MAR 13, 2019 10:40 AM PDT

Neuroethics: Invasive Human Neurophysiological Recordings for Basic Science: Is Altruism Enough?

Presented at: Neuroscience 2019
C.E. Credits: P.A.C.E. CE Florida CE
Speakers
  • Professor of Neurosurgery and Radiation Oncology and affiliated faculty in Bioengineering and Neuroscience, UCLA Medical Center & UCLA Brain Research Institute
    Biography
      Dr Pouratian is a Professor of Neurosurgery and Radiation Oncology and affiliated faculty in Bioengineering and Neuroscience. He has broad yet in depth training in both functional neurosurgery and the acquisition and comprehensive analysis of multiple brain mapping modalities and has published extensively in the field of human brain mapping, comparing human brain mapping signals from multiple modalities, including functional MRI, optical imaging, evoked potentials, electrocortical stimulation mapping, electrocorticography, local field potentials, and single unit recordings. As a neurosurgeon, neuroscientist, and bioengineer, he has the unique perspective and training to integrate these fields and take advantages of the unparalleled opportunities presented by neurosurgery to study human brain function and design novel neurotechnologies. His current focus is understanding the network basis of disease and neuromodulatory therapies and designing novel network-based interventions to address neurological and psychiatric disease.
    • Adjunct Assistant Professor, David Geffen School of Medicine at UCLA, Philosophy Department, UCLA
      Biography
        Dr. Feinsinger is an Adjunct Assistant Professor in the Department of Medicine and Department of Philosophy at UCLA and has unique expertise in issues at the intersection of ethics, medicine, and biomedical research. She has a PhD in Philosophy and formal training in theoretical and applied ethics, the nature of language and communication, philosophy of mind, and linguistics. Her current work at the David Geffen School of Medicine involves researching, teaching, and designing curricular materials about the nature of the physician-patient and researcher-subject relationship, informed consent, power and exploitation in medicine, and vulnerable populations. Currently, she collaborates with the Department of Neurosurgery, researching the ethics of invasive non-therapeutic clinical neuroscience trials in humans. This work takes an initial look at the ethical complexities of altruism in motivating participants to enroll in these trials and develops an ethical framework for thinking about the unique challenges of non-therapeutic neurophysiologic research. Given her background in ethics and communication, she is able to work closely with clinicians, psychologists, and other interdisciplinary team members, bringing philosophical methods and ethical theory to the field of brain research.

      Abstract

      What motivates patients to participate in clinical trials? Discussions most often revolve around potential study participants’ perception of therapeutic benefit. Misconceptions about therapeutic benefit can lead to an inappropriate motivation to participate in trials and incomplete understanding of the goals (and risks) of a clinical trial. This concept of “therapeutic misconception” is often the center of ethical discussions of clinical trials. Given clinical trials are designed to develop generalizable knowledge and are developed on the premise of clinical equipoise (in which there is no clear evidence of superiority of one treatment over another), investigators and society may suspect, and perhaps should expect, altruistic motives of study participants. In the case of clinical trials without the potential for therapeutic benefit (such as those projects participating in the BRAIN Research on Humans Consortium), the concept of altruism as a motivating factor becomes exponentially more important, as there is clearly no intended direct therapeutic benefit to the individual or society. Despite the key role of altruism in motivating participation in such studies, there are few systematic studies of altruistic motives or methods to assess and protect against altruistic vulnerabilities. Our overriding hypothesis is thataltruistic motives and intentions are complex and cannot necessarily be accepted at face value.


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