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A New Challenge for Research Ethics: Incidental Findings in Neuroimaging


It has become evident that neuroimaging raises new normative questions that cannot be addressed adequately within the (in this regard unspecific) frameworks of existing research ethics. Questions that are especially troubling are, among others, provoked by incidental findings. Two questions are particularly intricate in view of incidental findings: (1) How can the research subject’s right not to know be guaranteed? And (2) should a diagnostic check of scans by a neuroradiologist become an obligatory part of neuroscientific research protocols? The present paper examines these question against the background of two recent recommendations. The differentiation between “difference position” and “similarity position” serves as an analytic tool to further investigate the issue and to develop a distinct proposal for answering the questions.

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  1. 1.

    IMAGEN—a European research project on risk-taking behaviour in teenagers. URL [29.06.2010].


  1. Appelbaum, P.S., L.H. Roth, C.W. Lidz, P. Benson, and W. Winslade. 1987. False hopes and best data: Consent to research and the therapeutic misconception. The Hastings Center Report 17(2): 20–24.

    PubMed  Article  CAS  Google Scholar 

  2. Council for International Organizations of Medical Sciences (CIOMS). 2002. International ethical guidelines for biomedical research involving human subjects. Geneva. URL (accessed December 1, 2010).

  3. Council of Europe. 1997. Convention for the protection of human rights and dignity of the human being with regard to the application of biology and medicine: Convention on human rights and biomedicine. European Treaty Series No. 164. Oviedo.

  4. Council of Europe. 2005. Additional protocol to the convention on human rights and biomedicine, concerning biomedical research. European Treaty Series No. 195. Strassbourg.

  5. Heinemann, T., C. Hoppe, S. Listl, A. Spickhoff, and C.E. Elger. 2007. Zufallsbefunde bei bildgebenden Verfahren in der Hirnforschung: Ethische Überlegungen und Lösungsvorschläge. Deutsches Ärzteblatt 104(27): A1982–A1987.

    Google Scholar 

  6. Howard-Jones, N. 1982. Human experimentation in historical and ethical perspective. In human experimentation and medical ethics: Proceedings of the XVth CIOMS round table conference. Manila, 13–16 September 1981, ed. Zbigniew Bankowski and Norman Howard-Jones, 453–95. Geneva.

  7. Illes, J., M.P. Kirschen, K. Karetsky, M. Kelly, A. Saha, J.E. Desmond, T.A. Raffin, G.H. Glover, and S.W. Atlas. 2004. Discovery and disclosure of incidental findings in neuroimaging research. Journal of Magnetic Resonance Imaging 20(5): 743–747.

    PubMed  Article  Google Scholar 

  8. Illes, J., M.P. Kirschen, E. Edwards, L.R. Stanford, P.C.M.K. Bandettini, P.J. Ford, G.H. Glover, et al. 2006. Incidental findungs in brain imaging research. Science 311: 783–784.

    PubMed  Article  CAS  Google Scholar 

  9. Lidz, C.W., P.S. Appelbaum, T. Grisso, and M. Renaud. 2004. Therapeutic misconception and the appreciation of risks in clinical trials. Social Science & Medicine 58(9): 1689–1697.

    Article  Google Scholar 

  10. Miller, F.G., and H. Brody. 2003. A critique of clinical equipoise: Therapeutic misconception in the ethics of clinical trials. The Hastings Center Report 33(3): 19–28.

    PubMed  Article  Google Scholar 

  11. Miller, F.G., M.M. Mello, and S. Joffe. 2008. Incidental findings in human subject research: What do investigators owe research participants? The Journal of Law, Medicine & Ethics 36: 271–279.

    Article  Google Scholar 

  12. Morris, Z., W.N. Whiteley, W.T. Longstreth, F. Weber, Y.-C. Lee, Y. Tsushima, H. Alphs, et al. 2009. Incidental findings on brain magnetic resonance imaging: Systematic review and meta-analysis. British Medical Journal 339: 547–550.

    Google Scholar 

  13. Nuremberg Military Tribunal. 1950. Nuremberg code. In Trials of War Criminals Before the Nuremberg Military Tribunal under Control Council Law 10: Military Tribunal 1, Case 1. United States vs. Karl Brandt et al., October 1946–April 1949, ed. Nuremberg Military Tribunal, 181–82. 2 vols. Washington D.C.

  14. Wolf, S.M. 2008. Introduction. The challenge of incidental findings. Journal of Law, Medicine & Ethics 36: 216–218.

    Article  Google Scholar 

  15. Wolf, S.M., F.P. Lawrenz, C.A. Nelson, J.P. Kahn, M.K. Cho, E.W. Clayton, J.G. Fletscher, et al. 2008. Managing incidental findings in human subjects research: Analysis and recommendations. The Journal of Law, Medicine & Ethics 36: 219–248.

    Article  Google Scholar 

  16. World Medical Association. 1996. Declaration of Helsinki: Recommendations Guiding Medical Physicians in Biomedical Research Involving Human Subjects. Adopted by the 18th World Medical Assembly, Helsinki, Finland, June 1964, and amended by the 29th World Medical Assembly, Tokyo, Japan, October 1975, 35th World Medical Assembly, Venice, Italy, October 1983, 41st World Medical Assembly Hong Kong, September 1989 and the 48th General Assembly, Somerset West, Republic of South Africa, October 1996.

  17. World Medical Association. 2000. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. Adopted by the 18th WMA General Assembly Helsinki, Finland, June 1964 and amended by the 29th WMA General Assembly, Tokyo, Japan, October 1975 35th WMA General Assembly, Venice, Italy, October 1983 41st WMA General Assembly, Hong Kong, September 1989 48th WMA General Assembly, Somerset West, Republic of South Africa, October 1996 and the 52nd WMA General Assembly, Edinburgh, Scotland, October 2000.

  18. World Medical Association. 2008. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. Adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964, and amended by the 59th WMA General Assembly, Seoul, October 2008. URL (accessed January 30, 2010).

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The author acknowledges the stimulus and support of the IMAGEN consortium. IMAGEN receives research funding from the European Community’s Sixth Framework Programme (LSHM-CT-2007-037286). This paper reflects only the authors’ views and the community is not liable for any use that may be made of the information contained therein.

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Correspondence to Bert Heinrichs.

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Heinrichs, B. A New Challenge for Research Ethics: Incidental Findings in Neuroimaging. Bioethical Inquiry 8, 59–65 (2011).

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  • Incidental findings
  • Neuroimaging
  • Right to know/not to know
  • Diagnostic misconception
  • Similarity/difference position
  • Neuroethics