Ethical issues in the bioprediction of brain-based disorder

<p>The development of predictive biomarkers in neuroscience is increasingly enabling bioprediction of adverse behavioural events, from psychosis to impulsive violent reaction. Because many brain-based disorders can be thought of as end-states of a long development, bioprediction carries immens...

Full description

Bibliographic Details
Main Author: Baum, M
Other Authors: Savulescu, J
Format: Thesis
Language:English
Published: 2013
Subjects:
_version_ 1826286802892226560
author Baum, M
author2 Savulescu, J
author_facet Savulescu, J
Baum, M
author_sort Baum, M
collection OXFORD
description <p>The development of predictive biomarkers in neuroscience is increasingly enabling bioprediction of adverse behavioural events, from psychosis to impulsive violent reaction. Because many brain-based disorders can be thought of as end-states of a long development, bioprediction carries immense therapeutic potential.</p> <p>In this thesis, I analyse issues raised by the development of bioprediction of brain-based disorder. I argue that ethical analysis of probabilities and risk information bioprediction provides is confounded by philosophical and social structures that have, until recently, functioned nominally well by assuming categorical (binary) concepts of disorder, especially regarding brain-disorder. Through an analysis of the philosophical concept of disorder, I argue that we can and ought to reorient disorder around probability of future harm and stratify disorder based on the magnitude of risk. Rejection of binary concepts in favour of this non-binary (probability-based) one enables synergy with bioprediction and circumnavigation of ethical concerns raised about proposed disorders of risk in psychiatry and neurology; I specifically consider psychosis and dementia risk.</p> <p>I then show how probabilistic thinking enables consideration of the implications of bioprediction for two areas salient in mental health: moral responsibility and justice. Using the example of epilepsy and driving as a model of obligations to protect others against risk of harm, I discuss how the development of bioprediction is poised to enhance moral responsibility. I then engage with legal cases and science surrounding a predictive biomarker of impulsive violent reaction to propose that bioprediction can sometimes rightly diminish responsibility.</p> <p>Finally, I show the relevance of bioprediction to theories of distributive justice that assign priority to the worse off. Because bioprediction enables the identification of those who are worse off in a way of which we have previously been ignorant, a commitment to assign priority to the worse off requires development of and equal access to biopredictive technologies.</p>
first_indexed 2024-03-07T01:49:08Z
format Thesis
id oxford-uuid:9978211b-5b61-4dba-bbba-157239664b2c
institution University of Oxford
language English
last_indexed 2024-03-07T01:49:08Z
publishDate 2013
record_format dspace
spelling oxford-uuid:9978211b-5b61-4dba-bbba-157239664b2c2022-03-27T00:14:32ZEthical issues in the bioprediction of brain-based disorderThesishttp://purl.org/coar/resource_type/c_db06uuid:9978211b-5b61-4dba-bbba-157239664b2cMedical SciencesCriminology ? Sentencing and PunishmentPractical ethicsPsychotic illnessNeuroscienceEthics of the biosciencesMolecular neuropathologyPublic HealthEthics (Moral philosophy)PsychiatryNeurologyEnglishOxford University Research Archive - Valet2013Baum, MSavulescu, JSheehan, M<p>The development of predictive biomarkers in neuroscience is increasingly enabling bioprediction of adverse behavioural events, from psychosis to impulsive violent reaction. Because many brain-based disorders can be thought of as end-states of a long development, bioprediction carries immense therapeutic potential.</p> <p>In this thesis, I analyse issues raised by the development of bioprediction of brain-based disorder. I argue that ethical analysis of probabilities and risk information bioprediction provides is confounded by philosophical and social structures that have, until recently, functioned nominally well by assuming categorical (binary) concepts of disorder, especially regarding brain-disorder. Through an analysis of the philosophical concept of disorder, I argue that we can and ought to reorient disorder around probability of future harm and stratify disorder based on the magnitude of risk. Rejection of binary concepts in favour of this non-binary (probability-based) one enables synergy with bioprediction and circumnavigation of ethical concerns raised about proposed disorders of risk in psychiatry and neurology; I specifically consider psychosis and dementia risk.</p> <p>I then show how probabilistic thinking enables consideration of the implications of bioprediction for two areas salient in mental health: moral responsibility and justice. Using the example of epilepsy and driving as a model of obligations to protect others against risk of harm, I discuss how the development of bioprediction is poised to enhance moral responsibility. I then engage with legal cases and science surrounding a predictive biomarker of impulsive violent reaction to propose that bioprediction can sometimes rightly diminish responsibility.</p> <p>Finally, I show the relevance of bioprediction to theories of distributive justice that assign priority to the worse off. Because bioprediction enables the identification of those who are worse off in a way of which we have previously been ignorant, a commitment to assign priority to the worse off requires development of and equal access to biopredictive technologies.</p>
spellingShingle Medical Sciences
Criminology ? Sentencing and Punishment
Practical ethics
Psychotic illness
Neuroscience
Ethics of the biosciences
Molecular neuropathology
Public Health
Ethics (Moral philosophy)
Psychiatry
Neurology
Baum, M
Ethical issues in the bioprediction of brain-based disorder
title Ethical issues in the bioprediction of brain-based disorder
title_full Ethical issues in the bioprediction of brain-based disorder
title_fullStr Ethical issues in the bioprediction of brain-based disorder
title_full_unstemmed Ethical issues in the bioprediction of brain-based disorder
title_short Ethical issues in the bioprediction of brain-based disorder
title_sort ethical issues in the bioprediction of brain based disorder
topic Medical Sciences
Criminology ? Sentencing and Punishment
Practical ethics
Psychotic illness
Neuroscience
Ethics of the biosciences
Molecular neuropathology
Public Health
Ethics (Moral philosophy)
Psychiatry
Neurology
work_keys_str_mv AT baumm ethicalissuesinthebiopredictionofbrainbaseddisorder