Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-25T19:54:14.957Z Has data issue: false hasContentIssue false
  • English
  • Français

Bridging Philosophical and Practical Implications of Incidental Findings in Brain Research

Published online by Cambridge University Press:  01 January 2021

Judy Illes  and
Vivian Nora Chin
Get access Rights & Permissions [Opens in a new window]

Extract

In Phillip Kerr’s 1994 spellbinding novel A Philosophical Investigation, the medical test to which the protagonist refers is a functional brain scan based on positron emission tomography (PET). It is used to run large studies of male and female brains and, following a lead suggested by animal studies, has been used to identify rare cases of human male subjects who lack the ventral medial nucleus (VMN). This nucleus, in the experiment (and the story), is hypothesized to inhibit the activity of the sexually dimorphic nucleus (SDN), a preoptic area of the male brain believed to be a repository of male aggressive response. Prior research, we learn from the plot, shows that 3 in 100,000 human males are VMN-negative. Thirty percent of those affected are believed to be in prison or to have a criminal record; 70% are believed to stabilize levels of aggression by producing increased levels of estrogen. Identities of subjects participating in the brain scan studies are protected through the conversion of real names to those of famous figures of the past — Bertrand Russell, Charles Dickens. Those for whom results are unfavorable are recontacted, and they are offered counseling.

Type
Symposium
Information
Journal of Law, Medicine & Ethics , Volume 36 , Issue 2 , Summer 2008 , pp. 298 - 304
Copyright
Copyright © American Society of Law, Medicine and Ethics 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kerr, P., A Philosophical Investigation (New York: Bantam Books, 1995): at 34.Google Scholar
Katzman, G. L. et al, “Incidental Findings on Brain Magnetic Resonance Imaging from 1000 Asymptomatic Volunteers,” JAMA 282, no. 1 (1999): 36–39.CrossRefGoogle Scholar
Grossman, R. I. and Bernat, J. L., “Incidental Research Imaging Findings: Pandora's Costly Box,” Neurology 62, no. 6 (2004): 849–850; Illes, J., “On the Contents of Pandora's Box of Incidental Findings in Brain Imaging Research,” Nature Clinical Practice Neurology 2, no. 2 (2006): 60–61.CrossRefGoogle ScholarPubMed
Illes, J. and Chin, V., “Trust and Reciprocity: Foundational-Principles in Human Subjects Imaging Research,” Canadian Journal of Neurological Sciences 34, no. 1 (2007): 3–4.CrossRefGoogle Scholar
Kim, B. S. et al, “Incidental Findings on Pediatric MR Images of the Brain,” American Journal of Neuroradiology 23, no. 10 (2002): 1674–1677.Google Scholar
Illes, J. et al, “Practical Approaches to Incidental Findings on Brain Imaging Research,” Neurology 70, no. 5 (2008): 384–390.CrossRefGoogle Scholar
Id., at 2.Google Scholar
Mamourian, A., “Incidental Findings on Research Functional MR Images: Should We Look?” American Journal of Neuroradiology 25, no. 4 (2004): 520–522.Google Scholar
Weber, F. and Knopf, H., “Incidental Findings in Magnetic Resonance Imaging of Healthy Young Men,” Journal of Neurological Sciences 240, nos. 1–2 (2006): 81–84.CrossRefGoogle Scholar
Illes, J. and Kirschen, M., “New Prospects and Ethical Challenges for Neuroimaging Within and Outside the Health Care System,” American Journal of Neuroradiology 24, no. 10 (2003): 1932–1934; Eaton, M. L. and Illes, J., “Commercializing Cognitive Neurotechnology: The Ethical Terrain,” Nature Biotechnology 25, no. 4 (2007): 393–397.Google Scholar
Illes, J. et al, “Discovery and Disclosure of Incidental Findings on Brain MRI in Research,” Journal of Magnetic Resonance Imaging 20, no. 5 (2004): 743–747.CrossRefGoogle Scholar
For more details, see Detection and Disclosure of Incidental Findings in Neuroimaging Research, available at <http://www.ninds.nih.gov/news_and_events/proceedings/ifexecsummary.htm> (last visited February 15, 2008) and MRI Research Safety and Ethics, available at <http://www.nimh.nih.gov/council/advis.cfm> (last visited February 15, 2008).+(last+visited+February+15,+2008)+and+MRI+Research+Safety+and+Ethics,+available+at++(last+visited+February+15,+2008).>Google Scholar
Kirschen, M. P. et al, “Subjects’ Expectations in Neuroimaging Research,” Journal of Magnetic Resonance Imaging 23, no. 2 (2006): 205–209.CrossRefGoogle Scholar
Hilgenberg, S., “Transformation: From Medical Student to Patient,” Annals of Internal Medicine 144, no. 10 (2006): 779–780.CrossRefGoogle Scholar
Id., at 6.Google Scholar
Kass, N. E. et al, “Balancing Justice and Autonomy in Clinical Research with Healthy Volunteers,” Clinical Pharmacology and Therapeutics 82, no. 2 (2007): 219–227; Miller, F. G., “Ethical Issues in Research with Healthy Volunteers: Risk-Benefit Assessment,” Clinical Pharmacology and Therapeutics 74, no. 6 (2003): 513–515.CrossRefGoogle Scholar