ORCID Profile
0000-0003-0524-8649
Current Organisation
University of Tasmania
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Applied Ethics | Bioethics (human and animal) | Ethical Use of New Technology (e.g. Nanotechnology, Biotechnology) | Medical Ethics |
Technological Ethics | Bioethics | Expanding Knowledge in Philosophy and Religious Studies
Publisher: Informa UK Limited
Date: 03-04-2017
Publisher: Springer Science and Business Media LLC
Date: 04-2015
Publisher: University of Illinois Press
Date: 04-2011
DOI: 10.5406/JANIMALETHICS.1.1.0037
Abstract: In early 2009, President Obama overturned the ban on federal funding for research involving the derivation of human embryonic stem cells (hESC). The Food and Drug Administration (FDA) also approved Geron’s first-in-human hESC trial for spinal cord injury (SCI) patients. We anticipate an increase in both research in the United States to derive hESC and applications to the FDA for approval of clinical trials involving transplantation of hESCs. An increase of such clinical trials will require a concomitant increase in the number of preceding preclinical assays. We examine important issues concerning the use of animals in SCI stem cell research that require a reevaluation of the moral permissibility of studies such as Geron’s.
Publisher: Springer Science and Business Media LLC
Date: 02-12-2010
Publisher: Springer Science and Business Media LLC
Date: 18-10-2018
Publisher: Springer Science and Business Media LLC
Date: 11-11-2019
Publisher: Springer Netherlands
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 04-09-2014
Publisher: Informa UK Limited
Date: 02-04-2016
Publisher: Informa UK Limited
Date: 10-2016
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.NEUROBIOLAGING.2017.03.001
Abstract: The serendipitous discovery of triggered autobiographical memories and eventual memory improvement in an obese patient who received fornix deep brain stimulation in 2008 paved the way for several phase I and phase II clinical trials focused on the safety and efficacy of this potential intervention for people with Alzheimer's disease. In this article, we summarize clinical trials and case reports on fornix deep brain stimulation for Alzheimer's disease and review experiments on animal models evaluating the physiological or behavioral effects of this intervention. Based on information from these reports and studies, we identify potential translational challenges of this approach and determine practical and ethical considerations for clinical trials, focusing on issues regarding selection criteria, trial design, and outcome evaluation. Based on initial results suggesting greater benefit for those with milder disease stage, we find it essential that participant expectations are carefully managed to avoid treatment disenchantment and/or frustration from participants and caregivers. Finally, we urge for collaboration between centers to establish proper clinical standards and to promote better trial results comparison.
Publisher: BMJ
Date: 19-03-2012
DOI: 10.1136/MEDETHICS-2011-100044
Abstract: Although an invasive medical intervention, Deep Brain Stimulation (DBS) has been regarded as an efficient and safe treatment of Parkinson's disease for the last 20 years. In terms of clinical ethics, it is worth asking whether the use of DBS may have unanticipated negative effects similar to those associated with other types of psychosurgery. Clinical studies of epileptic patients who have undergone an anterior temporal lobectomy have identified a range of side effects and complications in a number of domains: psychological, behavioural, affective and social. In many cases, patients express difficulty adjusting from being chronically ill to their new status as 'treated' or 'seizure free'. This postoperative response adjustment has been described in the literature on epilepsy as the 'Burden of Normality' (BoN) syndrome. Most of the discussion about DBS postoperative changes to self is focused on abnormal side effects caused by the intervention (ie, hypersexuality, hypomania, etc). By contrast, relatively little attention is paid to the idea that successfully 'treated' in iduals might experience difficulties in adjusting to becoming 'normal'. The purpose of this paper is (1) to articulate the postoperative DBS psychosocial adjustment process in terms of the BoN syndrome, (2) to address whether the BoN syndrome illustrates that DBS treatment poses a threat to the patient's identity, and (3) to examine whether the current framework for rehabilitation after DBS procedures should be updated and take into account the BoN syndrome as a postoperative self-change response.
Publisher: Informa UK Limited
Date: 10-2011
Publisher: Informa UK Limited
Date: 04-2012
Publisher: Informa UK Limited
Date: 24-03-2022
Publisher: Springer Science and Business Media LLC
Date: 08-11-2021
Publisher: Informa UK Limited
Date: 13-06-2014
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.STEM.2011.04.012
Abstract: Geron recently announced that it had begun enrolling patients in the world's first-in-human clinical trial involving cells derived from human embryonic stem cells (hESCs). This trial raises important questions regarding the future of hESC-based therapies, especially in spinal cord injury (SCI) patients. We address some safety and efficacy concerns with this research, as well as the ethics of fair subject selection. We consider other populations that might be better for this research: chronic complete SCI patients for a safety trial, subacute incomplete SCI patients for an efficacy trial, and perhaps primary progressive multiple sclerosis (MS) patients for a combined safety and efficacy trial.
Publisher: Springer Science and Business Media LLC
Date: 11-06-2020
Publisher: Springer Science and Business Media LLC
Date: 15-07-2014
Publisher: Informa UK Limited
Date: 03-04-2015
Publisher: Springer Science and Business Media LLC
Date: 24-08-2023
DOI: 10.1007/S12152-023-09527-0
Abstract: From epileptic seizures to depressive symptoms, predictive neurotechnologies are used for a large range of applications. In this article we focus on advisory devices namely, predictive neurotechnology programmed to detect specific neural events (e.g., epileptic seizure) and advise users to take necessary steps to reduce or avoid the impact of the forecasted neuroevent. Receiving advise from a predictive device is not without ethical concerns. The problem with predictive neural devices, in particular advisory ones, is the risk of seeing one’s autonomous choice supplanted by the predictions instead of being supplemented by it. For users, there is a potential shift from being assisted by the system to being over-dependent on the technology. In other terms, it introduces ethical issues associated with epistemic dependency. In this article, we examine the notion of epistemic authority in relation to predictive neurotechnologies. Section 1 of our article explores and defines the concept of epistemic authority. In section 2, we illustrate how predictive devices are best conceived of as epistemic authorities and we explore the subject-device epistemic relationship. In section 3, we spell out the risk of harms interconnected with epistemic deferral. We conclude by stressing a set of preliminary measures to prepare users for the authoritative nature of predictive devices.
Publisher: Informa UK Limited
Date: 02-01-2021
Publisher: Springer Science and Business Media LLC
Date: 23-10-2018
DOI: 10.1007/S12152-018-9387-2
Abstract: The article Deflating the "DBS causes personality changes" bubble, written by Frederic Gilbert, J. N. M. Viaña and C. Ineichen, was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 19 June 2018 without open access.
Publisher: Informa UK Limited
Date: 2014
Publisher: Wiley
Date: 21-10-2021
DOI: 10.1111/BIOE.12961
Abstract: The increasing dementia prevalence worldwide is driving the testing of novel therapeutic approaches, such as invasive brain technologies, despite limited clinical evidence and the risk of accelerating cognitive decline. Our manuscript (a) reviews the NIH Clinicaltrials.gov database for deep brain stimulation, stem cell implantation, and gene therapy trials on people with dementia (b) discusses issues on beneficence, nonmaleficence, and autonomy associated with these trials and (c) proposes nine recommendations that build on elements from the Declaration of Helsinki. We found 49 preregistered high‐risk trials from nine countries planning to or involving 11,801 people with Alzheimer's or Lewy body dementia or dementia secondary to Parkinson's or Huntington's disease. Most of the people with Alzheimer's who are in these trials are from North America and East Asia. There is substantial heterogeneity in the enrolment criteria, even for trials recruiting only those with Alzheimer's disease. Although most trials enrol people in mild to moderate stages of Alzheimer's disease, trials in China enrol people who have severe Alzheimer's. Our findings highlight a pressing need to review and refine the enrolment criteria for invasive neural trials in people with dementia, considering risks, potential benefits, and capacity for informed consent. As a multidisciplinary team from Australia, the USA, Canada, and Germany with expertise in neurology, neuroscience, and ethics, we examine how it is essential to balance the risks of invasive neural research in a vulnerable population with limited capacity to provide informed consent to help advance the body of knowledge regarding a disease with limited therapeutic options.
Publisher: Informa UK Limited
Date: 02-10-2022
Publisher: Frontiers Media SA
Date: 2011
Publisher: Informa UK Limited
Date: 02-01-2016
Publisher: Informa UK Limited
Date: 02-10-2015
Publisher: Springer Science and Business Media LLC
Date: 31-01-2013
Publisher: Informa UK Limited
Date: 03-04-2018
Publisher: Informa UK Limited
Date: 10-2011
Publisher: Informa UK Limited
Date: 03-07-2019
Publisher: Informa UK Limited
Date: 04-04-2209
Publisher: Elsevier BV
Date: 2015
DOI: 10.1016/J.IJLP.2015.01.007
Abstract: This article reviews the current neurobiological literature on the aetiology of developmental and acquired paedophilia and examines what the consequences could be in terms of responsibility and treatment for the latter. Addressing the question of responsibility and punishment of offenders with acquired paedophilia from a neurobiological perspective is controversial. Consequently it is essential to avoid hasty conclusions based strictly on neurobiological abnormality justifications. This study establishes a distinction between developmental and acquired paedophilia. The article investigates whether offenders who fulfil the diagnosis of acquired paedophilia should be held fully responsible, particularly in cases where the offender's conduct appears to result from volitionally controlled behaviour that is seemingly incompatible with a neurological cause. Moreover, the article explores how responsibility can be compromised when offenders with acquired paedophilia have (partially) preserved moral knowledge despite their sexual disorder. The article then examines the option of offering mandatory treatment as an alternative to imprisonment for offenders with acquired paedophilia. Furthermore, the article addresses the ethical issues related to offering any form of quasi-coercive treatment as a condition of release. This study concludes that decisions to fully or partially excuse an in idual who fulfil the diagnosis of acquired paedophilia should take all relevant information into account, both neurobiological and other environmental evidence, and should proceed on a careful case by case analysis before sentencing or offering treatment.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Informa UK Limited
Date: 22-03-2017
Publisher: BMJ
Date: 13-01-2021
DOI: 10.1136/MEDETHICS-2020-106609
Abstract: Deep brain stimulation (DBS) interventions are novel devices being investigated for the management of severe treatment-resistant psychiatric illnesses. These interventions require the invasive implantation of high-frequency neurostimulatory probes intracranially aiming to provide symptom relief in treatment-resistant disorders including obsessive-compulsive disorder and anorexia nervosa. In the scientific literature, these neurostimulatory interventions are commonly described as reversible and to be used as a last resort option for psychiatric patients. However, the ‘last resort’ status of these interventions is rarely expanded upon. Contrastingly, usages of DBS devices for neurological symptoms (eg, Parkinson’s disease, epilepsy or dystonia) have paved the way for established safety and efficacy standards when used earlier in a disease’s timeline. As DBS treatments for these neurological diseases progress to have earlier indications, there is a parallel ethical concern that early implementation may one day become prescribed for psychiatric illnesses. The purpose of this article is to build off contemporary understandings of reversible neurostimulatory interventions to examine and provide clarifications on the ‘last resort’ status of DBS to better address its ethically charged use in psychiatric neurosurgery. To do this, evaluative differences between DBS treatments will be discussed to demonstrate how patient autonomy would be a paramount guiding principle when one day implementing these devices at various points along a psychiatric disease’s timeline. In presenting the clarification of ‘last resort’ status, the ethical tensions of early DBS interventions will be better understood to assist in providing psychiatric patients with more quality of life years in line with their values.
Publisher: Springer Science and Business Media LLC
Date: 2023
Publisher: Wiley
Date: 24-11-2018
DOI: 10.1111/BIOE.12414
Abstract: There has been a surge in mass media reports extolling the potential for using three-dimensional printing of biomaterials (3D bioprinting) to treat a wide range of clinical conditions. Given that mass media is recognized as one of the most important sources of health and medical information for the general public, especially prospective patients, we report and discuss the ethical consequences of coverage of 3D bioprinting in the media. First, we illustrate how positive mass media narratives of a similar biofabricated technology, namely the Macchiarini scaffold tracheas, which was involved in lethal experimental human trials, influenced potential patient perceptions. Second, we report and analyze the positively biased and enthusiastic portrayal of 3D bioprinting in mass media. Third, we examine the lack of regulation and absence of discussion about risks associated with bioprinting technology. Fourth, we explore how media misunderstanding is dangerously misleading the narrative about the technology.
Publisher: AMPCo
Date: 05-2012
DOI: 10.5694/MJA11.11218
Publisher: Springer Science and Business Media LLC
Date: 09-02-2018
DOI: 10.1007/S11948-017-9874-6
Abstract: Recent developments of three-dimensional printing of biomaterials (3D bioprinting) in medicine have been portrayed as demonstrating the potential to transform some medical treatments, including providing new responses to organ damage or organ failure. However, beyond the hype and before 3D bioprinted organs are ready to be transplanted into humans, several important ethical concerns and regulatory questions need to be addressed. This article starts by raising general ethical concerns associated with the use of bioprinting in medicine, then it focuses on more particular ethical issues related to experimental testing on humans, and the lack of current international regulatory directives to guide these experiments. Accordingly, this article (1) considers whether there is a limit as to what should be bioprinted in medicine (2) examines key risks of significant harm associated with testing 3D bioprinting for humans (3) investigates the clinical trial paradigm used to test 3D bioprinting (4) analyses ethical questions of irreversibility, loss of treatment opportunity and replicability (5) explores the current lack of a specific framework for the regulation and testing of 3D bioprinting treatments.
Publisher: Informa UK Limited
Date: 04-2013
Publisher: Hindawi Limited
Date: 2014
DOI: 10.1155/2014/398295
Abstract: High-grade meningiomas are rare extra-axial tumors, frequently causing brain invasion and prominent brain edema. Patients harboring high-grade meningiomas occasionally present with behavior changes. Data about frequency and prognostic importance of preoperative behavior changes in patients with high-grade meningiomas is missing. 86 patients with primary high-grade meningiomas were analyzed. Statistical analysis was performed to determine correlation of preoperative behavior changes with tumor location, preoperative brain edema, tumor cleavability, tumor grade, Ki67 proliferation index, and microscopic brain invasion. Survival analysis was performed. 30 (34.9%) patients presented with preoperative behavior changes. These changes were more frequent with male patients ( P = 0.066 ) and patients older than 55 years ( P = 0.018 ). They correlated with frontal location ( P = 0.013 ), tumor size ( P = 0.023 ), microscopic brain invasion ( P = 0.015 ), and brain edema ( P = 0.006 ). Preoperative behavior changes did not correlate with duration of symptoms, tumor cleavability, tumor malignancy grade, and Ki67 proliferation index. They were not significantly related to overall survival or recurrence-free survival of patients with primary high-grade meningiomas. Preoperative behavior changes are frequent in patients harboring primary high-grade meningiomas. They correlate with tumor size, microscopic brain invasion, and brain edema. Preoperative behavior changes do not predict prognosis in patients with primary high-grade meningiomas.
Publisher: Consortium Erudit
Date: 09-2011
DOI: 10.7202/1005715AR
Abstract: Bien que toute conclusion hâtive fondée strictement sur des explications biologiques doive être évitée, il convient de se poser la question de la nature des mesures pénales les plus adaptées pour sanctionner les crimes pédophiles, si l’origine de ces derniers est le résultat de propensions biologiques. En vue de protéger la société à long terme, l’objectif de cet article est d’examiner si l’application d’une justice exclusivement rétributive est appropriée à une lutte efficace contre le crime pédophile.
Publisher: Informa UK Limited
Date: 07-2011
Publisher: Informa UK Limited
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 10-08-2013
Publisher: Springer Science and Business Media LLC
Date: 19-06-2018
DOI: 10.1007/S12152-018-9373-8
Abstract: The idea that deep brain stimulation (DBS) induces changes to personality, identity, agency, authenticity, autonomy and self (PIAAAS) is so deeply entrenched within neuroethics discourses that it has become an unchallenged narrative. In this article, we critically assess evidence about putative effects of DBS on PIAAAS. We conducted a literature review of more than 1535 articles to investigate the prevalence of scientific evidence regarding these potential DBS-induced changes. While we observed an increase in the number of publications in theoretical neuroethics that mention putative DBS-induced changes to patients’ postoperative PIAAAS, we found a critical lack of primary empirical studies corroborating these claims. Our findings strongly suggest that the theoretical neuroethics debate on putative effects of DBS relies on very limited empirical evidence and is, instead, reliant on unsubstantiated speculative assumptions probably in lieu of robust evidence. As such, this may reflect the likelihood of a speculative neuroethics bubble that may need to be deflated. Nevertheless, despite the low number of first-hand primary studies and large number of marginal and single case reports, potential postoperative DBS changes experienced by patients remain a critical ethical concern. We recommend further empirical research in order to enhance theoretical neuroethics work in the area. In particular, we call for the development of better instruments capable of capturing potential postoperative variations of PIAAAS.
Publisher: Springer Science and Business Media LLC
Date: 26-05-2012
Publisher: Wiley
Date: 13-05-2018
Abstract: The arterial to end-tidal carbon dioxide tension difference (CO Patients presenting to tertiary Australian ED with suspected sepsis (n = 215) underwent near-simultaneous end-tidal carbon dioxide and partial pressure of carbon dioxide measurements. We investigated the correlation of CO Among patients included in the analysis (n = 165), the CO In this pilot study of patients with suspected sepsis from non-respiratory causes, an increased CO
Publisher: Springer Science and Business Media LLC
Date: 20-05-2018
Location: Australia
Location: Switzerland
Location: Australia
Start Date: 04-2015
End Date: 10-2020
Amount: $363,536.00
Funder: Australian Research Council
View Funded Activity