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Biomedical Microdevices

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Nanotechnology, neuromodulation & the immune response: Discourse, materiality & ethics

  • Joseph J. Fins
Article
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Abstract

Drawing upon the American Pragmatic tradition in philosophy and the more recent work of philosopher Karen Barad, this paper examines how scientific problems are both obscured, and resolved by our use of language describing the natural world. Using the example of the immune response engendered by neural implants inserted in the brain, the author explains how this discourse has been altered by the advent of nanotechnology methods and devices which offer putative remedies that might temper the immune response in the central nervous system. This emergent nanotechnology has altered this problem space and catalyzed one scientific community to acknowledge a material reality that was always present, if not fully acknowledged.

Keywords

Nanotechnology Neuromodulation Immune response Ethics Neuroethics Discourse Materials Philosophy of science NanoGagliato Karen Barad 

Notes

Acknowledgments

The author would like to thank Paola and Mauro Ferrari for inviting me to NanoGagliato 2014 (where an earlier version of this paper was presented); his fellow conferees for their collegiality and wisdom; and the people of Gagliato for their warm hospitality. He also gratefully acknowledges the editorial insights of Amy B. Ehrlich and partial support from the Clinical and Translational Science Center (UL1)-Cooperative Agreement (CTSC) 1UL1 RR024996 to Weill Cornell Medical College and its Ethics Core.

References

  1. Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death. A Definition of Irreversible Coma. JAMA. 205, 337–40 (1968)Google Scholar
  2. K. Barad, Meeting the Universe Halfway (Durham, Duke, 2007)CrossRefGoogle Scholar
  3. J. Dewey, Common sense and scientific inquiry, in The Theory of Inquiry (Henry Holt and Company, Inc., New York, 1938), pp. 60–80Google Scholar
  4. R. Dresser, Building and ethical forundation for First-in-Human Nanotrials. J. Law Med. Ethics (Winter), 802–808 (2012)Google Scholar
  5. L. Fatehi et al., Recommendations for nanomedicine human subjects research oversight: An evolutionary approach for an emerging field. J. Law Med. Ethics. (Winter), 716–750 (2012)Google Scholar
  6. M. Ferrari, No exceptions. No excuses: a testimonial, in Human Subjects Research after the Holocaust, ed. by Rubenfeld, Benedict (Springer, New York, 2014), p. 290Google Scholar
  7. J.J. Fins, Constructing an ethical stereotaxy for severe brain injury: balancing risks, benefits and access. Nat. Rev. Neurosci. 4, 323–327 (2003)CrossRefGoogle Scholar
  8. J.J. Fins, A Palliative Ethic of Care: Clinical Wisdom at Life’s End (Jones and Bartlett, Sudbury, 2006)Google Scholar
  9. J.J. Fins, Lessons from the injured brain: a bioethicist in the vineyards of neuroscience. Camb. Q. Health Care Ethics 18(1), 7–13 (2009)CrossRefGoogle Scholar
  10. J.J. Fins, Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness (Cambridge University Press, New York, 2015)Google Scholar
  11. J.J. Fins, N.D. Schiff, Conflicts of Interest in Deep Brain Stimulation Research and the Ethics of Transparency. J. Clin. Ethics 21(2), 125–132 (2010)Google Scholar
  12. J.J. Fins, M.D. Bacchetta, F.G. Miller, Clinical pragmatism: a method of moral problem solving. Kennedy Inst. Ethics J. 7(2), 129–145 (1997)CrossRefGoogle Scholar
  13. J.J. Fins, T.E. Schlaepfer, B. Nuttin, C.S. Kubu, T. Galert, V. Sturm, R. Merkel, H.S. Mayberg, Ethical guidance for the management of conflicts of interest for researchers, engineers and clinicians engaged in the development of therapeutic deep brain stimulation. J. Neural Eng. 8(3), 033001 (2011)CrossRefGoogle Scholar
  14. J.T. Giacino, K. Kalmar, The vegetative and minimally conscious states: a comparison of clinical features and functional outcome. J Head Trauma and Rehabil 12(4), 36–51 (1997)CrossRefGoogle Scholar
  15. J.T. Giacino, S. Ashwal, N. Childs et al., The minimally conscious state: definition and diagnostic criteria. Neurology 58(3), 349–353 (2002)CrossRefGoogle Scholar
  16. J. Giacino, J.J. Fins, A. Machado, N.D. Schiff, Central thalamic deep brain stimulation to promote recovery from chronic post-traumatic minimally conscious state: challenges and opportunities. Neuromodulation 15(4), 330349 (2012)CrossRefGoogle Scholar
  17. J.T. Giacino, J.J. Fins, S. Laureys, N.D. Schiff, Disorders of consciousness after acquired brain injury: the state of the science. Nat. Rev. Neurol. 10, 99–114 (2014)CrossRefGoogle Scholar
  18. R.M. Hall, Sun T and Ferrari M. A portrait of nanomedicine and its biomedical implications. J. Law Med. Ethics. (Winter), 763–779 (2012)Google Scholar
  19. L.F. Hogle, Concepts of risk in nanomedicine research. J. Law Med. Ethics. (Winter), 809–822 (2012)Google Scholar
  20. B. Jennett, The Vegetative State (Cambridge University Press, New York, 2002)CrossRefGoogle Scholar
  21. B. Jennett, F. Plum, Persistent vegetative state after brain damage. A syndrome in search of a name. Lancet 1(7753), 734–737 (1972)CrossRefGoogle Scholar
  22. H. Jonas, The Imperative of Responsibility: In Search of an Ethics for the Technological Age (University of Chicago Press, Chicago, 1985), p. 34Google Scholar
  23. M.H. Lammi, V.H. Smith, R.L. Tate et al., The minimally conscious state and recovery potential: a follow-up study 2 to 5 years after traumatic brain injury. Arch. Phys. Med. Rehabil. 86(4), 746–754 (2005)CrossRefGoogle Scholar
  24. S. Laureys, M.E. Faymonville, P. Peigneux, P. Damas, B. Lambermont, G. Del Fiore, C. Degueldre, J. Aerts, A. Luxen, G. Franck, M. Lamy, G. Moonen, P. Maquet, Cortical processing of noxious somatosensory stimuli in the persistent vegetative state. Neuroimage 17(2), 732–741 (2002)CrossRefGoogle Scholar
  25. P. Litton, “Nanoethics”? What’s new? Hastings Cent. Rep. 37(1), 22–25 (2007)CrossRefGoogle Scholar
  26. G.E. Marchant, D. J. Sylvester, K. W. Abbott, What does the history of technology regulation teach us about nano oversight? J. Law Med. Ethics. (Winter), 724–731 (2012)Google Scholar
  27. The Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state (1 and 2). N. Engl. J. Med. 330(21), 1499–508 and (22):1572–9 (1994)Google Scholar
  28. S. Minnikanti, M.G. Pereira, S. Jaraiedi, K. Jackson, C.M. Costa-Neto, Q. Li, N. Peixoto, In vivo electrochemical characterization and inflammatory response of multiwalled carbon nanotube-based electrodes in rat hippocampus. J. Neural Eng. 7(1), 16002 (2010)CrossRefGoogle Scholar
  29. NANOGAGLIATO, http://www.nanogagliatoconference.org. Accessed on 7 Aug 2014
  30. V.S. Polikov, P.A. Tresco, W.M. Reichert, J. Neurosci. Methods 148, 1–18 (2005)CrossRefGoogle Scholar
  31. M. Pollan, The year in ideas: A to Z.; Precautionary Principle. The New York Times. December 9, 2001. http://query.nytimes.com/gst/fullpage.html?res=9804EEDE143CF93AA35751C1A9679C8B63 Accessed 9 Dec 2001
  32. President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Defining Death: Medical, Legal and Ethical Issues in the Determination of Death (Government Printing Office, Washington, D.C., 1981)Google Scholar
  33. J.T. Robinson, M. Jorgolli, H. Park, Nanowires electrodes for high-density stimulation and measurement of neural circuits. Front Neural Circuits 7, 38 (2013)CrossRefGoogle Scholar
  34. N.D. Schiff, D. Rodriguez-Moreno, A. Kamal, K. Kim, J. Giacino, F. Plum, J. Hirsch, fMRI reveals large scale network activation in minimally conscious patients. Neurology 64(3), 514–523 (2005)CrossRefGoogle Scholar
  35. N.D. Schiff, J.T. Giacino, K. Kalmar, J.D. Victor, K. Baker, M. Gerber, B. Fritz, B. Eisenberg, J. O’Connor, E.J. Kobylarz, S. Farris, A. Machado, C. McCagg, F. Plum, J.J. Fins, A.R. Rezai, Behavioral improvements with thalamic stimulation after severe traumatic brain injury. Nature 448(7153), 600–603 (2007)CrossRefGoogle Scholar
  36. N.D. Schiff, J.T. Giacino, J.J. Fins, Deep brain stimulation, neuroethics and the minimally conscious state: moving beyond proof of principle. Arch. Neurol. 66(6), 697–702 (2009)Google Scholar
  37. M. Sherer, T. Hart, T.G. Nick, J. Whyte, R.N. Thompson, S.A. Yablon, Early impaired self-awareness after traumatic brain injury. Arch. Phys. Med. Rehabil. 84(2), 168–176 (2003)CrossRefGoogle Scholar
  38. S. Syed, A. Zubair, Frieri, Immune response to nanomaterials: implications for medicine and literature review. Curr. Allergy Asthma Rep. 13(1), 50–57 (2013)CrossRefGoogle Scholar
  39. The Shorter Oxford English Dictionary, ed. by W. Little, H. W.Gowler, J. Coulson, C. T. Onions (Oxford, Clarendon Press, 1973)Google Scholar
  40. Uniform Determination of Death Act. 12 Uniform Laws Annotated 320 (1990 Supp.)Google Scholar
  41. H. van den Belt, Debating the precautionary principle: “guilty until proven innocent” or “innocent until proven guilty”? Plant Physiol. 132, 1122–1126 (2003)CrossRefGoogle Scholar
  42. H. Wei et al., Nanoscale laminin coating modulates cortical scarring response around implanted silicon microelectrodres. J. Neural Eng. 3, 316–326 (2006)CrossRefGoogle Scholar
  43. S.M. Wolf, The challenge of nanomedicine human subjects research: Protecting participants, workers, bystanders, and the environment. J. Law Med. Ethics (Winter), 712–715 (2012)Google Scholar
  44. I. Yoon et al., Intracellular neural recordings with pure carbon nanotube probes. PLoS ONE 8(6), e65715 (2013)CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Division of Medical EthicsWeill Cornell Medical College New YorkUSA
  2. 2.Consortium for the Advanced Study of Brain Injury (CASBI)Weill Cornell Medical College and The Rockefeller UniversityNew YorkUSA
  3. 3.The Rockefeller University and Rockefeller University HospitalNew YorkUSA
  4. 4.The Houston Methodist Hospital Research InstituteHoustonUSA

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