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.
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.
Last month Center Assistant Professor Dr. Laura Cabrera presented at the International Neuroethics Society (INS) Annual Meeting in Chicago. The meeting theme, “Mapping Neuroethics: An Expanded Vision” resulted in a gathering of a truly diverse group of scholars, scientists, clinicians, and professionals dedicated to the responsible use of advances in brain science.
Dr. Cabrera participated in the panel “Incapable Patients and Psychiatric Neurosurgery: What do Law and Ethics Have to Say?”, discussing the regulatory and ethical landscape around psychiatric neurosurgery. Additionally, Dr. Cabrera had two posters discussing results from her NEURON collaboration with Dr. Judy Illes (University of British Columbia), and two posters discussing results from her NIH BRAIN Initiative grant on psychiatric electroceutical interventions. Undergraduate research assistants Emily Castillo and Marissa Cortright were there to present the posters discussing results from the developmental stage of the ongoing NIH BRAIN project. They are pictured below with the posters “Public Views About Treating Depression Across Four Treatment Modalities” and “Perceived Invasiveness of Psychiatric Electroceutical Interventions as Treatment for Clinical Depression.”
Marissa Cortright with the poster “Public Views About Treating Depression Across Four Treatment Modalities.” Photo courtesy of Emily Castillo.
Emily Castillo with the poster “Perceived Invasiveness of Psychiatric Electroceutical Interventions as Treatment for Clinical Depression.” Photo courtesy of Emily Castillo.
Michigan State University students Marissa Cortright and Emily Castillo presented a poster at the 9th annual Mid-Michigan Symposium for Undergraduate Research Experiences (Mid-SURE), held July 24 at Spartan Stadium. Their poster, “Perceived Invasiveness of Psychiatric Electroceutical Interventions as Treatment for Clinical Depression,” presented research from an ongoing NIH BRAIN Initiative grant related to the ethical concerns and attitudes toward the use of psychiatric electroceutical interventions (PEIs) in treatment resistant depression.
Image description: Emily Castillo (left) and Marissa Cortright (right) pose for a photo with their poster at Mid-SURE on July 24. Photo courtesy of Peggy Anderson.
Cortright and Castillo, who are both majoring in neuroscience, have been working with MSU faculty mentors Laura Cabrera, Robyn Bluhm, Aaron McCright, and Eric Achytes. Their poster specifically addressed the invasiveness of multiple PEIs—electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), and adaptive brain implants (ABI)—based on the analysis of semi-structured interviews with Michigan-based psychiatrists. Cortright and Castillo concluded that the results of the interview analysis “suggest that while physical features are key for assessments of invasiveness, psychological, emotional, and lifestyle effects also play an important role.”
Cortright and Castillo both enjoyed the experience of presenting at Mid-SURE. “It provided a positive and engaging environment to share my work on the project as well as develop my professional skills,” said Castillo, adding, “I left the day feeling inspired and excited to keep working on a topic that is not only important me, but relevant and meaningful to many others.”
With attendees and presenters from many institutions and disciplines, Mid-SURE provided an opportunity to share research and network with a wide variety of individuals. “Many people were excited to learn about the PEIs and the potential to help lots of patients with treatment resistant depression,” said Cortright. “I learned that many people were interested in other segments of our project, and were anticipating the further research and results. I also learned that many people had no idea that PEIs even existed, and were extremely interested in the psychiatrist perspective on these therapies.”
“By sharing the research findings, I learned how different backgrounds can influence how data is interpreted across different disciplines,” said Castillo. “For example, I had an interesting conversation with a chemist who was curious about how the use of magnets or electrical stimulation can alter the chemical balance of the brain and how that relates to invasiveness. I thought this was an interesting question and enjoyed learning about how he interpreted the data coming from a chemistry background.”
Castillo continued: “My interactions with the other students and professors sparked great conversations about the stigma surrounding PEIs and mental illness. It reminded me how critical this research is in educating the public and informing future guidelines and policies surrounding these treatments.”
As the second year of the project approaches, Cortright and Castillo look forward to continuing the research and analysis. “I’m looking forward to looking deeper into the other neuroethical considerations and understanding how these topics vary between psychiatrists, patients, and the general public,” shared Castillo.
Please visit the project webpage to learn more about the NIH BRAIN Initiative grant “Is the Treatment Perceived to be Worse than the Disease?: Ethical Concerns and Attitudes towards Psychiatric Electroceutical Interventions,” led by Center Assistant Professor Dr. Laura Cabrera.
“Interpreting Patients’ Beliefs About Deep Brain Stimulation for Treatment-Resistant Depression: The Need for Caution and for Context” is an open peer commentary available in the latest AJOB Neuroscience issue. Michigan State University co-authors Dr. Laura Cabrera, Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Translational Science & Molecular Medicine, and Dr. Robyn Bluhm, Associate Professor in the Department of Philosophy and Lyman Briggs College, are currently working on an NIH BRAIN Initiative funded project on a related topic.
Dr. Cabrera and Dr. Bluhm focus on two points raised by the Lawrence et al. paper. First, they discussed a couple methodological decisions made by the authors which may have had an important influence on the results presented in the article. The second point relates to the work of Dr. Cabrera and Dr. Bluhm, examining differences in the bioethics literature’s discussion of deep brain stimulation and public comments on newspaper and magazine studies covering the intervention; this part of the open peer commentary shows how their findings can help to deepen the analysis by Lawrence et al.
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 in the January issue of Social Science & Medicine. The article, “Online comments about psychiatric neurosurgery and psychopharmacological interventions: Public perceptions and concerns,” was written by Dr. Cabrera, Marisa Brandt, Rachel McKenzie, and Robyn Bluhm.
Abstract: The field of biological psychiatry is controversial, with both academics and members of the public questioning the validity and the responsible use of psychiatric technological interventions. The field of neuroethics provides insight into these controversies by examining key themes that characterize specific topics, attitudes, and reasoning tools that people use to evaluate interventions in the brain and mind. This study offers new empirical neuroethical insights into how the public responds to the use and development of psychiatric technological interventions by comparing how the public evaluates pharmacological and neurosurgical psychiatric interventions, in the context of online comments on news media articles about these topics. We analyzed 1142 comments from 108 articles dealing with psychopharmacological and psychiatric neurosurgery interventions on websites of major circulation USA newspapers and magazines published between 2005 and 2015. Personal anecdote, medical professional issues, medicalization, social issues, disadvantages, scientific issues and cautionary realism were among the main themes raised by commenters. The insights derived from the comments can contribute to improving communication between professionals and the public as well as to incorporating the public’s views in policy decisions about psychiatric interventions.
The full text is available online via Science Direct (MSU Library or other institutional access may be required to view this article).
Continue reading below for a list of recent journal articles from Center faculty, including online first publications. MSU Library or other institutional access may be required to view these articles.
Recently assigned an issue
Stahl D. Patient reflections on the disenchantment of techno-medicine. Theoretical Medicine and Bioethics. December 2018;39(6):499-513. Available online November 1, 2018. View full text via Springer Link.
Cabrera LY, Bittlinger M, Lou H, Müller S, Illes J. Reader comments to media reports on psychiatric neurosurgery: past history casts shadows on the future. Acta Neurochirurgica. December 2018;160(12):2501-2507. Available online October 24, 2018. View full text via Springer Link.
Fleck LM. Healthcare Priority-Setting: Chat-Ting Is Not Enough; Comment on “Swiss-CHAT: Citizens Discuss Priorities for Swiss Health Insurance Coverage”. International Journal of Health Policy and Management. October 2018;7(10):961-963. Available online July 28, 2018. View full text via IJHPM.
Zhuang J, Bresnahan M, Zhu Y, Yan X, Bogdan-Lovis E, Goldbort J, Haider S. The impact of coworker support and stigma on breastfeeding after returning to work. Journal of Applied Communication Research. 2018;46(4):491-508. Available online July 19, 2018. View full text via Taylor & Francis Online.
Online first
Cabrera LY, Brandt M, McKenzie R, Bluhm R. Comparison of philosophical concerns between professionals and the public regarding two psychiatric treatments. AJOB Empirical Bioethics. Available online November 6, 2018. View full text via Taylor & Francis Online.
Bluhm R, Cabrera LY. It’s Not Just Counting that Counts: a Reply to Gilbert, Viaña, and Ineichen. Neuroethics. Available online October 27, 2018. View full text via Springer Link.
De Vries RG, Ryan KA, Gordon L, Krenz CD, Tomlinson T, Jewell S, Kim SYH. Biobanks and the Moral Concerns of Donors: A Democratic Deliberation. Qualitative Health Research. Available online August 10, 2018. View full text via SAGE Journals.
Cabrera LY, Goudreau J, Sidiropoulos C. Critical appraisal of the recent US FDA approval for earlier DBS intervention. Neurology. 2018. Available online June 13, 2018. View full text via Neurology.
Zhuang J, Bresnahan MJ, Yan X, Zhu Y, Goldbort J, Bogdan-Lovis E. Keep Doing the Good Work: Impact of Coworker and Community Support on Continuation of Breastfeeding. Health Communication. Available online May 17, 2018. View full text via Taylor & Francis Online.
A team led by Center Assistant Professor Dr. Laura Y. Cabrera will examine the ethical concerns, beliefs, and attitudes of psychiatrists, patients, and healthy members of the public, including caregivers, regarding the development and use of psychiatric electroceutical interventions (PEIs).
The U.S. National Institutes of Health BRAIN Initiative has awarded a four-year, $1,414,478 grant to the Michigan State University team, which also includes Professor Aaron M. McCright (Sociology), Associate Professor Robyn Bluhm (Philosophy and Lyman Briggs College) and Associate Professor Eric Achtyes (Director of the College of Human Medicine Division of Psychiatry and Behavioral Medicine).
Using electrical stimuli to treat psychiatric conditions, PEIs offer great promise in addressing the profound suffering related to such disorders. While PEIs have been available in various forms for years, divergent perceptions among medical professionals, patients, and the broader public have impeded their wider adoption in practice. Key stakeholders’ concerns, beliefs, and attitudes also might affect the future adoption of novel, more invasive PEIs. As new PEIs emerge in the neurotechnology landscape, it is urgent to understand such concerns and related social policy choices.
“This grant could not come at a better time, and we are grateful to the National Institutes of Health for recognizing the importance of this issue and supporting our proposal,” said Dr. Achtyes, who has seen firsthand the benefits of such treatments.
Pictured left to right: Laura Cabrera, Aaron McCright, Eric Achtyes, Robyn Bluhm.
Dr. Cabrera, whose research focuses on neuroethics and is leading the effort as the Principal Investigator, said, “I am delighted for this exciting opportunity to lead our team of experts and work together towards the sustained ethical development and translation of this type of psychiatric treatment.”
The significance of this work lies in anticipating potential future policy challenges in ways that will both effectively safeguard sustained ethical PEI development and translation, and benefit individuals affected by mental health disorders.
“One strength of our project is that we have experts from philosophy, neuroethics, psychiatry, and sociology working closely together. So, the insights we generate will likely transcend typical disciplinary boundaries and hopefully will be more meaningful to key stakeholders,” said Dr. McCright.
On February 18, Center Assistant Professor 
MSU Bioethics 