Showing papers by "Cynthia Forlini published in 2017"

Contextualized Autonomy and Liberalism: Broadening the Lenses on Complementary and Alternative Medicines in Preclinical Alzheimer's Disease.

Abstract: Given advances in Alzheimer's disease (AD) research, some experts have proposed a state of "preclinical" AD to describe asymptomatic individuals displaying certain biomarkers. The diagnostic accuracy of these biomarkers remains debated; however, given economic pressures, this "diagnosis" may eventually reach consumers. Since evidence-based prevention and treatment options remain only modestly effective, patients may turn to complementary and alternative medicine (CAM). We explore ethical challenges associated with CAM use in preclinical AD. We first consider these issues through the liberal lens, which emphasizes informed choice while occasionally disregarding the complexity of decision making, at least as currently applied to CAM policies. We then broaden the liberal lens with a socio-contextual lens, which describes the impact of social context on choice. Finally, we describe an alternate lens (contextualized liberalism) and its practical health and policy implications while 1) building on the liberal commitment to autonomy and 2) recognizing contextual determinants of choice.

A prospectus for ethical analysis of ageing individuals' responsibility to prevent cognitive decline.

Abstract: As the world's population ages, governments and non-governmental organizations in developed countries are promoting healthy cognitive ageing to reduce the rate of age-related cognitive decline and sustain economic productivity in an ageing workforce. Recommendations from the Productivity Commission (Australia), Dementia Australia, Government Office for Science (UK), Presidential Commission for the Study of Bioethical Issues (USA), Institute of Medicine (USA), among others, are encouraging older adults to engage in mental, physical, and social activities. These lifestyle recommendations for healthy cognitive ageing are timely and well supported by scientific evidence but they make implicit normative judgments about the responsibility of ageing individuals to prevent cognitive decline. Ethical tensions arise when this individual responsibility collides with social and personal realities of ageing populations. First, we contextualize the priority given to healthy cognitive ageing within the current brain-based medical and social discourses. Second, we explore the individual responsibility by examining the economic considerations, medical evidence and individual interests that relate to the priority given to healthy cognitive ageing. Third, we identify three key ethical challenges for policymakers seeking to implement lifestyle recommendations as an effective population-level approach to healthy cognitive ageing. The result is a prospectus for future in-depth analysis of ethical tensions that arise from current policy discussions of healthy cognitive ageing.

Patient Preferences May Be Indicative of Normative Issues in Dementia Research.

Abstract: Robillard and Feng highlight incongruence between patient preferences and the procedural aspects of research ethics as they relate to protocols for dementia research Their findings break ground for a reassessment of how research ethics, researchers, and participants (including patients and caregivers) approach participation in dementia research However, it is unclear whether patient preferences may also herald a normative gap between how dementia research is being conducted and how it should be done This response uses one of Robillard and Feng's findings to illustrate how descriptive empirical data might be reinterpreted into normative questions that reframe current practices in the context of dementia research

Growing Up with Neuroethics: Challenges, Opportunities and Lessons from Being a Graduate Student at a Disciplinary Crossroads

Abstract: As neuroethics grew as a field of study, training and research progams produced a cohort of pioneer graduate students. These students helped define the foundations and develop neuroethics scholarship as we know it. In this chapter, I describe three persisting experiences that marked my graduate studies in neuroethics: (1) training and researching at a disciplinary crossroads, (2) establishing a knowledge base in a nascent and interdisciplinary field and (3) practising responsible communication of topical research. Each experience presented unique challenges, opportunities and lessons that marked my journey as a graduate student during the emergence of neuroethics and influenced my trajectory as an early career researcher. I conclude by considering how growing as a researcher alongside a developing field contrasts with the experience of current students within specialized neuroethics training and research programs.

Throwing the Ethics (Hand)Book at Professional Organizations in the Neurological Sciences

Abstract: Moses and Illes (2017) convincingly illustrate the poor and heterogeneous representation of ethics in professional organizations, focusing on the neurological sciences. While we welcome their criti...