AJOB Neuroscience最新文献

Healthcare decisions evaluate treatment risks and benefits, using a shared decision-making process between patient and clinician. Healthcare workers (HCWs) offer treatments based on condition specific evidence and expert knowledge. The patient evaluates treatment choices from their individual perception of how helpful or harmful treatment might be. This is a "risk-taking" decision. Those in a disorder of consciousness (DOC) have unreliable or absent awareness. They cannot participate in the risk-taking decisional process outlined above. Instead, family members and HCWs evaluate the options and determine how much risk is acceptable. We propose this is a distinctly different decisional process called "risk-making," and that for those in a DOC it is influenced by multiple poorly understood factors. The different ways that decisions are made on their behalf may be negatively impacting their healthcare and creating a distributive justice need. A "risk-making" theory of DOC healthcare decision-making was developed via narrative literature review. It aims to explicate the realities of DOC decision-making practices, and surface rarely discussed assumptions and social factors possibly impacting DOC healthcare for discussion and future exploration.

With the growth of neuroscience research, new neuroscience and society (NeuroX) fields like neuroethics, neurolaw, neuroarchitecture, neuroeconomics, and many more have emerged. In this article we report on lessons learned about mentoring students in the interdisciplinary space of neuroscience and society. We draw on our experiences with the recently launched Dana Foundation Career Network in Neuroscience & Society. This resource supports educators and practitioners mentoring students aiming to apply neuroscience in diverse fields beyond medicine and biomedical science. Through our programming, we identified three key lessons: (1) students are interested in exploring a wide range of neuroscience and society intersections; (2) outreach to underserved institutions generates avenues for students to join NeuroX conversations; and (3) by offering free access to online NeuroX resources and a network of subject-matter experts, the Career Network joins many partners helping to bridge the gap between neuroscience and society.

A significant goal of neuroethics is to offer neuroscientists, health care providers, law- and policy-makers and others, ways of thinking and acting on matters relevant to brain health and conditions that affect the central nervous system. This goal and related calls to action have been derived from theory or empirical work and bring different levels of normative force. To bring the latter in particular to the foreground of discussion, we explored for this Policy Forum different calls to action as they are associated with chosen terminology, the definitions of terms, origins to which they are benchmarked, locations in text, and targeted audiences. We find variability on all of these factors as they appear in the original foundational journals for neuroethics: AJOB Neuroscience and Neuroethics. We recommend that for a field whose very existence relies on uptake of advice, better consistency of language will improve credibility, acceptance, and implementation.

Navigating the demands of translational research requires not only addressing scientific issues, but also managing conflicting sociopolitical, cultural, psychosocial, epistemic, and ethical relationships across diverse communities and academic disciplines. Data and analysis of intensive interviews on these phenomena with researchers are presented here, which led to the co-design of a larger, ongoing study in a neuropsychiatric research community. The results generated a set of hypotheses-particularly regarding conflicts and challenges at the neuroscience-neuroethics interface as experienced by neuroscientists-which have not been fully articulated or examined in the neuroethics literature. Results suggest that knowledge system-level dynamics which limit reflexive engagement with the emotional-intellectual challenges of interdisciplinary work pose barriers to neuroethics-neuroscience integration. This article describes the data and methods which provide the foundation for a qualitative metascience model designed in response to these psychosocial and sociocultural challenges. The goal of qualitative metascience is to cultivate healthier and more translationally impactful neuroscience-neuroethics research ecosystems.

Deep Brain Stimulation (DBS) represents a key area of neuromodulation that has gained wide adoption for the treatment of neurological and experimental testing for psychiatric disorders. It is associated with specific therapeutic effects based on the precision of an evolving mechanistic neuroscientific understanding. At the same time, there are obstacles to achieving symptom relief because of the incompleteness of such an understanding. These obstacles are at least in part based on the complexity of neuropsychiatric disorders and the incompleteness of DBS devices to represent prosthetics that modulate the breadth of pathological processes implicated in these disorders. Neuroprostheses, such as an implanted DBS system, can have vast effects on subjects in addition to the specific neuropsychiatric changes they are intended to produce. These effects largely represent blind spots in the current debate on neuromodulation. Anthropological accounts can illustrate the broad existential dimensions of patients' illness and responses to neural implants. In combination with current neuroscientific understanding, neuropsychiatric anthropology may illuminate the possibilities and limits of neurodevices as technical "world enablers".

Scholarship in neuroethics and related disciplines has long reflected on the value of different conceptual models of disability and impairment. While this theoretical work is valuable, centering the voices of people with mental health conditions in neuroethics research can help us better understand how such models apply in everyday people's lives. Drawing on qualitative data from a study on mental health peer providers' lived experiences of recovery, this paper will demonstrate that peers borrow from both a neurodiversity framework and the medical model of disability, though their feelings toward the two models were often complex and ambivalent. These findings advance neuroethics by indicating that future research and clinical practice should take a nuanced approach to responding to the needs of people with mental health conditions and turn to peers as experts, honoring their values and recognizing both the promise and pitfalls of living with a mental health condition.