Dr. Cabrera published in March issue of ‘Journal of Cognitive Enhancement’

Laura Cabrera photoCenter Assistant Professor Dr. Laura Cabrera and Dr. Karen Herrera-Ferrá (Asociación Mexicana de Neuroética) are co-authors of an article published in the March 2020 issue of the Journal of Cognitive Enhancement. Their article is titled “¿Neuroensanchamiento?: Concepts and Perspectives About Neuroenhancement in the Hispanic Literature.”

Abstract: While neuroenhancement has been widely debated in the bioethics and neuroethics literature, the Anglo-American perspective has dominated a majority of these discussions. Thus, little is known about the motives and attitudes towards neuroenhancement in other cultures. Cultural values and linguistic peculiarities likely shape distinct attitudes and perspectives about neuroenhancement. In this paper, we aim to identify universals and points of divergence between the Anglo-American and the Hispanic discussions about neuroenhancement. We carried out a literature review of articles published in the Spanish language discussing perspectives and ethical issues around neuroenhancement. We analyzed the content for (1) the terms used to convey the concept of “neuroenhancement” and (2) the ethical concerns raised. Our results show a wide range of Spanish terms used to refer to neuroenhancement, as well as important differences on the scope and concerns raised. These results invite further research regarding cross-cultural perspectives on neuroenhancement and neuroethical discussion.

The full text is available online via Springer (MSU Library or other institutional access may be required to view this article).

Dr. Cabrera published in journal’s special section on feminist neurotechnologies

Laura Cabrera photoDr. Robyn Bluhm, Associate Professor in the Department of Philosophy and Lyman Briggs College, and Dr. Laura Cabrera, Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Translational Neuroscience, are co-authors of an article in the Spring 2020 issue of IJFAB: International Journal of Feminist Approaches to Bioethics.

Their article, “Deep Brain Stimulation and Relational Agency: Negotiating Relationships,” appears in a special section on feminist neurotechnologies. From the article’s introduction:

In this commentary, we consider three aspects of [Timothy] Brown’s discussion of DBS and relational agency: (1) the importance of thinking critically about what it means to have a relationship with a DBS device; (2) how the development of “closed loop” implants might change the kinds of relationships that are possible; and (3) the need to consider how an individual’s relationship with their device is shaped by their relationship with others in their lives. We see ourselves as building on, or offering suggestions for further developing, Brown’s important paper.

Drs. Bluhm and Cabrera are co-investigators on the project “Is the Treatment Perceived to be Worse than the Disease?: Ethical Concerns and Attitudes towards Psychiatric Electroceutical Interventions,” funded by the NIH BRAIN Initiative. Deep brain stimulation (DBS) is one of four types of psychiatric electroceutical interventions (PEIs) included in the scope of the project.

The full text is available online via University of Toronto Press (MSU Library or other institutional access may be required to view this article).

Center faculty published in ‘Brain Sciences’ on deep brain stimulation patient study

Laura Cabrera photoKaren Kelly-Blake photoCenter for Ethics Assistant Professor Dr. Laura Cabrera and Associate Professor Dr. Karen Kelly-Blake, along with Dr. Christos Sidiropoulos of the Department of Neurology & Ophthalmology, are co-authors of a new article in Brain Sciences. Their article “Perspectives on Deep Brain Stimulation and Its Earlier Use for Parkinson’s Disease: A Qualitative Study of US Patients” appears in a special issue on “Brain Stimulation and Parkinson’s Disease.”

Abstract
Background: Deep brain stimulation (DBS) is being used earlier than was previously the case in the disease progression in people with Parkinson’s disease (PD). To explore preferences about the timing of DBS, we asked PD patients with DBS whether they would have preferred the implantation procedure to have occurred earlier after diagnosis. Methods: Twenty Michigan-based patients were interviewed about both their experiences with DBS as well as their attitudes regarding the possible earlier use of DBS. We used a structured interview, with both closed and open-ended questions. Interviews were transcribed verbatim and analyzed using a mixed-methods approach. Results: We found that the majority of our participants (72%) had high overall satisfaction with DBS in addressing motor symptoms (mean of 7.5/10) and quality of life (mean of 8.25/10). Participants were mixed about whether they would have undergone DBS earlier than they did, with five participants being unsure and the remaining nearly equally divided between yes and no. Conclusion: Patient attitudes on the early use of DBS were mixed. Our results suggest that while patients were grateful for improvements experienced with DBS, they would not necessarily have endorsed its implementation earlier in their disease progression. Larger studies are needed to further examine our findings.

The full text is available online via MDPI.

Article from Dr. Laura Cabrera in November ‘Bioethics’ issue

Laura Cabrera photoAn article by Center Assistant Professor Dr. Laura Cabrera has been published in the November 2019 issue of Bioethics. The article, “A human rights approach to low data reporting in clinical trials of psychiatric deep brain stimulation,” advocates for “the importance of reporting clinical trial data of invasive procedures in highly vulnerable populations, such as psychiatric DBS trials.”

Abstract: The reporting of clinical trial data is necessary not only for doctors to determine treatment efficacy, but also to explore new questions without unnecessarily repeating trials, and to protect patients and the public from dangers when data are withheld. This issue is particularly salient in those trials involving invasive neurosurgical interventions, such as deep brain stimulation (DBS), for ‘treatment refractory’ psychiatric disorders. Using the federal database ClinicalTrials.gov, it was discovered that out of the completed or unknown‐status trials related to psychiatric DBS up to November 2018, only two had submitted results to ClinicalTrials.gov. These results suggest that, despite federal requirements to report clinical trial data, reporting on psychiatric DBS trials is problematically minimal. It is argued that a human rights approach to this problem establishes a legal and ethical foundation for the need to report clinical trial results in this area.

The full text is available online via Wiley Online Library (MSU Library or other institutional access may be required to view this article).

Dr. Laura Cabrera and co-authors published in ‘Nature Biomedical Engineering’

Laura Cabrera photoCenter Assistant Professor Dr. Laura Cabrera and co-authors Charles Sadle and Dr. Erin Purcell have an article in the August 2019 issue of Nature Biomedical Engineering. In “Neuroethical considerations of high-density electrode arrays,” the authors state that “the development of implantable electrode arrays that broadly and seamlessly integrate with brain tissue will require innovation that responsibly considers clinically relevant neuroethical concerns.”

The full text is available online via Nature (MSU Library or other institutional access may be required to view this article).

International Neuroethics Society on “Neuroethics at 15”

Laura Cabrera photoThe International Neuroethics Society (INS) Emerging Issues Task Force has a new article in AJOB Neuroscience on “Neuroethics at 15: The Current and Future Environment for Neuroethics.” Center Assistant Professor Dr. Laura Cabrera is a member of the task force, which advises INS by providing expertise, analysis, and guidance for a number of different audiences.

Abstract: Neuroethics research and scholarship intersect with dynamic academic disciplines in science, engineering, and the humanities. On the occasion of the 15th anniversary of the formation of the International Neuroethics Society, we identify current and future topics for neuroethics and discuss the many social and political challenges that emerge from the converging dynamics of neurotechnologies and artificial intelligence. We also highlight the need for a global, transdisciplinary, and integrated community of researchers to address the challenges that are precipitated by this rapid sociotechnological transformation.

The full text is available online via Taylor & Francis Online (MSU Library or other institutional access may be required to view this article).

New deep brain stimulation article from Dr. Cabrera in ‘World Neurosurgery’

Laura Cabrera photoCenter Assistant Professor Dr. Laura Cabrera is co-author of an article in the August 2019 issue of World Neurosurgery. In “Perspectives on the Earlier Use of Deep Brain Stimulation for Parkinson Disease from a Qualitative Study of U.S. Clinicians,” authors Dr. Cabrera, Dr. Harini Sarva (Weill Cornell Medical College), and Dr. Christos Sidiropoulos (Michigan State University Department of Neurology & Ophthalmology) share the results of Michigan-based clinician interviews about the use of deep brain stimulation (DBS) therapy in people with Parkinson’s disease. They conclude that there is a wide variation in clinicians’ parameters for when they suggest DBS as a treatment option for their patients.

The full text is available online via Science Direct (MSU Library or other institutional access may be required to view this article).

New health care justice article from Dr. Fleck in ‘Cambridge Quarterly of Healthcare Ethics’

Leonard Fleck photoCenter Acting Director and Professor Dr. Leonard Fleck has an article in the July 2019 issue of Cambridge Quarterly of Healthcare Ethics. “Precision QALYs, Precisely Unjust” addresses issues of health care justice and cost effectiveness.

Abstract: Warwick Heale has recently defended the notion of individualized and personalized Quality-Adjusted Life Years (QALYs) in connection with health care resource allocation decisions. Ordinarily, QALYs are used to make allocation decisions at the population level. If a health care intervention costs £100,000 and generally yields only two years of survival, the cost per QALY gained will be £50,000, far in excess of the £30,000 limit per QALY judged an acceptable use of resources within the National Health Service in the United Kingdom. However, if we know with medical certainty that a patient will gain four extra years of life from that intervention, the cost per QALY will be £25,000. Heale argues fairness and social utility require such a patient to receive that treatment, even though all others in the cohort of that patient might be denied that treatment (and lose two years of potential life). Likewise, Heale argues that personal commitments of an individual (religious or otherwise), that determine how they value a life-year with some medical intervention, ought to be used to determine the value of a QALY for them. I argue that if Heale’s proposals were put into practice, the result would often be greater injustice. In brief, requirements for the just allocation of health care resources are more complex than pure cost-effectiveness analysis would allow.

The full text is available online via Cambridge University Press (MSU Library or other institutional access may be required to view this article).

Tomlinson and De Vries: “Human Biospecimens Come from People”

Tom Tomlinson photoCenter Professor Dr. Tom Tominson and co-author Raymond De Vries have an article in the March-April 2019 issue of Ethics & Human Research, “Human Biospecimens Come from People.” The issue’s theme is “The Scientific Value and Validity of Research.”

Abstract: Contrary to the revised Common Rule, and contrary to the views of many bioethicists and researchers, we argue that broad consent should be sought for anticipated later research uses of deidentified biospecimens and health information collected during medical care. Individuals differ in the kinds of risk they find concerning and in their willingness to permit use of their biospecimens for future research. For this reason, asking their permission for unspecified research uses is a fundamental expression of respect for them as persons and should be done absent some compelling moral consideration to the contrary. We examine three moral considerations and argue that each of them fails: that there is a duty of easy rescue binding on all, that seeking consent creates a selection bias that undermines the validity of biospecimen research, and that seeking and documenting consent will be prohibitively expensive.

The full text is available online via Wiley Online Library (MSU Library or other institutional access may be required to view this article).

Dr. Cabrera a co-author of ‘Neuroethics’ article on deep brain stimulation and personal identity

Laura Cabrera photoCenter Assistant Professor Dr. Laura Cabrera and co-authors Dr. Robyn Bluhm and Rachel McKenzie have a new article available online in Neuroethics, “What we (Should) Talk about when we Talk about Deep Brain Stimulation and Personal Identity.” The article resulted from the team’s Science and Society at State funded project on “Psychiatric Interventions: Values and Public Attitudes.”

Abstract: A number of reports have suggested that patients who undergo deep brain stimulation (DBS) may experience changes to their personality or sense of self. These reports have attracted great philosophical interest. This paper surveys the philosophical literature on personal identity and DBS and draws on an emerging empirical literature on the experiences of patients who have undergone this therapy to argue that the existing philosophical discussion of DBS and personal identity frames the problem too narrowly. Much of the discussion by neuroethicists centers on the nature of the threat posed by DBS, asking whether it is best understood as a threat to personal identity, autonomy, agency, or authenticity, or as putting patients at risk of self-estrangement. Our aim in this paper is to use the empirical literature on patients’ experiences post-DBS to open up a broader range of questions – both philosophical and practical, and to suggest that attention to these questions will help to provide better support to patients, both before and after treatment.

The full text is available online via Springer Link (MSU Library or other institutional access may be required to view this article).