Abstract
In their article published in Nanoethics, “Ethical, Legal and Social Aspects of Brain-Implants Using Nano-Scale Materials and Techniques”, Berger et al. suggest that there may be a prima facie moral obligation to improve neuro implants with nanotechnology given their possible therapeutic advantages for patients [Nanoethics, 2:241–249]. Although we agree with Berger et al. that developments in nanomedicine hold the potential to render brain implant technologies less invasive and to better target neural stimulation to respond to brain impairments in the near future, we argue against presenting the development of nanobionic clinical devices in terms of a moral obligation to conduct this research. In the first part of the paper, we consider what a duty to pursue new technologies might mean, and in the second we explore some of the negative consequences of defending such development as a moral obligation based on potential benefit. We argue that promoting the advances available to brain implants through developments in nanotechnology and bionics could contribute to medical rhetoric that indirectly increases the risk of exposing patients to harm when participating in clinical trials. We argue that rather than there being a moral obligation to improve nanobionics implants because of their potential benefit, the pursuit of improved neuro implants must be balanced against the prima facie obligations to protect patients against harm and to promote and protect patient autonomy.
Similar content being viewed by others
References
Berger F, Gevers G, Siep L, Weltring K-M (2008) Ethical, legal and social aspects of brain-implants using nano-scale materials and techniques. Nanoethics 2:241–249
Clausen J (2010) Ethical brain stimulation—neuroethics of deep brain stimulation in research and clinical practice. Eur J Neurosci 32:1152–1162
Wallace GG, Higgins MJ, Moulton SE, Wang C (2012) Nanobionics: the impact of nanotechnology on implantable medical bionic devices. Nanoscale 4(15):4327–4347
Ellis-Behnke R (2007) Nano neurology and the four P’s of central nervous system regeneration: preserve, permit, promote. Plasticity, Medical Clinics of North America 91(5):937–962
Council for International Organizations of Medical Sciences (CIOMS) (2002) International ethical guidelines for biomedical research involving human subjects, www.cioms.ch/publications/layout_guide2002.pdf
Freedman B (1987) Equipoise and the ethics of clinical research. N Engl J Med 317(3):141–145
World Medical Association (WMA) (2008) WMA Declaration of Helsinki -Ethical principles for medical research involving human subjects (http://www.wma.net/en/30publications/10policies/b3/index.html).
Pender S (2005) Between medicine and rhetoric. Early Science and Medicine 10(1):36–64
Solomon M (1985) The rhetoric of dehumanization: An analysis of medical reports of the Tuskegee syphilis project. Western Journal of Speech Communication 49(4):233–247
Gilbert F (2013) Deep brain stimulation for treatment resistant depression: postoperative feelings of self-estrangement, suicide attempt and impulsive-aggressive behaviours. Neuroethics. doi:10.1007/s12152-013-9178-8
Seaton A, Tran L, Aitken R, Donaldson K (2010) Nanoparticles, human health hazard and regulation. J R Soc Interface 7:S119–S129
Gatti AM, Montanari S, Monari E, Gambarelli A, Capitani F, Parisini B (2004) Detection of micro- and nano-sized biocompatible particles in the blood. J Mater Sci Mater Med 15:469–472
Shrader-Frechette K (2007) Nanotoxicology and ethical conditions for informed consent. Nanoethics 1:47–56. doi:10.1007/s11569-007-0003-x
Gramowski A, Flossdorf J, Bhattacharya K, Jonas L, Lantow M, Rahman Q, Schiffmann D, Weiss DG, Dopp E (2010) Nanoparticles induce changes of the electrical activity of neuronal networks on microelectrode array neurochips, Environmental Health Perspectives, 118 (10)
Gilbert F (2013) Nano-bionic devices for purpose of cognitive enhancement: toward a preliminary ethical framework, Chapter 11, 125–138. In: Hildt E, Franke A (eds.) Cognitive enhancement: an interdisciplinary perspective, trends in augmentation of human performance 1, doi:10.1007/978-94-007-6253-411
Gilbert F, Vranic A, Hurst S (2013) Involuntary & voluntary brain surgery: ethical issues related to acquired aggressiveness. Neuroethics 6:115–128. doi:10.1007/s12152-012-9161-9
Gilbert F (2012) The burden of normality: from ‘chronically ill’ to ‘symptom free’. New ethical challenges for deep brain stimulation postoperative treatment. Journal of Medical Ethics 38:408–412. doi:10.1136/medethics-2011-100044
Sharma A, Dorman MF, Spahr AJ (2002) A sensitive period for the development of the central auditory system in children with cochlear implants: implications for age of implantation. Ear & Hearing 23(6):532–539
Fryauf-Bertschy H et al (1997) Cochlear implant use by prelingually deafened children: the influences of age at implant and length of device use. J Speech Lang Hear Res 40:183–199
National statement on ethical conduct in human research, National health and medical research council, Australian research council. Australian Government
Crouch RA (1997) Letting the deaf be deaf: Reconsidering the use of cochlear implants in prelingually deaf children, The Hastings Center Report, 27
Tucker BP (1998) Deaf culture, cochlear implants, and elective disability, The Hastings Center Report, 28(4)
Kennedy PR, Bakay RAE (1998) Restoration of neural output from a paralyzed patient by a direct brain connection. Neuroreport 9:1707–1711
Acknowledgement
Research for this article was supported by the Australian Research Council Australian Centre of Excellence for Electromaterials Science CE0561616. An earlier version of parts two and three of this paper was presented to the 2nd Asia Pacific Nanobionics Symposium.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gilbert, F., Dodds, S. Is There a Moral Obligation to Develop Brain Implants Involving NanoBionic Technologies? Ethical Issues for Clinical Trials. Nanoethics 8, 49–56 (2014). https://doi.org/10.1007/s11569-013-0177-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11569-013-0177-3