Assistant Professor Dr. Laura Cabrera is the author of a guest editorial on “The Need for Guidance around Recruitment and Consent Practices in Intracranial Electrophysiology Research,” published in the current issue of AJOB Neuroscience. Dr. Cabrera stresses the importance of the involvement of institutional review boards and funding agencies with regard to study recruitment and participant consent.
The full text is available online via Taylor & Francis Online (MSU Library or other institutional access may be required to view this article).
Center Assistant Professor Dr. Laura Cabrera is co-author of an article published last month in Frontiers in Human Neuroscience. Appearing in the Brain Imaging and Stimulation section of the journal, “International Legal Approaches to Neurosurgery for Psychiatric Disorders” was written by an international group of researchers.
Abstract: Neurosurgery for psychiatric disorders (NPD), also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law (what should be regulated), what types of regulations are required (eligibility criteria, approval procedures, data collection, and oversight mechanisms), and how to approach international harmonization given the potential migration of researchers and patients.
The full article is available online with free and open access from Frontiers.
Authors Aakash A. Dave and Dr. Laura Cabrera, Assistant Professor in the Center for Ethics, have an article in the December issue of the Journal of Cognitive Enhancement. The article, “Osteopathic Medical Students’ Attitudes Towards Different Modalities of Neuroenhancement: a Pilot Study,” was available online first in January of this year.
Abstract: The advancement of society has coincided with the development and use of technologies intended to improve cognitive function, which are collectively known as neuroenhancers. While several studies have assessed public perception towards the moral acceptability of pharmacological and device-based cognitive enhancers, just a few have compared perceptions across different modalities of cognitive enhancers. In this pilot study, 154 osteopathic medical students were asked to read one of six possible vignettes describing a certain type of improvement—therapy or above the norm—brought about by using one of three modalities—neurodevice, pill, or herbal supplement. Subjects answered questions that were designed to reveal their attitudes towards the given scenario. Our participants suggested that improvement using neurodevices and herbal supplements is more acceptable than when pills are used. We also found that acceptable attitudes towards cognitive enhancement were subserved by reasons such as “positive outcome from use” and “it’s safe” and unacceptable attitudes by reasons such as “safety concerns” and “no need.” Furthermore, a majority of participants would prefer to consult with a physician regarding the use of cognitive enhancers prior to accessing them. These results provide novel insights into pressing neuroethical issues and warrant further studying.
The full text is available online via Springer Link (MSU Library or other institutional access may be required to view this article).
Center Assistant Professor Dr. Laura Cabrera and Dr. Robyn Bluhm, Associate Professor in the Department of Philosophy and Lyman Briggs College, are co-authors of a commentary published in the latest issue of AJOB Neuroscience.
In “Fostering Neuroethics Integration: Disciplines, Methods, and Frameworks,” Drs. Cabrera and Bluhm comment on two papers that are part of the journal’s special issue on the BRAIN 2.0 Neuroethics roadmap.
Drs. Cabrera and Bluhm are co-investigators on an ongoing NIH BRAIN Initiative project,
“Is the Treatment Perceived to be Worse than the Disease?: Ethical Concerns and Attitudes towards Psychiatric Electroceutical Interventions.”
The full text is available online via Taylor & Francis Online (MSU Library or other institutional access may be required to view this article).
Center Assistant Professor Dr. Laura Cabrera and co-author Dov Greenbaum have written an editorial published in Frontiers in Genetics, titled “ELSI in Human Enhancement: What Distinguishes It From Therapy?”
The open access editorial, published June 23, is available in full from Frontiers in Genetics.
In a state of public health emergency, such as the one brought on by COVID-19, different countries have invoked extra powers to help mitigate the public health threat. These special powers would under normal circumstances be considered infringements on our liberty and privacy. A recent Wired article addressed that big tech companies like Google and Facebook are having discussions with the White House to share collective data on people’s movement during the current pandemic. For example, using phone location data or private social media posts to help track whether people are remaining at home and keeping a safe distance to stem the outbreak, and to measure the effectiveness of calls for social distancing. In the U.S., the government would generally need to obtain a user’s permission or a court order to acquire that type of user data from Google and Facebook. But as mentioned above, the government has broader powers in an emergency.
Obtaining this data could help governments prepare for the coming weeks of this public health emergency. For example, smart phone location data analysis from the New York Times has shed light on the disparities regarding which groups can afford to stay home limiting their exposure to the coronavirus. This is certainly useful to better understand the spread of the disease in different areas and across different socioeconomic groups. Facebook is working with Chapman University and other collaborators to develop maps that show how people are moving between areas that are hotspots of COVID-19 cases and areas that are not, and such maps could be useful in understanding the spread of the disease. Announced in a news release this month, Apple and Google have launched a joint effort to help governments and health agencies reduce the spread of the virus by using application programming interfaces and operating system-level technology to assist in enabling “contact tracing.”
Image description: an illustrated image of a pink brain coming out of the top of a person’s head; a magnifying glass with a brown handle, silver rim, and blue lens is above the brain as if looking into it. The background is light green. Image source: artwork from vecteezy.com.
While this sounds promising, one of the main obstacles has to do with concerns over the privacy of users whose data might be handed over by the companies. It would be unprecedented for the government to openly mine user movement data on this scale. To add to the issue, the current state of affairs where many more people now rely on digital tools to work or attend classes remotely, as well as to stay connected with family and friends, makes the amount and type of data gathered richer. However, as pointed out in a New York Times editorial, we should not sacrifice our privacy as a result of this pandemic.
Another relevant concern related to the use of collective data is government surveillance. For example, the use of mobile data to track the movement of individual coronavirus patients in China or South Korea can be seen as more controversial uses of the collected data.
It is certain that during this challenging time, data sharing and collaboration between academia, governments, civil society and the private sector is key to monitor, understand and help mitigate this pandemic. However, without rules for how companies should anonymize the data, and without clear limits on the type of data they can collect and how the data could be used and kept secure by researchers and governments, the perils might be greater than the promises. Furthermore, we need a clear path for what happens after all of this is over. For example, people should be given the option to delete user profiles they created as part of new work and school arrangements.
Given past scandals around privacy and transparency surrounding these big tech companies (in addition to the several scandals with the current government administration), it is hard to trust that the idea would be to only gather aggregate trends, and that they would not collect any identifying information about users, or track people over long periods beyond the scope of the pandemic.
Civil groups and academics have discussed the need to protect civil liberties and public trust, arguing for the need to identify best practices to maintain responsible data collection, processing, and use at a global scale.
The following are some of the key ideas that have been discussed:
In a public health emergency like the one we are living, some privacy intrusions might be warranted, but they need to be proportionate. For example, it would not be proportionate to gather 10 years of travel history of all individuals for the type of two-week incubation disease we are dealing with.
This type of government and big tech company partnership needs to have a clear expiration date, as there is a hazard for improper surveillance that could come with continuation of data gathering after the crisis is over. Given the historical precedents on how life-saving programs used in a state of emergency have continued after the state of emergency was resolved, we as a society need to be very cautious with how to ensure that such extraordinary measures do not become permanent fixtures in the landscape of government intrusions into daily life.
The collection of data should be based on science, and without bias based on nationality, ethnicity, religion, or race (unlike bias present in other government containment efforts of the past).
There is a need to be transparent with the public about any government use of “big tech data” and provide detailed information on items such as the information being gathered, the retention period, tools used, and the ways in which these guide public health decisions.
Finally, if the government seeks to limit a person’s rights based on the data gathered, the person should have the opportunity to challenge those conclusions and limits.
A few weeks ago the European Data Protection Board issued a statement on the importance of protecting personal data when used in the fight against COVID-19. The statement highlighted specific articles in the General Data Protection Regulation legislation. For example, Article 9 mentions that processing of personal data “for reasons of public interest in the area of public health, such as protecting against serious cross-border threats to health” is allowed, provided such processing is proportionate to the aims pursued. In the U.S. we are far from having such a framework to start discussing data collection, sharing, and use under the current circumstances.
There is no doubt as to potential public health benefits associated with analysis of such data and surveillance. For example, the utility of identifying individuals who have traveled to hotspot areas, or tracing and isolating contacts of those infected. However, without a clear framework on how digital data collection companies will address privacy and surveillance concerns, the more cautious we should be about access to other areas of our life, access that would also be shared with governments. Without due caution, not only will public trust continue to be undermined, but additionally people will be less likely to follow public health advice or recommendations, leading to even worse public health consequences.
Laura Cabrera, PhD, is an Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Translational Neuroscience at Michigan State University.
Join the discussion! Your comments and responses to this commentary are welcomed. The author will respond to all comments made by Thursday, May 7, 2020. With your participation, we hope to create discussions rich with insights from diverse perspectives.
Article narration by Liz McDaniel, Communications Assistant, Center for Ethics.
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Center 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. 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).
On February 18, Center Assistant Professor Dr. Laura Cabrera presented a talk entitled “The ethics of psychiatric neurosurgery” at Schuler Books & Music in Okemos. The event was part of the Cafe Scientifique series presented by the Lansing Community College Science Department.
In her presentation Dr. Cabrera shared results from her Science and Society at State grant with the audience, and discussed how the insights from that project led to her current NIH-funded project, “Is the Treatment Perceived to be Worse than the Disease?: Ethical Concerns and Attitudes towards Psychiatric Electroceutical Interventions.” The presentation also highlighted the role of neuroethics in examining and addressing public perceptions and values around psychiatric neurosurgery.
Visit the Lansing Community College website for information on future Cafe Scientifique events, which are free to attend and open to the public.
Center for Ethics Assistant Professor Dr. Laura Cabrera traveled to Mexico City earlier this month to give a keynote presentation at the 1st International Bioethics Congress: Knowledge, Law and New Technologies in Health.
Dr. Cabrera’s presentation, “Neuroethical Aspects of Psychiatric Neurosurgery,” gave an overview of her work as part of the NEURON Consortium with Dr. Judy Illes (University of British Columbia) on media and public perceptions around psychiatric neurosurgery. The congress had several parallel tracks touching on a variety of important bioethics topics, including neuroethics, nanomedicine, clinical ethics, research ethics, biolaw, medical devices regulation, and translational medicine.
Image description: Dr. Laura Cabrera stands while presenting her talk to attendees at the 1st International Bioethics Congress in Mexico City. Photo courtesy of Laura Cabrera.
Center Assistant Professor 
MSU Bioethics 