Advanced Neuroimaging: Ethical, Legal, and Social Issues

描述(由申请人提供)：现代神经科学要应用于最大限度地促进公共健康，关键是要在研究的最早阶段确定和解决研究与伦理和社会的相互作用。我们第一个获奖期的目的是确定使用功能神经成像的神经行为研究的趋势，并预测研究和临床实践的伦理挑战。我们论证了在研究过程早期主动纳入伦理原则的必要性，超越了研究行为和保护人类受试者的既定标准。这一概念的证明来自于研究中偶然发现的临床异常的例子，越来越多的具有社会神经科学内容和在公众中广泛可见度的成像研究，以及新兴的商业化趋势。我们展示了图像在帮助诊断严重抑郁障碍方面的可取性，以及对治疗、自我形象和隐私的预期影响。我们进一步确定了人们对神经成像在预测疾病方面的高期望，以及与这种希望相比，仍处于早期最先进水平的神经成像带来的伦理悖论。在本文的目标1中，我们建议使用引用模式分析来检查神经伦理学与神经科学的整合。我们预测，神经科学中对伦理和社会问题的考虑正在增加，这一趋势可以通过同行评议的神经科学文献中与大脑和中枢神经系统具体相关的伦理主题来发现。为了验证我们的假设，我们将使用广泛用于文本挖掘的软件工具来分析和审查人类神经科学和生物伦理学的文章。这些措施，即使在神经伦理学的早期阶段，也将建立在文献中吸收神经伦理学的趋势，并通过持续的话语模式阐明神经科学中神经伦理学的认识论挑战。在目标2中，我们将使用脑成像-神经成像、成像基因组学和神经刺激-作为模型，评估将神经伦理学整合到神经科学中的特定研究人员的需求。我们将对不同研究环境中的个体研究人员进行大规模调查和焦点小组研究，以详细分析在研究规划过程中及早整合道德规范的优先事项、障碍和激励因素。结果将描述引用分析没有捕捉到的影响，特别是在神经科学研究人员的日常工作中出现的主题。在目标3中，我们将继续与关键的临床利益相关者进行翻译工作，将他们的声音带到用于诊断和干预的脑图方法的上游开发中。我们的目标是能够在研究过程的最早阶段纳入利益相关者的观点、关切和期望。我们的总体方法是通过协商的科学-社会过程来应对和解决棘手的伦理挑战，并最终通过促进这一过程的研究，最终提供将伦理学早期纳入基础和转化性神经科学的方法。为了将现代神经科学研究应用于最大限度地促进公共健康，关键是在研究的最早阶段确定和解决研究与伦理和社会的相互作用，以便在利益攸关方之间就技术承诺和限制达成共识，促进研究和应用，而不是不必要地阻碍，并在科学发展的同时为政策提供信息。我们将通过了解目前神经伦理学主题在人类神经科学文献中的渗透情况，确定使用脑成像方法的研究人员的伦理需求和优先事项，并将患者和从业者的声音引入研究设计过程，从而实现这一目标。

DESCRIPTION (provided by applicant): For modern neuroscience to be applied for maximum public health good, it is critical to identify and address the interactions of the research with ethics and society at its earliest stages. The aims of our first award period were to identify trends in neurobehavioral research that uses functional neuroimaging, and to anticipate ethical challenges for research and clinical practice. We demonstrated the need for proactively incorporating ethics principles early in the research process, beyond well-established standards for research conduct and protection of human subjects. This proof of concept was derived through examples of clinical anomalies detected incidentally in research, increasing numbers of imaging studies that have social neuroscience content and wide visibility in the public, and emerging trends for commercialization. We demonstrated the desirability of images for aiding the diagnosis of major depressive disorder and for the anticipated impact on treatment and self-image and privacy. We further identified high expectations of neuroimaging for predicting disease, and ethical paradoxes that the still early state-of-the-art raises in comparison with that hope. In Aim 1 of this continuation, we propose to examine the integration of neuroethics into neuroscience using citation pattern analysis. We predict that consideration of ethical and societal issues in neuroscience is increasing, and that this trend can be detected through the presence of ethics themes specifically related to the brain and central nervous system in the peer-reviewed neuroscience literature. To test our hypothesis, we will analyze empirical and review human neuroscience and bioethics articles with software tools widely used for text mining. Such measures, even at this early stage for neuroethics, will establish trends for the uptake of neuroethics in the literature and elucidate epistemological challenges for neuroethics in neuroscience through patterns of ongoing discourse. In Aim 2, we will evaluate specific investigator needs for integrating neuroethics into neuroscience, using brain mapping - neuroimaging, imaging genomics and neurostimulation - as the model. We will conduct a large-scale survey and focus group study of individual investigators in different research settings to provide a detailed analysis of priorities, barriers and incentives to integrating ethics early in the research planning process. Results will describe the influences not captured by the citation analysis and topics arising, in particular, in the daily work of neuroscience investigators. In Aim 3, we will continue our translational work with key clinical stakeholders to bring their voice to the upstream development of brain mapping methods for diagnosis and intervention. Our goal is to enable the incorporation of stakeholder views, concerns and expectations in the earliest stages of the research process. Our overall approach is to address and resolve difficult ethical challenges through a negotiated scientific-social process, and to ultimately deliver methods for integrating ethics early into basic and translational neuroscience through research that is empowering of that process. For modern neuroscience research to be applied for maximum public health good, it is critical to identify and address the interactions of the research with ethics and society at its earliest stages so that a common understanding about technological promise and limitations among stakeholders is achieved, studies and applications are facilitated and not unnecessarily impeded, and policy can be informed simultaneously as the science unfolds. We will pursue this goal by gaining an understanding of the current penetration of neuroethics themes in human neuroscience literature, identifying ethics needs and priorities of researchers who use brain mapping methods, and bringing the voice of patients and practitioners upstream to the research design process.