41 found
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  1.  35
    Returning Individual Research Results from Digital Phenotyping in Psychiatry.Francis X. Shen, Matthew L. Baum, Nicole Martinez-Martin, Adam S. Miner, Melissa Abraham, Catherine A. Brownstein, Nathan Cortez, Barbara J. Evans, Laura T. Germine, David C. Glahn, Christine Grady, Ingrid A. Holm, Elisa A. Hurley, Sara Kimble, Gabriel Lázaro-Muñoz, Kimberlyn Leary, Mason Marks, Patrick J. Monette, Jukka-Pekka Onnela, P. Pearl O’Rourke, Scott L. Rauch, Carmel Shachar, Srijan Sen, Ipsit Vahia, Jason L. Vassy, Justin T. Baker, Barbara E. Bierer & Benjamin C. Silverman - 2024 - American Journal of Bioethics 24 (2):69-90.
    Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...)
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  2.  47
    Researcher Views on Changes in Personality, Mood, and Behavior in Next-Generation Deep Brain Stimulation.Peter Zuk, Clarissa E. Sanchez, Kristin Kostick-Quenet, Katrina A. Muñoz, Lavina Kalwani, Richa Lavingia, Laura Torgerson, Demetrio Sierra-Mercado, Jill O. Robinson, Stacey Pereira, Simon Outram, Barbara A. Koenig, Amy L. McGuire & Gabriel Lázaro-Muñoz - 2023 - American Journal of Bioethics Neuroscience 14 (3):287-299.
    The literature on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises concerns that these technologies may affect personality, mood, and behavior. We conducted semi-structured interviews with researchers (n = 23) involved in developing next-generation DBS systems, exploring their perspectives on ethics and policy topics including whether DBS/aDBS can cause such changes. The majority of researchers reported being aware of personality, mood, or behavioral (PMB) changes in recipients of DBS/aDBS. Researchers offered varying estimates of the frequency of PMB changes. A (...)
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  3.  35
    Researcher Perspectives on Ethical Considerations in Adaptive Deep Brain Stimulation Trials.Katrina A. Muñoz, Kristin Kostick, Clarissa Sanchez, Lavina Kalwani, Laura Torgerson, Rebecca Hsu, Demetrio Sierra-Mercado, Jill O. Robinson, Simon Outram, Barbara A. Koenig, Stacey Pereira, Amy McGuire, Peter Zuk & Gabriel Lázaro-Muñoz - 2020 - Frontiers in Human Neuroscience 14.
  4.  30
    DBS and Autonomy: Clarifying the Role of Theoretical Neuroethics.Peter Zuk & Gabriel Lázaro-Muñoz - 2019 - Neuroethics 14 (1):83-93.
    In this article, we sketch how theoretical neuroethics can clarify the concept of autonomy. We hope that this can both serve as a model for the conceptual clarification of other components of PIAAAS and contribute to the development of the empirical measures that Gilbert and colleagues [1] propose.
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  5.  20
    Identity Theft, Deep Brain Stimulation, and the Primacy of Post‐trial Obligations.Joseph J. Fins, Amanda R. Merner, Megan S. Wright & Gabriel Lázaro-Muñoz - 2024 - Hastings Center Report 54 (1):34-41.
    Patient narratives from two investigational deep brain stimulation trials for traumatic brain injury and obsessive‐compulsive disorder reveal that injury and illness rob individuals of personal identity and that neuromodulation can restore it. The early success of these interventions makes a compelling case for continued post‐trial access to these technologies. Given the centrality of personal identity to respect for persons, a failure to provide continued access can be understood to represent a metaphorical identity theft. Such a loss recapitulates the pain of (...)
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  6.  30
    Neural Safeguards against Global Impacts of Memory Modification on Identity: Ethical and Practical Considerations.Kristin Marie Kostick & Gabriel Lázaro-Muñoz - 2021 - American Journal of Bioethics Neuroscience 12 (1):45-48.
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  7.  49
    Looking for Trouble: Preventive Genomic Sequencing in the General Population and the Role of Patient Choice.Gabriel Lázaro-Muñoz, John M. Conley, Arlene M. Davis, Marcia Van Riper, Rebecca L. Walker & Eric T. Juengst - 2015 - American Journal of Bioethics 15 (7):3-14.
    Advances in genomics have led to calls for developing population-based preventive genomic sequencing programs with the goal of identifying genetic health risks in adults without known risk factors. One critical issue for minimizing the harms and maximizing the benefits of PGS is determining the kind and degree of control individuals should have over the generation, use, and handling of their genomic information. In this article we examine whether PGS programs should offer individuals the opportunity to selectively opt out of the (...)
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  8.  34
    Pediatric Deep Brain Stimulation for Dystonia: Current State and Ethical Considerations.Katrina A. Muñoz, Jennifer Blumenthal-Barby, Eric A. Storch, Laura Torgerson & Gabriel Lázaro-muñoz - 2020 - Cambridge Quarterly of Healthcare Ethics 29 (4):557-573.
    Dystonia is a movement disorder that can have a debilitating impact on motor functions and quality of life. There are 250,000 cases in the United States, most with childhood onset. Due to the limited effectiveness and side effects of available treatments, pediatric deep brain stimulation has emerged as an intervention for refractory dystonia. However, there is limited clinical and neuroethics research in this area of clinical practice. This paper examines whether it is ethically justified to offer pDBS to children with (...)
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  9.  37
    Neuroethics at 15: Keep the Kant but Add More Bacon.Gabriel Lázaro-Muñoz, Peter Zuk, Stacey Pereira, Kristin Kostick, Laura Torgerson, Demetrio Sierra-Mercado, Mary Majumder, J. Blumenthal-Barby, Eric A. Storch, Wayne K. Goodman & Amy L. McGuire - 2019 - American Journal of Bioethics Neuroscience 10 (3):97-100.
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  10.  33
    Ethical Analysis of “Mind Reading” or “Neurotechnological Thought Apprehension”: Keeping Potential Limitations in Mind.Peter Zuk & Gabriel Lázaro-Muñoz - 2019 - American Journal of Bioethics Neuroscience 10 (1):32-34.
    We appreciate Meynen’s examination of ethical implications of using neurotechnologies to decode neural data and make inferences about cognitive processes. Here, we address three issues that we beli...
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  11.  48
    Perspectives on informed assent and bodily integrity in prospective deep brain stimulation for youth with refractory obsessive-compulsive disorder.Jared N. Smith, Natalie Dorfman, Meghan Hurley, Ilona Cenolli, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A. Storch & Jennifer Blumenthal-Barby - 2024 - Clinical Ethics 19 (4):297-306.
    Background Deep brain stimulation is approved for treating refractory obsessive-compulsive disorder in adults under the US Food and Drug Administration Humanitarian Device Exemption, and studies have shown its efficacy in reducing symptom severity and improving quality of life. While similar deep brain stimulation treatment is available for pediatric patients with dystonia, it is not yet available for pediatric patients with obsessive-compulsive disorder, although soon could be. The prospect of growing indications for pediatric deep brain stimulation raises several ethical concerns relating (...)
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  12.  39
    Alienation, Quality of Life, and DBS for Depression.Peter Zuk, Amy L. McGuire & Gabriel Lázaro-Muñoz - 2018 - American Journal of Bioethics Neuroscience 9 (4):223-225.
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  13.  43
    Researcher Perspectives on Data Sharing in Deep Brain Stimulation.Peter Zuk, Clarissa E. Sanchez, Kristin Kostick, Laura Torgerson, Katrina A. Muñoz, Rebecca Hsu, Lavina Kalwani, Demetrio Sierra-Mercado, Jill O. Robinson, Simon Outram, Barbara A. Koenig, Stacey Pereira, Amy L. McGuire & Gabriel Lázaro-Muñoz - 2020 - Frontiers in Human Neuroscience 14:578687.
    The expansion of research on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises important neuroethics and policy questions related to data sharing. However, there has been little empirical research on the perspectives of experts developing these technologies. We conducted semi-structured, open-ended interviews with aDBS researchers regarding their data sharing practices and their perspectives on ethical and policy issues related to sharing. Researchers expressed support for and a commitment to sharing, with most saying that they were either sharing their data (...)
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  14.  37
    Testimonial injustice: considering caregivers in paediatric behavioural healthcare.Michelle Trang Pham, Eric A. Storch & Gabriel Lázaro-Muñoz - 2021 - Journal of Medical Ethics 47 (11):738-739.
    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 (...)
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  15.  24
    Treatment Search Fatigue and Informed Consent.Peter Zuk & Gabriel Lázaro-Muñoz - 2021 - American Journal of Bioethics Neuroscience 12 (1):77-79.
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  16.  25
    Trust in Neuroethics.Michelle Trang Pham & Gabriel Lázaro-Muñoz - 2022 - American Journal of Bioethics Neuroscience 13 (1):33-35.
    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...
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  17.  31
    Is Real-Time ELSI Realistic?John M. Conley, Anya E. R. Prince, Arlene M. Davis, Jean Cadigan & Gabriel Lazaro-Munoz - 2020 - AJOB Empirical Bioethics 11 (2):134-144.
    Background: A growing literature has raised—skeptically—the question of whether cutting-edge scientific research can identify and address broader ethical and policy considerations in real time. In genomics, the question is: Can ELSI contribute to genomics in real time, or will it be relegated to its historical role of after-the-fact outsider critique? We address this question against the background of a genomic screening project where we participated as embedded, real-time ELSI researchers and observers, from its initial design through its conclusion.Methods: As part (...)
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  18.  14
    Brain Device Research and the Underappreciated Role of Care Partners before, during, and Post-Trial.Amanda R. Merner, Joseph J. Fins & Gabriel Lázaro-Muñoz - 2022 - American Journal of Bioethics Neuroscience 13 (4):236-239.
    The number of clinical trials for experimental brain implants continues to grow, and with this growth comes an increased reliance upon patients with treatment-refractory conditions to volunteer as...
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  19.  23
    Research Comparing iPSC-Derived Neural Organoids to Ex Vivo Brain Tissue of Postmortem Donors: Identity After Life?Peter Zuk, Laura Stertz, Consuelo Walss-Bass & Gabriel Lázaro-Muñoz - 2022 - American Journal of Bioethics Neuroscience 13 (2):111-113.
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  20.  30
    Responsible Translation of Psychiatric Genetics and Other Neuroscience Developments: In Need of Empirical Bioethics Research.Gabriel Lázaro-Muñoz - 2017 - American Journal of Bioethics 17 (4):33-35.
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  21.  49
    Proceedings of the Eighth Annual Deep Brain Stimulation Think Tank: Advances in Optogenetics, Ethical Issues Affecting DBS Research, Neuromodulatory Approaches for Depression, Adaptive Neurostimulation, and Emerging DBS Technologies.Vinata Vedam-Mai, Karl Deisseroth, James Giordano, Gabriel Lazaro-Munoz, Winston Chiong, Nanthia Suthana, Jean-Philippe Langevin, Jay Gill, Wayne Goodman, Nicole R. Provenza, Casey H. Halpern, Rajat S. Shivacharan, Tricia N. Cunningham, Sameer A. Sheth, Nader Pouratian, Katherine W. Scangos, Helen S. Mayberg, Andreas Horn, Kara A. Johnson, Christopher R. Butson, Ro’ee Gilron, Coralie de Hemptinne, Robert Wilt, Maria Yaroshinsky, Simon Little, Philip Starr, Greg Worrell, Prasad Shirvalkar, Edward Chang, Jens Volkmann, Muthuraman Muthuraman, Sergiu Groppa, Andrea A. Kühn, Luming Li, Matthew Johnson, Kevin J. Otto, Robert Raike, Steve Goetz, Chengyuan Wu, Peter Silburn, Binith Cheeran, Yagna J. Pathak, Mahsa Malekmohammadi, Aysegul Gunduz, Joshua K. Wong, Stephanie Cernera, Aparna Wagle Shukla, Adolfo Ramirez-Zamora, Wissam Deeb, Addie Patterson, Kelly D. Foote & Michael S. Okun - 2021 - Frontiers in Human Neuroscience 15:644593.
    We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...)
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  22.  43
    What Happens After a Neural Implant Study? Neuroethics Expert Workshop on Post-Trial Obligations.Ishan Dasgupta, Eran Klein, Laura Y. Cabrera, Winston Chiong, Ashley Feinsinger, Joseph J. Fins, Tobias Haeusermann, Saskia Hendriks, Gabriel Lázaro-Muñoz, Cynthia Kubu, Helen Mayberg, Khara Ramos, Adina Roskies, Lauren Sankary, Ashley Walton, Alik S. Widge & Sara Goering - 2024 - Neuroethics 17 (2):1-14.
    What happens at the end of a clinical trial for an investigational neural implant? It may be surprising to learn how difficult it is to answer this question. While new trials are initiated with increasing regularity, relatively little consensus exists on how best to conduct them, and even less on how to ethically end them. The landscape of recent neural implant trials demonstrates wide variability of what happens to research participants after an neural implant trial ends. Some former research participants (...)
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  23.  38
    The Fiduciary Relationship Model for Managing Clinical Genomic “Incidental” Findings.Gabriel Lázaro-Muñoz - 2014 - Journal of Law, Medicine and Ethics 42 (4):576-589.
    This paper examines how the application of legal fiduciary principles , can serve as a framework to promote management of clinical genomic “incidental” or secondary target findings that is patient-centered and consistent with recognized patient autonomy rights. The application of fiduciary principles to the clinical genomic testing context gives rise to at least four physician fiduciary duties in conflict with recent recommendations by the American College of Medical Genetics and Genomics . These recommendations have generated much debate among lawyers, clinicians, (...)
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  24.  29
    Adolescent OCD Patient and Caregiver Perspectives on Identity, Authenticity, and Normalcy in Potential Deep Brain Stimulation Treatment.Jared N. Smith, Natalie Dorfman, Meghan Hurley, Ilona Cenolli, Kristin Kostick-Quenet, Eric A. Storch, Gabriel Lázaro-Muñoz & Jennifer Blumenthal-Barby - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (4):507-520.
    The ongoing debate within neuroethics concerning the degree to which neuromodulation such as deep brain stimulation (DBS) changes the personality, identity, and agency (PIA) of patients has paid relatively little attention to the perspectives of prospective patients. Even less attention has been given to pediatric populations. To understand patients’ views about identity changes due to DBS in obsessive-compulsive disorder (OCD), the authors conducted and analyzed semistructured interviews with adolescent patients with OCD and their parents/caregivers. Patients were asked about projected impacts (...)
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  25.  27
    Ethical and Social Considerations for Increasing Use of DTC Neurotechnologies.Kristin M. Kostick, Demetrio Sierra-Mercado & Gabriel Lázaro-Muñoz - 2019 - American Journal of Bioethics Neuroscience 10 (4):183-185.
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  26.  49
    Could Genetic Enhancement Really Lead to Obsolescence?Gabriel Lázaro-Muñoz, Kristin M. Kostick & Peter Zuk - 2019 - American Journal of Bioethics 19 (7):34-36.
    Volume 19, Issue 7, July 2019, Page 34-36.
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  27.  10
    Experience, Embodiment, and Post-Trial Obligations in Brain-Based Visual Prosthesis Research.Odile C. van Stuijvenberg, Erika Versalovic, Gabriel Lázaro-Muñoz & Peter Zuk - 2024 - American Journal of Bioethics Neuroscience 15 (3):181-184.
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  28.  35
    Hope and Optimism in Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives.Natalie Dorfman, Lilly Snellman, Ynez Kerley, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A. Storch & Jennifer Blumenthal-Barby - 2023 - Neuroethics 16 (3):1-15.
    IntroductionDeep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in “last resort” intervention scenarios such as DBS for refractory conditions.ObjectiveThis study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.Materials and MethodsSemi-structured interviews (...)
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  29.  71
    Genomic Contraindications for Heart Transplantation.Danton S. Char, Gabriel Lázaro-Muñoz, Aliessa Barnes, David Magnus, Michael J. Deem & John D. Lantos - 2017 - Pediatrics 139 (4).
  30.  5
    Deep Brain Stimulation for Childhood Treatment-Resistant Obsessive-Compulsive Disorder: Mental Health Clinician Views on Candidacy Factors.Ilona Cenolli, Tiffany A. Campbell, Natalie Dorfman, Meghan Hurley, Jared N. Smith, Kristin Kostick-Quenet, Eric A. Storch, Jennifer Blumenthal-Barby & Gabriel Lázaro-Muñoz - forthcoming - AJOB Empirical Bioethics.
    Introduction Deep brain stimulation (DBS) is approved under a humanitarian device exemption to manage treatment-resistant obsessive-compulsive disorder (TR-OCD) in adults. It is possible that DBS may be trialed or used clinically off-label in children and adolescents with TR-OCD in the future. DBS is already used to manage treatment-resistant childhood dystonia. Evidence suggests it is a safe and effective intervention for certain types of dystonia. Important questions remain unanswered about the use of DBS in children and adolescents with TR-OCD, including whether (...)
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  31.  25
    Curiosity and Uncertainty Resolution: Inflating the Perceived Utility of Genetic Information.Rémy Furrer, Dorit Barlevy, Stacey Pereira & Gabriel Lázaro-Muñoz - 2023 - American Journal of Bioethics 23 (7):53-55.
    When considering the question, “Is it just for a [genetic] screening program to give people all the information they want?” it is first necessary to understand how the information is being presente...
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  32.  20
    Nurtured Genetics: Prenatal Testing and the Anchoring of Genetic Expectancies.Rémy Furrer, Shai Carmi, Todd Lencz & Gabriel Lázaro-Muñoz - 2023 - American Journal of Bioethics 23 (3):42-44.
    If polygenic risk scores for traits are to be provided to parents before—as opposed to after—a child is born, these scores will provide the very first units of information upon which parents will b...
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  33.  31
    Capacities and Limitations of Using Polygenic Risk Scores for Reproductive Decision Making.Gabriel Lázaro-Muñoz, Stacey Pereira, Meghna Mukherjee, Kristin Marie Kostick-Quenet, Shai Carmi, Todd Lencz & Dorit Barlevy - 2022 - American Journal of Bioethics 22 (2):42-45.
    In their article “Implementing Expanded Prenatal Genetic Testing: Should Parents Have Access to Any and All Fetal Genetic Information?” Bayefsky and Berkman briefly mention that: “[s]ome are...
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  34.  28
    Researchers’ Ethical Concerns About Using Adaptive Deep Brain Stimulation for Enhancement.Kristin Kostick-Quenet, Lavina Kalwani, Barbara Koenig, Laura Torgerson, Clarissa Sanchez, Katrina Munoz, Rebecca L. Hsu, Demetrio Sierra-Mercado, Jill Oliver Robinson, Simon Outram, Stacey Pereira, Amy McGuire, Peter Zuk & Gabriel Lazaro-Munoz - 2022 - Frontiers in Human Neuroscience 16.
    The capacity of next-generation closed-loop or adaptive deep brain stimulation devices to read and write shows great potential to effectively manage movement, seizure, and psychiatric disorders, and also raises the possibility of using aDBS to electively modulate mood, cognition, and prosociality. What separates aDBS from most neurotechnologies currently used for enhancement is that aDBS remains an invasive, surgically-implanted technology with a risk-benefit ratio significantly different when applied to diseased versus non-diseased individuals. Despite a large discourse about the ethics of enhancement, (...)
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  35.  36
    Scientific Social Responsibility: Lessons From the Corporate Social Responsibility Movement.John M. Conley, Gabriel Lázaro-Muñoz, Anya E. R. Prince, Arlene M. Davis & R. Jean Cadigan - 2015 - American Journal of Bioethics 15 (12):64-66.
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  36.  21
    Reconceptualizing Triage to Incorporate Principles of Risk and Uncertainty: An Example from Deep Brain Stimulation Patients with Treatment-Resistant Disorders.Lavina Kalwani, Kristin Kostick, Eric A. Storch & Gabriel Lázaro-Muñoz - 2020 - American Journal of Bioethics 20 (7):207-209.
    Volume 20, Issue 7, July 2020, Page 207-209.
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  37.  34
    Operationalizing Agency in Brain Computer Interface (BCI) Research.Kristin Kostick, Peter Zuk & Gabriel Lázaro-Muñoz - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):203-205.
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  38.  23
    The Ethics of Getting Ahead When All Heads Are Enhanced.Kristin Marie Kostick, J. S. Blumenthal-Barby, Eric A. Storch & Gabriel Lázaro-Muñoz - 2020 - American Journal of Bioethics Neuroscience 11 (4):256-258.
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  39.  30
    Response to Open Peer Commentaries on “Looking for Trouble: Preventive Genomic Sequencing in the General Population and the Role of Patient Choice”.Gabriel Lázaro-Muñoz, John M. Conley, Arlene M. Davis, Marcia Van Riper, Rebecca L. Walker & Eric T. Juengst - 2015 - American Journal of Bioethics 15 (12):6-9.
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  40.  32
    Automatic Placement of Genomic Research Results in Medical Records: Do Researchers Have a Duty? Should Participants Have a Choice?Anya E. R. Prince, John M. Conley, Arlene M. Davis, Gabriel Lázaro-Muñoz & R. Jean Cadigan - 2015 - Journal of Law, Medicine and Ethics 43 (4):827-842.
    The growing practice of returning individual results to research participants has revealed a variety of interpretations of the multiple and sometimes conflicting duties that researchers may owe to participants. One particularly difficult question is the nature and extent of a researcher’s duty to facilitate a participant’s follow-up clinical care by placing research results in the participant’s medical record. The question is especially difficult in the context of genomic research. Some recent genomic research studies — enrolling patients as participants — boldly (...)
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  41.  27
    Enhance Diversity Among Researchers to Promote Participant Trust in Precision Medicine Research.Demetrio Sierra-Mercado & Gabriel Lázaro-Muñoz - 2018 - American Journal of Bioethics 18 (4):44-46.
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