Anticipating ethical challenges and disparities in the dissemination of novel neurotechnologies

预测新型神经技术传播中的伦理挑战和差异

• 批准号: 10448454
• 负责人: Winston Chiong
• 金额: $ 43.92万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-10 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10448454
• 关键词: Address; Adoption; Affect; Attention; Attitude; BRAIN initiative; Base of the Brain; Brain; Brain Diseases; COVID-19 pandemic; Caring; Clinic; Clinical; Collaborations; Communities; Complex; Consensus; Consent; Development; Devices; Ensure; Epilepsy; Ethics; Ethnic Origin; Ethnography; FDA approved; Face; Funding; Future; Goals; Health Promotion; Housing; Implant; Information Dissemination; Institution; Institutional Racism; International; Internet; Intervention; Interview; Investments; Justice; Leadership; Methods; Mind; Mission; Neurology; Neurosciences; Participant; Pathway interactions; Patient Care; Patients; Persons; Population; Privacy; Psychiatry; Public Health; Race; Recording of previous events; Religion; Reporting; Research; Research Methodology; Research Personnel; Risk; Role; Sampling; Science; Social Problems; Social Sciences; Socioeconomic Status; Specialized Center; Surveys; Techniques; Technology; Underserved Population; United States National Institutes of Health; Universities; Victimization; Work; base; community engaged research; community engagement; comparative; compliance behavior; disability; family burden; geographic disparity; health equity; improved; individual patient; innovation; insight; member; neglect; neural implant; neuroethics; neuropsychiatric disorder; neuropsychiatry; neuroregulation; neurotechnology; new technology; novel; novel strategies; novel therapeutics; prospective; racial and ethnic disparities; recruit; science and society; side effect; social; socioeconomic disparity; tool

PROJECT SUMMARY/ABSTRACT A central goal for the second half of the BRAIN Initiative is to develop new circuit-based treatments for brain diseases. However, improving care for neuropsychiatric illness will require not only discovering interventions, but also ensuring that research products meet patients’ needs and are accessible to underserved groups. While neuroethics to date has largely examined individualistic concerns (such as privacy, consent and identity), this application uses closed-loop neuromodulation as a circuit-based treatment paradigm for examining neuroethical challenges at a societal level such as equity/access and the democratization of research methods. To address challenging topics including socioeconomic, racial/ethnic, and geographic disparities will require special expertise in rigorous social science and in community engagement, to include perspectives missing in academic neuroethical discourse. Applying principles of community-engaged research, a Community Advisory Board will be recruited to meet quarterly with project leaders and advise on preliminary findings, research methods and the dissemination of results. Nationwide collaborations have been developed to facilitate research pursuing three specific aims: 1) Compare ethical concerns about novel neurotechnology among diverse groups; 2) Examine practice and patient factors in access to closed-loop neuromodulation in varied clinical settings; and 3) Investigate ethical and practical challenges in reducing barriers to closed-loop neuromodulation research. Aim 1 will address the views of prospective patients/users about neurotechnology in a nationally-representative sample with a focus on underserved groups. Aim 2 will examine the clinic setting via comparative ethnographic research in epilepsy centers using NeuroPace RNS treatment, which is currently the only FDA-approved and commercially available closed-loop brain implant, and therefore can be used to anticipate broader challenges in psychiatry and neurology with future applications of closed-loop approaches. Aim 3 will utilize a novel opportunity for studying ethical concerns in research through a new NIH-funded international collaboration to disseminate expertise and best practices in closed-loop neuromodulation. The approach is innovative, in the applicants’ view, addressing societal-level neuroethical concerns with advanced social scientific and community engagement methods not widely applied in neuroethics. The proposed research is significant because it addresses considerations of equity and democratization that are critical to future neurotechnology and neuroscience. Ultimately, this work will broaden the scope of normative issues addressed in neuroethics, such as distributive justice and tensions in broadening research. In neurotechnology, the work will contribute to fuller engagement with ethical challenges in the adoption of new techniques and the early integration of neuroethics in efforts to lower research barriers.

项目概要/摘要 BRAIN Initiative 下半年的中心目标是开发新的基于回路的治疗方法 脑部疾病。然而，改善神经精神疾病的护理不仅需要发现 干预措施，但也要确保研究产品满足患者的需求并且可供使用 服务不足的群体。虽然迄今为止的神经伦理学主要研究了个人主义问题（例如 隐私、同意和身份），该应用程序使用闭环神经调节作为基于电路的 用于检查社会层面神经伦理挑战的治疗范式，例如公平/机会和 研究方法的民主化。为了解决具有挑战性的话题，包括社会经济、 种族/族裔和地理差异将需要严格的社会科学和 社区参与，包括学术神经伦理话语中缺失的观点。正在申请 社区参与研究的原则，将招募一个社区咨询委员会来满足 每季度与项目负责人会面，并就初步发现、研究方法和 传播结果。全国范围内的合作已经发展起来，以促进研究的开展 三个具体目标：1）比较不同群体对新型神经技术的伦理担忧； 2) 检查不同临床中获得闭环神经调节的实践和患者因素 设置; 3) 研究减少闭环障碍的道德和实际挑战 神经调节研究。目标 1 将解决潜在患者/用户对以下方面的看法 神经技术在全国代表性样本中的应用，重点关注服务不足的群体。目标2将 使用 NeuroPace 通过癫痫中心的比较人种学研究检查临床环境 RNS治疗，这是目前唯一获得FDA批准并可商业化的闭环脑治疗 植入物，因此可用于预测精神病学和神经学领域更广泛的挑战 闭环方法的未来应用。目标 3 将利用一个新的机会来研究伦理 通过美国国立卫生研究院 (NIH) 资助的一项新的国际合作来传播专业知识和 闭环神经调节的最佳实践。申请人认为该方法具有创新性， 通过先进的社会科学和社区解决社会层面的神经伦理问题 参与方法在神经伦理学中尚未广泛应用。拟议的研究意义重大，因为它 解决对未来神经技术至关重要的公平和民主化考虑 神经科学。最终，这项工作将扩大规范问题的范围 神经伦理学，例如分配正义和扩大研究中的紧张局势。在神经技术领域， 工作将有助于更充分地应对采用新技术和 早期将神经伦理学纳入努力降低研究障碍。