Global Neuroethics and Cultural Diversity: Some Challenges to Consider
Karen Herrera-Ferrá, MD, MA lives in Mexico City and founded the Mexican Association of Neuroethics. She has a Post-doctorate in Neuroethics (Neuroethics Studies Program at the Pellegrino Center for Clinical Bioethics (PCCB) at Georgetown University), a MA on Clinical Psychology, and an MD. She also has a Certificate on Cognitive Behavioral Therapy and another one on History of Religions. She has a one-year fellowship on Psychosis and another on OCD. She is currently a PhD Candidate on Bioethics. On May 2016 she developed a national project to formally introduce and develop neuroethics in her country. The main focus of this project is to depict and include national leaders in mental health, interested in neuroethics, so to inform and divulge this discipline among scholars and society. She also works as a mental health clinician in a private hospital, lectures in different hospitals and Universities in Mexico and is an Affiliated Scholar of the Neuroethics Studies Program at the Pellegrino Center for Clinical Bioethics PCCB at Georgetown University. Her interests and research focus on two main topics: recurrent violent behavior and globalization of neuroethics in Latin America.
|Image courtesy of Wikimedia.
While increased awareness of the scope of international issues is easier to accomplish, such awareness is less impactful if not followed by some kind of action. But if action is needed, the issue becomes: what is the moral framework that should guide it? More fundamentally, is there a unified moral framework that will allow us to address neuroethical issues in their cultural and social contexts? While the search for a unified framework might sound promising, its existence is not without difficulties. It requires rethinking usual approaches and ethical frameworks, making us aware of local context as a critical element when addressing the issues, and considering history and prevalent socio-cultural traditions that might play a key role in shaping people’s attitudes towards neuroscience, the questions it raises, and the potential ways to resolve them. This requires a good deal of conceptual work on issues such as how to understand notions of culture and difference and the potential stereotypical understanding of the values and beliefs of different groups. It also requires examination of the moral weight of particularities in order to ensure that inclusivity recognizes differences but at the same time does not overstate their impact or otherwise promotes further separation of other cultures.
a) Medical and Scientific: Both Mexico and Argentina are not only consumers of advanced neuroscientific techniques and neurotechnological tools in the clinical and research areas (e.g. Genomics, Diffusion Tensor Imaging, Deep Brain Stimulation, Transcranial Electric Stimulation, Transcranial Magnetic Stimulation) (5-12) but also producers of neuroscientific research (13,14). Importantly, while both countries share global medical priorities, such as the correct diagnosis and treatment of Alzheimer’s and Parkinson Diseases, there are additional local relevant neuropsychiatric priorities. For instance, in Mexico, Guatemala, Colombia, Brazil, etc., brain parasites accounts for up to 30% of epilepsy’s etiology (15).
|Image courtesy of Wikimedia.
b) Cultural: Another important issue is how mental health and wellbeing are perceived and addressed locally. For example in Mexico, the mix of western and pre-Hispanic philosophies has been an important factor in leading many patients to consider going to a priest or a Chamán before consulting a psychologist or a psychiatrist (16). On the other hand, in Argentina, the prevalence of a psychoanalytic culture often results in people visiting psychoanalysts rather than psychiatrists (1). Indeed, the discipline of psychology, particularly in its psychoanalytic form is part of the everyday landscape and has shaped the language and beliefs of a significant portion of the population (1, 2).
c) Social/practical: When thinking of a global, cross-cultural or international neuroethics it is key to consider international collaborations. This requires reflection of the day-to-day practical considerations of carrying crossborder collaborations. Cultural differences bring challenges in terms of different bureaucratic hurdles. In some locations, Institutional Review Boards (IRBs) might work quite differently, in terms of the expertise of their members, the number of meetings they have, the information requested for protocols that might not involve clinical research. In fact, in some places IRBs might not even exist. There might be places where collaboration with certain countries only occurs in certain research areas, but not so much in the field of neuroethics. In order to develop fruitful international collaboration to better understand neuroethical issues from a cross-cultural perspective more needs to be done to address those more day-to-day practical considerations.
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Herrera-Ferrá, K., Salles, A., and Cabrera, L. (2018). Global Neuroethics and Cultural Diversity: Some Challenges to Consider. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2018/04/global-neuroethics-and-cultural.html