Advanced Neuroimaging: Ethical, Legal, and Social Issues

描述：（由研究者提供）先进神经成像技术的新功能以前所未有的方式创造了评估和预测复杂人类行为和疾病的可能性。迄今为止，我们的工作已经证明了具有明显社会和政策意义的研究的稳步扩展，包括对人类合作与竞争、道德推理、自我控制、暴力人群的大脑差异、遗传影响以及大脑发育模式的可变性的研究。类似于20世纪90年代的基因检测，这种能力引发了有关研究行为、临床实践和向公众传播信息的伦理问题。因此，本研究的总体目标是描述这些能力带来的挑战，重点关注功能磁共振成像（fMRI）作为模型。具体而言，（目标1）在研究领域，我们将通过焦点小组、调查和对神经成像医师、利益相关者和多学科咨询委员会的个人访谈，确定具有伦理、法律和社会影响的人类神经成像研究的新兴趋势，并广泛传播我们的发现和建议。与此同时，我们还将发表一本关于在招募作为健康对照的研究参与者中发现的异常功能性脑激活发现的病例手册。（目标2和3）在目标1和fMRI在两个主要临床领域的方法学前景的基础上，我们将确定功能神经成像在提供精神疾病定量诊断确认方面的益处和风险，以重度抑郁症为模型。我们将研究从业者如何预测功能激活图像将改变他们的实践模式，以及患者如何预测图像将改变他们对自己病情的看法。我们将进一步确定使用fMRI预测亚临床疾病的伦理挑战，以阿尔茨海默病（AD）为模型，并考虑使用功能神经成像预测的医学和社会后果，不同临床AD亚组的预测成像，知情同意，获取和成本，隐私问题，咨询和教育。我们的工作成果将影响到神经科学、生物伦理学、法律和政策社区以及媒体的学者、专业人士和患者权益团体，并促进负责任的交流和使用由大脑功能的视觉图像所代表的关于人类行为的复杂新信息。

DESCRIPTION: (provided by investigator) 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.