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Exploring the Risks of Digital Health Research: Towards a Pragmatic Framework

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By Dr. John Torous Image courtesy of Flickr user Integrated Change We often hear much about the potential of digital health to revolutionize medicine and transform care – but less about the risks and harms associated with the same technology-based monitoring and care. “It’s a smartphone app … how much harm can it really cause?” is a common thought today, but also the starting point for a deeper conversation. That conversation is increasingly happening at Institutional Review Boards (IRBs) as they are faced with an expanding number of research protocols feature digital- and smartphone-based technologies. In our article, ‘Assessment of Risk Associated with Digital and Smartphone Health Research: a New Challenge for IRBs” published in the Journal of Technology and Behavioral Science [1], we explore the evolving ethical challenges in evaluating digital health risk, and here expand on them. While risk and harm in our 21 st century digital era are themselves evolving topics that change wi
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The interplay between social and scientific accounts of intergroup difference

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By Cliodhna O’Connor Image courtesy of Wikimedia Commons The investigation of intergroup difference is a ubiquitous dimension of biological and behavioural research involving human subjects. Understanding almost any aspect of human variation involves the comparison of a group of people, who are defined by some common attribute, with a reference group which does not share that attribute. This is an inescapable corollary of applying the scientific method to study human minds, bodies and societies. However, this scientific practice can have unanticipated – and undesirable – social consequences. As my own research has shown in the contexts of psychiatric diagnosis (O’Connor, Kadianaki, Maunder, & McNicholas, in press), gender (O’Connor & Joffe, 2014) and sexual orientation (O’Connor, 2017), scientific accounts of intergroup differences can often function to reinforce long-established stereotypes, exaggerate the homogeneity of social groups, and impose overly sharp divisions between
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Solitary Confinement: Isolating the Neuroethical Dilemma

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By Kristie Garza   Eastern State Penitentiary Image courtesy of Wikimedia Commons In 1842, Charles Dickens visited the Eastern Penitentiary in Philadelphia to examine what was being called a revolutionary form of rehabilitation. After his visit, he summarized his observations into an essay in which he stated, “I am only the more convinced that there is a depth of terrible endurance in it which none but the sufferers themselves can fathom, and which no man has a right to inflict upon his fellow-creature. I hold this slow and daily tampering with the mysteries of the brain, to be immeasurably worse than any torture of the body” (1).  Dickens’ words describe solitary confinement. While there is no one standard for solitary confinement conditions, it usually involves an individual being placed in complete sensory and social isolation for 23 hours a day. What Dickens observed in 1842 is not unlike current solitary confinement conditions . At its start, the justice system was meant to be re
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Neuroethics: the importance of a conceptual approach

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By Arleen Salles, Kathinka Evers, and Michele Farisco Image courtesy of Wikimedia Commons . What is neuroethics? While there is by now a considerable bibliography devoted to examining the philosophical, scientific, ethical, social, and regulatory issues raised by neuroscientific research and related technological applications (and a growing number of people in the world claim to take part in the neuroethical debate), less has been said about how to interpret the field that carries out such examination. And yet, this calls for discussion, particularly considering that the default understanding of neuroethics is one that sees the field as just another type of applied ethics, and, in particular, one dominated by a Western bioethical paradigm. The now-classic interpretation of neuroethics as the “neuroscience of ethics” and the “ethics of neuroscience” covers more ground, but still fails to exhaust the field (1). As we have argued elsewhere, neuroethics is a complex field characterized by
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Facial recognition, values, and the human brain

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By Elisabeth Hildt Image courtesy of  Pixabay . Research is not an isolated activity. It takes place in a social context, sometimes influenced by value assumptions and sometimes accompanied by social and ethical implications. A recent example of this complex interplay is an article, “ Deep neural networks can detect sexual orientation from faces ” by Yilun Wang and Michal Kosinski, accepted in 2017 for publication in the J ournal of Personality and Social Psychology. In this study on face recognition, the researchers used deep neural networks to classify the sexual orientations of persons depicted in facial images uploaded on a dating website. While the discriminatory power of the system was limited, the algorithm was reported to have achieved higher accuracy in the setting than human subjects. The study can be seen in the context of the “prenatal hormone theory of sexual orientation,” which claims that gay men and women tend to have gender-atypical facial morphology. The abstract of t
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Disrupting diagnosis: speech patterns, AI, and ethical issues of digital phenotyping

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By Ryan Purcell, PhD Jim Schwoebel, presenter at April The Future Now: (NEEDS) Diagnosing schizophrenia can be complex, time-consuming, and expensive. The April seminar on The Future Now: (NEEDs) Neuroscience and Emerging Ethical Dilemmas at Emory focused on one innovative effort to improve this process in the flourishing field of digital phenotyping. Presenter and NeuroLex founder and CEO Jim Schwoebel had witnessed his brother struggle for several years with frequent headaches and anxiety, and saw him accrue nearly $15,000 in medical expenses before his first psychotic break. From there it took many more years and additional psychotic episodes before Jim’s brother began responding to medication and his condition stabilized. Unfortunately, this experience is not uncommon; a recent study found that the median period from the onset of psychotic symptoms until treatment is 74 weeks. Naturally, Schwoebel thought deeply about how this had happened and what clues might have been seen ear
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