cognitive behaviors across the lifespan, and provide measures of our ability to make judgments that invoke phenomena like rational decision-making and consciousness. The implications for this are profound, but inasmuch as knowledge may be powerful, runaway uses of this information may impose risks to investigators, patients, and society alike. What are our obligations for informing our research participants about the way that they make decisions consistent with a norm or outside it? How do we manage information about our biologic dispositions to addictive behaviors, aggression, memory loss or dementia? What are the social implications of cognitive profiling on individual employability, the health care system, in law?

To begin to respond to some of these questions, the papers in this special issue are divided equally between ethical challenges in basic research and challenges in applied clinical research: the first six papers cover legal issues in research, incidental findings, safety issues, neurotherapeutics, the potential for microstructural mapping of cognitive function, and neural maps of emotion and personality; the latter six contributions present clinical dilemmas in the fetal and pediatric clinical imaging environments, methodological considerations and responsibilities in adult clinical fMRI, and fMRI in the context of neurodegenerative disease. Many of the authors who have contributed to this special issue have tackled, for the first time, moral dilemmas embodied in the their respective areas, drawing fresh perspectives from principles in bioethics, a term first coined by Van Rensselar Potter in 1970 as “a new discipline that combines biological knowledge with a knowledge of human value systems.” (as cited in Jonsen, 1998).

Section snippets

Ethical challenges in neuroimaging research

In the first contribution to the research section, attorney Jennifer Kulynych’s paper, Legal and Ethical Issues in Neuroimaging Research: Human Subjects Protection, Medical Privacy, and the Communication of Research Results, rapidly draws our attention to issues of human subjects protections, but beyond the traditional requirements of institutional IRBs. She discusses new issues of privacy under federal medical privacy regulations, addresses responsible communication of research results, and

Ethical issues in applied clinical neuroimaging

The move to the clinical arena begins with two papers that address ethical and imaging issues of the fetus and newborn. Levine describes the evolution of MR imaging for prenatal diagnosis of central nervous system anomalies as an adjunct to conventional sonography. This information may change patient counseling and patient management, but the difficulties of predicting a child’s neurobehavioral future, as Stevenson and Goldworth also describe, extend well beyond the technical ones. How does MRI

Summary

The first specific references to “neuroethics” and neuroethical issues in the literature were made a little over a decade ago, describing the role of the neurologist as a neuroethicist faced with patient care and end-of-life decisions (Cranford, 1989), philosophical perspectives on the brain and the self (Churchland, 1991), and neurophysiological and neuropsychological influences on child-rearing and education (Pontius, 1993). Beyond these writings and the neuroimaging topics raised in this

Acknowledgements

The generous support of The Greenwall Foundation for making this effort possible is gratefully acknowledged.

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