Ethical Issues in Behavioral Neuroscience

Lee G, Mizgalewicz A, Borgelt E, Illes J, Grace Lee, Ania Mizgalewicz, Emily Borgelt, Judy Illes

Background According to the World Health Organization, mental illness is one of the leading causes of disability worldwide. The first onset of mental illness usually occurs during childhood or adolescence, with nearly 12 million diagnosed cases in the United States alone. NeuroimagingNeuroimaging and genetic testingGenetic testing have been invaluable in research on behavioral, affective, and attentional disorders, particularly with their potential predictive capabilities, and ability to improve diagnosis and to decrease the associated burdens of disease. The present study focused specifically the perspectives of mental healthMental health providers on the role of neuroimagingNeuroimaging and genetic testingGenetic testing in clinical practice with children and adolescents. Methods We interviewed 38 psychiatrists, psychologists, and allied mental health professionals who work primarily with youth about their receptivity toward either the use of neuroimagingNeuroimaging or genetic testingGenetic testing . Interviews probed the role they foresee for these modalities for prediction, diagnosis, treatment planning, and the benefits and risks they anticipate. Results Practitioners anticipated three major benefits associated with clinical introduction of imaging and genetic testingGenetic testing in the mental healthMental health care for youth: (1) improved understanding of the brain and mental illness, (2) more accurate diagnosis than available through conventional clinical examination, and (3) legitimization of treatment plans. They also perceived three major risks: (1) misuse or misinterpretation of the imaging or genetic data, (2) potential adverse impacts on employment and insurance as adolescents reach adulthood, and (3) infringements on self-esteem or self-motivation. Limitations The nature of the interview questions focused on the future of neuroimagingNeuroimaging and genetic testingGenetic testing research in the context of clinical neuroscience. Therefore, the responses from interview participants are based on anticipated rather than actual experience. Conclusions Continued expansion of brain imagingBrain imaging and genetic testingGenetic testing into clinical care will require a delicate balance of brain biology and respect for autonomy in the still-evolving cognitive and affective world of young individuals.