Achieving ethical integration in the development of novel neurotechnologies

项目总结/摘要 调节大脑功能的新技术在减轻持续负担方面具有巨大潜力 抑郁症和其他神经精神疾病，但也提出了具有挑战性的伦理和社会问题， 关于自我所有权和控制我们的思想，情绪和行动。由于这些原因， 总统的生物伦理委员会和其他专家呼吁将伦理和 神经科学从最早的研究阶段。这种整合需要跨人文学科的协作 和科学学科;为了使这项工作有效地塑造该领域未来的伦理发展， 还必须积极地让患者和研究人员参与到新神经技术的前沿。需要 神经科学的伦理整合将由一个具有以下专业知识的跨学科团队来解决： 神经科学、临床护理、法律、哲学和社会科学。这项工作将嵌入其中的两个 由DARPA资助的团队作为BRAIN计划的一部分，开发可植入的“闭环”设备， 都能监控并自适应地改变涉及情绪和行为调节的大脑系统。等 嵌入将有助于实现成功开发和采用所需新技术的总体目标， 通过认识、沟通和纳入伦理问题来治疗神经精神疾病 患者和其他利益相关者参与神经技术疗法的设计。创新比较 人种学技术将应用于人类神经技术临床前沿的人群， 追求三个具体目标：1）在现有的闭环临床应用中引发伦理问题 神经调节; 2）在闭环神经调节的调查研究中引起伦理问题， 评估学科背景对研究者道德评价的影响 性问题目的1将重点关注接受NeuroPace刺激的耐药癫痫临床患者， 这是目前被批准用于临床的唯一一种闭环大脑调节形式。目标2将侧重于研究 在DARPA赞助的一项研究项目中， 使用一种新型的植入式脑深部刺激器来测量和修改情绪的神经相关性。目标3 解决了如何将这些患者的经验和关注纳入临床医生和研究人员的 关于神经技术伦理发展的观点。这种方法是创新的，因为嵌入了一个 跨学科团队，直接在DARPA资助的一个高级定性方法的专业知识 神经技术计划将有助于在最早阶段纳入伦理问题， 技术开发。拟议的研究是重要的，因为它解决了核心的道德和社会问题。 这些问题将影响情绪闭环神经调节的可接受性，这是情绪调节的核心要素。 大脑计划，这将可能继续增长沿着我们先进的能力，以操纵人类 个脑袋

PROJECT SUMMARY/ABSTRACT New technologies that modulate brain function have tremendous potential for alleviating the persistent burden of depression and other neuropsychiatric disorders, but also raise challenging ethical and societal questions regarding self-ownership and control over our thoughts, emotions and actions. For these reasons, the President’s Bioethics Commission and other experts have called for the integration of ethics and neuroscience from the earliest stages of research. Such integration requires collaboration across humanistic and scientific disciplines; and for this work to effectively shape the future ethical development of the field, it must also actively engage patients and researchers at the forefront of novel neurotechnologies. The need for ethical integration in neuroscience will be addressed by a cohesive interdisciplinary team with expertise in neuroscience, clinical care, law, philosophy and social science. This work will be embedded in one of the two teams funded by DARPA as part of the BRAIN Initiative to develop implantable “closed-loop” devices that will both monitor and adaptively modify brain systems involved in mood and behavior regulation. Such embedding will facilitate the overall goal of enabling the successful development and adoption of needed new treatments for neuropsychiatric illness by recognizing, communicating, and incorporating the ethical concerns of patients and other stakeholders into the design of neurotechnological therapies. Innovative comparative ethnographic techniques will be applied in populations at the clinical frontier of human neurotechnology, in pursuit of three specific aims: 1) Elicit ethical concerns in existing clinical applications of closed-loop neuromodulation; 2) Elicit ethical concerns in investigational research on closed-loop neuromodulation of mood; and 3) Assess the influence of disciplinary backgrounds on investigators’ evaluation of ethical concerns. Aim 1 will focus on clinic patients with drug-resistant epilepsy undergoing NeuroPace stimulation, the only form of closed-loop brain modulation currently approved for clinical use. Aim 2 will focus on research patients with Parkinson’s disease and comorbid depression in a DARPA-sponsored research project to measure and modify neural correlates of mood using a novel implanted deep brain stimulator. Aim 3 addresses how these patient experiences and concerns can be incorporated in clinicians’ and researchers’ views about the ethical development of neurotechnology. The approach is innovative, as embedding an interdisciplinary team with expertise in advanced qualitative methods directly in a DARPA-funded neurotechnology program will facilitate the incorporation of ethical concerns in the earliest stages of technology development. The proposed research is significant, because it addresses core ethical and societal concerns that will affect the acceptability of closed-loop neuromodulation of mood, a core element of the BRAIN Initiative, and that will likely continue to grow along with our advancing ability to manipulate the human brain.