By Laura Y. Cabrera
This post is part of a series featuring authors who have received the Neuroethics R01 (Research Project Grants) supported by the NIH BRAIN Initiative. These research projects specifically address prominent ethical issues arising from emerging technologies and advancements in human brain research.
A little bit over a year ago, my colleagues and I got very exciting news. The grant proposal we had submitted for the National Institutes of Health BRAIN Neuroethics funding had been accepted. This was the first major grant proposal I received as a Principal Investigator, and I am truly honored and excited to be given the opportunity to be doing the work that we have been carrying out for the past year.
I am an Assistant Professor at the
Center for Ethics and Humanities in the Life Sciences at Michigan State University (MSU), and my research focuses on Neuroethics. I now have the privilege of working on this grant with three very engaging and thoughtful colleagues at MSU: 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). Having such an interdisciplinary team is definitely one key strength of our project. As my colleague, Dr. McCright, puts it, “the insights we generate will likely transcend typical disciplinary boundaries and hopefully will be more meaningful to key stakeholders.” Another important part of our team is the students. We have a sociology graduate student, one medical student, and two neuroscience undergraduates working with us.
Our grant focuses on psychiatric electroceutical interventions (PEIs) – bioelectronic treatments that employ electrical stimulation to affect and modify brain function – with the goal to mitigate the symptoms of such disorders. There are PEIs, such as electroconvulsive therapy (
ECT), that have been used for several years in clinical practice, and although effective, remains a controversial intervention among patients and the public. There are novel PEIs, like deep brain stimulation (
DBS) that although used for several years in the treatment of tremor and Parkinson’s disease, are still under investigation for psychiatric disorders. Despite the invasiveness of the procedure, previous studies have found
over-optimistic portrays from the media,
optimistic views from the public and a diversity of views from patients. Thus, key stakeholders’ concerns, beliefs, and attitudes are likely to play a very important role in shaping the future adoption or rejection of novel PEIs. As novel and new forms of PEIs emerge in the neurotechnology landscape, it is imperative that we understand such concerns and attitudes as well as the related social policy choices at stake.
As part of our work, we are examining the ethical concerns, beliefs, and attitudes of psychiatrists, patients, and healthy members of the public (including caregivers) regarding the development and use of four (PEIs): ECT, transcranial magnetic stimulation (TMS), DBS, and adaptive implants for major depressive disorder. All of our research instruments ask specifically about the use of a given PEI for the treatment of depression.
During the first year of the grant we have focused on the developmental phase of the project, which involved expert interviews with psychiatrists, patients, and members of the public in Michigan. We are using this qualitative data, and input from our scientific advisory board, to guide the team in developing and administering an online survey experiment to a national sample of psychiatrists, patients, caregivers, and the general public. As part of year one, we have also been piloting the instrument survey we will use for the national surveys. The survey will contain questions to help the team determine how ethical concerns, beliefs, and attitudes are shaped by key technological characteristics of the four PEIs we are examining, as well as how those are similar or different among the different stakeholders.
Taken together, all the different results from the project will allow us to develop a guide to anticipate future policy challenges regarding PEI innovation and use.
If you are interested in learning more about the work we are doing, please feel free to check our
webpage.
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Dr. Cabrera is Assistant Professor of Neuroethics at the Center for Ethics and Humanities in the Life Sciences. She is also Faculty Affiliate at the National Core for Neuroethics, University of British Columbia. Dr. Cabrera’s interests focus on the ethical and societal implications of neurotechnologies used for treatment as well as for enhancement purposes. She has been working on projects at the interface of normative and empirical methods, exploring the attitudes of professionals and the public toward pharmacological and brain stimulation interventions, as well as their normative implications. She has also work on the ethical and social implications of environmental changes for brain and mental health. Her current work focuses on the responsible use of psychiatric electroceutical interventions. She received a BSc in Electrical and Communication Engineering from the Instituto Tecnológico de Estudios Superiores de Monterrey (ITESM) in Mexico City, an MA in Applied Ethics from Linköping University in Sweden, and a PhD in Applied Ethics from Charles Sturt University in Australia. She is a member of the Emerging Issues Advisory Task Force of the International Neuroethics Society as well as a member of the IEEE BRAIN Neuroethics group. Her career goal is to pursue interdisciplinary neuroethics scholarship, provide active leadership, and train and mentor future leaders in the field.
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