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Research unit director

The Neuroethics research unit pursues research to address the spectrum of challenges in neurological and psychiatric care such as providing quality patient information, diminishing stigma, and promoting respectful healthcare services. Our research program aims at bridging these various challenges to identify practical solutions.

This pillar examines ethical challenges in the public understanding of neurological and psychiatric conditions, the dissemination of neuroscience research, public engagement and the cultural representation of mental illness.

Non-medical use of prescription stimulants by Australian university students: Attitudes, prevalence of, and motivations for use
Jayne Lucke, Sharlene Kaye, Bradley Partridge, Matthew Dunn, Wayne Hall, Michael Farrell, Eric Racine

Transformation of everyday psychopathology: From ancient nevrosis to contemporary anxiety and depressions
Johanne Colin, Marcelo Otero, Henri Dorvil, Eric Racine, Constantin Tranulis

Generating genius: A critical examination of how an Alzheimer’s drug has become a “cognitive enhancer”1
Lucie Wade, Cynthia Forlini, Eric Racine
Donepezil, an acetylcholinesterase inhibitor, has been widely cited in media and bioethics literature as having the potential to improve the cognitive ability of healthy individuals. In both literatures, this claim has been widely supported by the results of a singly study (Yesavage et al. 2002) despite recent evidence suggesting that donepezil is not a proven cognitive enhancement agent. The factors contributing to this apparent discrepancy in the understanding of the effects of donepezil are unclear. We examine the nature of media and bioethics coverage of this landmark study, aiming to provide insight into how evidence from neurological research may be shaped within different discourses, potentially influencing important policy, ethics, and clinical practice decisions.

The search for a cure for Fragile X Syndrome (FXS) and Autism Spectrum Disorders (ASD): A critical examination of messages in the media4
Lucie Wade, Eric Racine
FXS is the most common form of inherited intellectual disability as well as the most frequent known genetic risk factor associated with ASD. Pharmaceuticals (e.g., mGluR5 inhibitors) are being tested in clinical trials as treatments for these neurodevelopmental disorders. This study aims to examine media and website coverage of mGluR5 drug development in order to assess their role in shaping views of individuals with neurodevelopmental disorders. Specifically, we will analyse whether the discourse is inclusive and accepting or othering by evaluating: (1) the language used to discuss FXS and ASD; (2) the extent to which fatalistic or nuanced depictions of life with FXS or ASD are presented; and, (3) whether ethical issues are raised.

Examining discourses on brain death3
Ariane Daoust, Eric Racine
Accepted by the medical community, the concept of brain death is still misunderstood by healthcare providers and the public and remains a source of controversy. This ongoing historical controversy intersects with debates about organ donation. This study examines how Canadian and American media have depicted brain death and aims to identify factors contributing to the confusion about brain death. Our results will inform strategies to address these issues, which have medical and ethical implications for both the public in its understanding of this controversial but tangible concept, and healthcare providers in their aim to offer the best quality of care.

This pillar examines ethical challenges in the delivery of accessible and high quality healthcare to neurological and psychiatric patients.

Experience and attitudes of healthcare professionals regarding ethics issues and end-of-life decision making in patients suffering from chronic disorders of consciousness3
Eric Racine, Ralf Jox, Katja Kuehlmeyer, Nicole Palmour, James Bernat, Richard Riopelle, Sam Shemie
In disorders of consciousness (coma, the vegetative state, and the minimally conscious state), the accurate understanding and communication of the diagnosis and prognosis is crucial for medical decision making. This study aims to better identify and characterize the attitude and experience of providers regarding ethical issues and decision-making in the care of patients suffering from disorders of consciousness.

A qualitative study of caregiver and patient perspectives on ethical and social issues in deep brain stimulation for Parkinson's disease and neuropsychiatric disorders5
Eric Racine, Emily Bell, Lila Karpowicz, Mary Ellen MacDonald, Debra Mathews, Mary Pat McAndrews, Abbas Sadikot
Deepbrain stimulation (DBS) is a treatment for Parkinson’s disease that offers advantages over drug therapy, especially for later disease stages. There are few if any empirical studies identifying and characterizing the ethical and social landscape of both current and emerging practices. Of particular ethical importance is the need to understand the experience of patients and caregivers. Accordingly, we will: 1) identify and characterize ethical and social issues in the application of DBS to Parkinson's disease based on patient and caregiver perspectives and experiences and 2) recommend venues for practice and research in the ethical use of DBS in Parkinson's disease and neuropsychiatric disorders.

Examining mental health provider and patient perspectives on ethical and social issues in the treatment of mental illness using deep brain stimulation (DBS)5
Emily Bell, Camillo Zacchia, Lila Karpowicz, Eric Racine
Investigations of deep brain stimulation (DBS) used to treat psychiatric conditions such as major depressive disorder, obsessive compulsive disorder (OCD), and Tourette's syndrome have shown some potentially promising results. However, important ethical and social challenges are associated with the technique and its use in psychiatric disorders, both with regards to research uses and its potential future in clinical care. Mental health stakeholders will be crucial in managing potential ethical and social concerns, and in guiding acceptance and uptake of the intervention. This research proposal aims to better understand ethical and social issues in DBS for psychiatric disorders from the perspective of mental health patients and trainees in allied health professions involved in the care of psychiatric patients.

Neuroprognostication and end-of-life decision-making in pediatric intensive care4
Isabelle Chouinard, Michael Shevell, Eric Racine
Withdrawal or withholding of treatment routinely precedes death in pediatric and neonatal intensive care units, and the conditions in which end-of-life decisions take place in the pediatric intensive care context leave a heavy burden on physicians who must participate in decisions typically made on the patients’ behalf. Prognostication is fundamental in the care of severely ill patients; however, its specific role in end-of-life decision-making in pediatric intensive care settings is less clear. Through participant observation and case study analysis, our research aims to identify the effects of (1) variability in neuroprognostication; (2) prognostic uncertainty; and (3) the context of evidence-based medicine on end-of-life decision-making for physicians in pediatric intensive care settings.

This pillar examines ethical challenges in the responsible conduct of neuroscience research to identify practices that best serve science and society.

Neuroethics of therapy and prevention of mental illness in early adolescence, childhood and adolescence
Kohji Ishihara, Osamu Sakura, Tanno Yoshiyuki, Manabu Oi, Tamami Fukushi, Kevin Chien-Chang Wu, Eric Racine

The neuroethics of detecting, suppressing and enhancing memory
Jennifer Chandler, Eric Racine

Evidence-based ethics in imaging genetics: Perspectives of research participants2
Nicole Palmour, Eric Racine
Neuroimaging innovations have spurred discussion about contemporary ethical uses of translational neuroscience within and beyond healthcare. Have the ethical issues been sufficiently addressed within each domain or does the integration of technologies change the ethical topography? We will delineate the contours of the issues and highlight the gaps in ethical coverage.

The ethics of neurosurgical innovation: What does the evidence say?2,5
Lila Karpowicz, Emily Bell, Mark Bernstein, Eric Racine
Surgical innovation is a grey zone between research and clinical care, thus falling beyond most research ethics regulations and the purview of mainstream clinical ethics. Ethical issues related to surgical innovation warrant a thorough examination because this practice not only affects stakeholders but is also an important force driving the development of neurosurgery. Importantly, there is a range of normative positions regarding the ethical acceptability of surgical innovation in the literature. Therefore, the goal of this study is to review the ethical landscape of neurosurgical innovation while exploring the importance of assessing the evidence supporting ethical recommendations for this practice in the normative ethics literature.

This pillar examines the theoretical and epistemological foundation of neuroethics as well as the potential impact of neuroscience research on bioethical concepts and principles.

Pragmatism and the neuroscience revolution: Ethical and social implications of social neuroscience1
Eric Racine
There are mounting claims and expectations that neuroscience will transform ethics scholarship and practices as well as related social science disciplines. Building on historical writings informed by contemporary interdisciplinary ethics scholarship, and social science research, this project will examine critically ethical and social issues arising in the development of neuroscience, in particular social neuroscience and its applications based on a pragmatic theoretical framework.

Examining the epistemological foundation of neuroethics: A patient-centred pragmatist perspective
Eric Racine, Nicole Palmour and Amaryllis Ferrand

Specialty training and physician decision-making in the care of critically ill neurologic patients
Eric Racine, Marie-Josée Dion, Judy Illes, Christine Wijman and Maarten Lansberg

Alzheimer’s disease (AD) and dietary supplements: Health claims, risks, and medical information in the top 25 websites1, 2
Nicole Palmour, Brandy Vanderbyl, Emma Zimmerman, Serge Gauthier, Eric Racine

Examining stakeholder perspectives and public understanding of the ethical and social issues of cognitive enhancement using methylphenidate1
Cynthia Forlini, Eric Racine

The regulatory frameworks for neurodevices and neuroimplants
Ghislaine Mathieu

A multi-site qualitative study of ethical and social issues in functional neurosurgery using neurostimulation2
Eric Racine, Emily Bell, Bruce Maxwell, Mary-Pat McAndrews, Abbas Sadikot

Examining ethical and social challenges in healthcare and research for adolescents and young adults with cerebral palsy4
Danaë Larivière-Bastien, Emily Bell, Michael Shevell, Annette Majnemer, Eric Racine

Brain Matters 2: Ethics in the translation of neuroscience research to psychiatric and neurological care6
Eric Racine, Rémi Quirion, Constance Ladouceur-Deslauriers

Translating social neuroscience to applied ethics: An epistemological and critical examination of the field1
Emma Zimmerman, Eric Racine

Peer reviewed research funding *

  1. Standard grant, Social Sciences and Humanities Research Council
  2. States of Mind: Emerging Issues in Neuroethics, Canadian Institutes of Health Research
  3. Tri-lateral Neuroethics Initiative grant, Canadian Institutes of Health Research
  4. NeuroDevNet, Canadian Centre of Excellence
  5. Operating grant, Canadian Institutes of Health Research
  6. Meetings, planning, and dissemination grant, Ethics Office, Canadian Institutes of Health Research

*Excludes career awards, fellowships, scholarships, sponsors

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