Emerging ethical issues raised by highly portable MRI research in remote and resource-limited international settings.
Emerging ethical issues raised by highly portable MRI research in remote and resource-limited international settings.
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在偏远和资源有限的国际环境中高度便携式MRI研究提出的新出现的伦理问题。
DOI：
10.1016/j.neuroimage.2021.118210
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发表时间：
2021-09
期刊：
影响因子：
5.7
通讯作者：
Vaughan JT
中科院分区：
文献类型：
--
作者：
Shen FX;Wolf SM;Bhavnani S;Deoni S;Elison JT;Fair D;Garwood M;Gee MS;Geethanath S;Kay K;Lim KO;Lockwood Estrin G;Luciana M;Peloquin D;Rommelfanger K;Schiess N;Siddiqui K;Torres E;Vaughan JT
更小、更实惠、更便携的MRI脑部扫描仪为解决偏远和资源有限的国际环境中未满足的研究需求和长期存在的健康不平等提供了令人兴奋的机会。在低收入和中等收入国家（LMICs）开展基于实地的神经影像学研究可以提高当地进行结构和功能神经科学研究的能力，扩大对脑损伤、神经精神和神经发育障碍的了解，并最终提高地球仪临床诊断和治疗的及时性和质量。促进远程MRI研究还可以使神经科学的参考数据库多样化，提高对不同人群一生中大脑发育和退化的理解，并有助于建立可靠的婴儿和儿童发育测量方法。这些更深入的理解可以导致与社区合作的新战略，以减轻并有望克服对大脑发育和生活质量产生负面影响的挑战。尽管在偏远和资源有限的环境中使用高度便携式MRI的研究具有潜在的重要性，但很少有对随之而来的伦理、法律的和社会问题（ELSI）的分析。为了开始解决这一差距，本文介绍了在复杂的全球环境中创建道德和法律的指导的设想的多阶段和迭代方法的第一阶段的结果。第1节简要介绍了基于场的MRI研究的新兴技术。第2节介绍了我们在远程和资源有限的环境中为MRI研究生成合理用例并识别相关ELSI问题的方法。第3节分析了在偏远、资源有限的环境中设计和进行基于现场的MRI研究的核心ELSI问题，并提出了建议。我们认为，在这些情况下，基于现场的MRI研究的指导原则应该包括当地社区和研究参与者在整个研究过程中，以创造持续的本地价值。第4节提出了下一阶段工作的建议路径，可以进一步调整这些用例，解决道德和法律的问题，并与当地社区合作共同制定指南。
Smaller, more affordable, and more portable MRI brain scanners offer exciting opportunities to address unmet research needs and long-standing health inequities in remote and resource-limited international settings. Field-based neuroimaging research in low- and middle-income countries (LMICs) can improve local capacity to conduct both structural and functional neuroscience studies, expand knowledge of brain injury and neuropsychiatric and neurodevelopmental disorders, and ultimately improve the timeliness and quality of clinical diagnosis and treatment around the globe. Facilitating MRI research in remote settings can also diversify reference databases in neuroscience, improve understanding of brain development and degeneration across the lifespan in diverse populations, and help to create reliable measurements of infant and child development. These deeper understandings can lead to new strategies for collaborating with communities to mitigate and hopefully overcome challenges that negatively impact brain development and quality of life. Despite the potential importance of research using highly portable MRI in remote and resource-limited settings, there is little analysis of the attendant ethical, legal, and social issues (ELSI). To begin addressing this gap, this paper presents findings from the first phase of an envisioned multi-staged and iterative approach for creating ethical and legal guidance in a complex global landscape. Section 1 provides a brief introduction to the emerging technology for field-based MRI research. Section 2 presents our methodology for generating plausible use cases for MRI research in remote and resource-limited settings and identifying associated ELSI issues. Section 3 analyzes core ELSI issues in designing and conducting field-based MRI research in remote, resource-limited settings and offers recommendations. We argue that a guiding principle for field-based MRI research in these contexts should be including local communities and research participants throughout the research process in order to create sustained local value. Section 4 presents a recommended path for the next phase of work that could further adapt these use cases, address ethical and legal issues, and co-develop guidance in partnership with local communities.
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DOI：
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