title: In the mind's eye: provider and patient attitudes on functional brain imaging.
abstract: Success in functional neuroimaging has brought the promise of quantitative data in the form of brain images to the diagnosis of disorders of the central nervous system for which only qualitative clinical criteria have previously existed. Even though the translation of research to clinical neuroimaging for conditions such as major depression may not be available yet, rapid innovation along this trajectory of discovery to implementation compels exploration of how such information will eventually affect providers and patients. Clinical neuroethics is devoted to elucidating ethical challenges prior to and during the transfer of new research capabilities to the bedside. Through a model of proactive ethics, clinical neuroethics promotes the development of responsible social and public policies in response to new diagnostic and prognostic capabilities for the benefit of patients and their families, and for providers within the health care systems in which they practice. To examine views about the potential interaction of clinical neuroimaging and depression, we surveyed both mental health providers and outpatients and inpatients diagnosed with major depressive disorder. From responses of 52 providers and 72 patients, we found high receptivity to brain scans for treatment tailoring and choice, for improving understanding of and coping with disease, and for mitigating the effects of stigma and self-blame. Our results suggest that, once ready, roll out of the fully validated technology has significant potential to reduce social burden associated with highly stigmatized illnesses like depression.
authors.affiliation: Stanford Center for Biomedical Ethics, Stanford University, Department of Pediatric, Stanford, CA 94305, United States. jilles@interchange.ubc.ca
authors.forename: J
authors.initials: J
authors.lastname: Illes
authors.forename: S
authors.initials: S
authors.lastname: Lombera
authors.forename: J
authors.initials: J
authors.lastname: Rosenberg
authors.forename: B
authors.initials: B
authors.lastname: Arnow
mesh_terms: D000328:Adult; D001290:Attitude; D001921:Brain; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis*; D003625:Data Collection / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000941:ethics / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010361:Patients / Q000523:psychology / Q000706:statistics & numerical data; D011570:Psychiatry / Q000706:statistics & numerical data*; D011584:Psychology / Q000706:statistics & numerical data*; D013240:Stereotyping