Harcourt argues that in clinical contexts, children and young people with mental health illness can experience epistemic, specifically testimonial, injustice when their perspectives are unjustifiably discounted by health service providers.1 Our goal in this commentary was to illustrate how caregivers, a critical component of CYP treatment triad, can also engage in testimonial injustice towards CYP patients. Testimonial injustice occurs when one suffers a credibility deficit and that credibility deficit is based on prejudice.2 Harcourt expands Fricker’s account of testimonial injustice by (...) arguing that for CYPs, the credibility deficits attributed to them by clinicians, for example, may result from epistemic arrogance in that CYPs are viewed as having unreliable knowledge about their condition. Harcourt writes: ‘Being a CYP is treated as a heuristic for epistemic unreliability across a wide range of domains’, including clinical settings. Harcourt’s expansion of Fricker’s account thus includes epistemic arrogance as an alternative necessary condition, in addition to prejudice, to apply the concept of testimonial injustice. We think Harcourt’s argument can also be extended to caregivers, who are central to the CYP treatment triad. We illustrate how this may be the case by drawing from research we conducted to understand the perspectives of clinicians and prospective families, both caregivers and paediatric patients with obsessive–compulsive disorder about the possibility of …. (shrink)

Motivated by exploitation concerns, we argue for the importance of participant engagement in basic human intracranial electrophysiology research. This research takes advantage of unique neurosurgical opportunities to better understand complex systems of the human brain, but it also exposes participants to additional risks without immediate therapeutic intent. We argue that understanding participant values and incorporating their perspectives into the research process may help determine whether and to what extent research practices and the resulting distributions of risks and benefits constitute exploitation (...) and contribute to building a brain research paradigm that is genuinely responsive to participant values. More broadly, we highlight the importance of paying attention to participant interests in non-therapeutic brain research. (shrink)

Dubljević et al. (2022) argue that neuroethics has a socio-political role that can “(1) serve to clarify and resolve conflicts, (2) orient the public with regards to the moral status of neurotechno...

In ‘Discrimination Against the Dying’, Phillip Reed argues that terminally ill patients are subjected to a distinct form of discrimination called ‘terminalism’. One of Reed’s primary examples of terminalism is right to try laws, which offer terminally ill patients the option to request medications that are not FDA-approved and without IRB involvement. In this analysis, we consider additional contextual factors about right to try, suggesting that it may not neatly count as an exemplar of terminalism. When pursued with appropriate protocols (...) and oversight, right to try has the potential to broaden treatment opportunities for the terminally ill by bypassing FDA and IRB restrictions, functioning as a less stringent alternative to expanded access for patients with limited time and dwindling options. Reed acknowledges that differential treatment of patients is not inherently unjust. For instance, Reed praises expanded access laws that grant patients with severe or life-threatening diseases access to treatment options otherwise unavailable. Patients not afflicted by severe illness or who have found success with standard treatment options are unlikely to face discrimination for inability to access nonessential treatment. Conversely, availability of these treatments for the terminally ill could enhance their well-being and prolong their lifespan. It is also significant to highlight important …. (shrink)

Brain-computer Interface (BCI) research is rapidly expanding, and it engages domains of human experience that many find central to our current understanding of ourselves. Ethical principles or guidelines can provide researchers with tools to engage in ethical reflection and to address practical problems in research. Though researchers have called for clearer ethical principles or guidelines, there is little existing data on what form these should take. We developed a prospective set of ethical principles for BCI research with specific guidelines and (...) shared them, via a survey, to participants at the 6th International BCI Meeting at the Asilomar Conference Center in 2016. Respondents were broadly supportive of principles of Care for Subjects, Modesty, Participation, Inclusivity, Relationality, Justice, and Social Impact. Principles more traditionally aligned with responsible conduct of research showed higher levels of endorsement. Researcher support for specific principle-based ethical guidelines varied with respect to stringency of researcher obligations. (shrink)

Nelson et al. (2023) make a unique contribution, raising key questions and considerations about the value of lived experiences as they pertain to normative debates in bioethics. The authors grapple...

Recent advancements in neuroengineering research have prompted neuroethicists to propose a variety of “ethical guidance” frameworks (e.g., principles, guidelines, framing questions, responsible research innovation frameworks, and ethical priorities) to inform this work. In this chapter, we offer a comparative analysis of five recently proposed ethical guidance frameworks (NIH neuroethics guiding principles, Nuffield Council on Bioethics, Global Neuroethics Summit Delegates, the Center for Neurotechnology’s neuroethical principles and guidelines, and the Neurotechnology Ethics Taskforce’s ethical priorities). We identify some common themes among these (...) frameworks, making explicit significant areas of convergence. We also highlight three areas of ethical consideration that have not received sufficient attention across these frameworks (extended care for research participants, cultural salience, and stakeholder input). Further attention and analysis of these three areas would improve the breadth and scope of ethical considerations for neuroengineering research. (shrink)