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At least 109 records · Page 6Linked to original sources
PubMed2006

Depression, SSRIs, and the supposed obligation to suffer mentally.

Within both popular and academic literature, concerns have been expressed about the implications of antidepressant use on character development. In this paper, I identify specific versions of these worries and argue that they are misguided. I begin by arguing that the obligation to suffer if it will bring about a noble character is imagined. Legitimate concerns about character enhancement remain, but they do not count against most antidepressant use. Thus there is no moral prohibition against antidepressant use. Furthermore, some of the calls for caution about antidepressant use, such as those expressed by the President's Council on Bioethics, are overstated.

Advisory Committees↗
PubMed1999

How will we regulate genetic enhancement?

Genetic enhancement technologies present difficult and novel regulatory issues, including the problem of measuring and comparing risks and benefits and dealing with the impact of these technologies on social values. This Article describes and evaluates the potential approaches that may be taken to regulate these technologies. The author concludes that a variety of approaches will be necessary, involving self-regulation, government restrictions on access and use, licensing, and a national lottery.

American Medical Association↗
PubMed2006

Neuroethics.

Neuroimaging, psychosurgery, deep-brain stimulation, and psychopharmacology hold considerable promise for more accurate prediction and diagnosis and more effective treatment of neurological and psychiatric disorders. Some forms of psychopharmacology may even be able to enhance normal cognitive and affective capacities. But the brain remains the most complex and least understood of all the organs in the human body. Mapping the neural correlates of the mind through brain scans, and altering these correlates through surgery, stimulation, or pharmacological interventions can affect us in both positive and negative ways. We need to carefully weigh the potential benefit against the potential harm of such techniques. This paper examines some of these techniques and explores the emerging ethical issues in clinical neuroscience.

Behavior Control↗
PubMed2004

Memory: Pandora's hippocampus?

Greater knowledge of the human brain has enabled us to begin devising therapies to rescue or modify memory for the afflicted, such as Alzheimer's patients or post-traumatic stress disorder victims. This same knowledge could also allow us to alter how normal, healthy memory operates; we may become able to enhance memory and learning through biological intervention. But the brain consists of complex, interactive networks, and unintended consequences could easily occur. Moreover, memory is woven into our individuality. Altering our memory processes therefore risks altering us fundamentally. We may not be able to resist opening this neuroscientific Pandora's Box, John Gabrieli writes, but we must proceed with all the wisdom we can muster.

Amnesia↗
PubMed2006

[Cognition on demand?--The wish for cognition-enhancing drugs in medicine].

DEFINITION OF THE PROBLEM: Due to recent advances in psychopharmacology, a large variety of drugs can be offered that intend to improve one's mood, memory and executive functions. These offers seem to meet the wishes and needs of people striving for enhancement of their mental capacities. How should medicine deal with these wishes? And, especially, what criteria might serve a physician's decision-making? ARGUMENTS: As shown in the following, this decision-making process cannot be convincingly informed by criteria drawing on the distinction between 'enhancement' and 'treatment' or on certain concepts of disease, normality or medicine. Instead, a decision-making model will be developed which builds on the traditional criteria of a physician's practice: the criteria of benevolence, non-maleficence, and autonomy. CONCLUSION: By means of this model, a new concept of "medicine-on-demand" will be suggested: a subjective medicine with a physician's recommendation and veto right.

Biomedical Enhancement↗
PubMed2005

A psychophysical evaluation of spectral enhancement.

Listeners with sensorineural hearing loss have well-documented elevated hearing thresholds; reduced auditory dynamic ranges; and reduced spectral (or frequency) resolution that may reduce speech intelligibility, especially in the presence of competing sounds. Amplification and amplitude compression partially compensate for elevated thresholds and reduced dynamic ranges but do not remediate the loss in spectral resolution. Spectral-enhancement processing algorithms have been developed that putatively compensate for decreased spectral resolution by increasing the spectral contrast, or the peak-to-trough ratio, of the speech spectrum. Several implementations have been proposed, with mixed success. It is unclear whether the lack of strong success was due to specific implementation parameters or whether the concept of spectral enhancement is fundamentally flawed. The goal of this study was to resolve this ambiguity by testing the effects of spectral enhancement on detection and discrimination of simple, well-defined signals. To that end, groups of normal-hearing (NH) and hearing-impaired (HI) participants listened in 2 psychophysical experiments, including detection and frequency discrimination of narrowband noise signals in the presence of broadband noise. The NH and HI listeners showed an improved ability to detect and discriminate narrowband increments when there were spectral decrements (notches) surrounding the narrowband signals. Spectral enhancements restored increment detection thresholds to within the normal range when both energy and spectral-profile cues were available to listeners. When only spectral-profile cues were available for frequency discrimination tasks, performance improved for HI listeners, but not all HI listeners reached normal levels of discrimination. These results suggest that listeners are able to take advantage of the local improvement in signal-to-noise ratio provided by the spectral decrements.

Acoustic Stimulation↗
PubMed2004

Designing the future: NBIC technologies and human performance enhancement.

Never before has any civilization had the unique opportunity to enhance human performance on the scale that we will face in the near future. The convergence of nanotechnology, biotechnology, information technology, and cognitive science (NBIC) is creating a set of powerful tools that have the potential to significantly enhance human performance as well as transform society, science, economics, and human evolution. As the NBIC convergence becomes more understood, the possibility that we may be able to enhance human performance in the three domains of therapy, augmentation, and designed evolution will become anticipated and even expected. In addition, NBIC convergence represents entirely new challenges for scientists, policymakers, and business leaders who will have, for the first time, vast new and powerful tools to shape markets, societies, and lifestyles. The emergence of NBIC convergence will challenge us in new ways to balance risk and return, threat and opportunity, and social responsibility and competitive advantage as we step into the 21st century.

Biological Evolution↗
PubMed2004

Cosmetic neurology: the controversy over enhancing movement, mentation, and mood.

Advances in cognitive neuroscience and neuropharmacology are yielding exciting treatments for neurologic diseases. Many of these treatments are also likely to have uses for people without disease. Here, I review the ways in which medicine might make bodies and brains function better by modulating motor, cognitive, and affective systems. These potential "quality of life" interventions raise ethical concerns, some related to the individual and others related to society. Despite these concerns, I argue that major restraints on the development of cosmetic neurology are not likely. Neurologists and other clinicians are likely to encounter patient-consumers who view physicians as gatekeepers in their own pursuit of happiness.

Affect↗
PubMedDate not supplied

Enhancing cognition in the intellectually intact.

As science learns more about how the brain works, and fails to work, the possibility for developing "cognition enhancers" becomes more plausible. And the demand for drugs that can help us think faster, remember more, and focus more keenly has already been demonstrated by the market success of drugs like Ritalin, which tames the attention span, and Prozac, which ups the competitive edge. The new drug Aricept, which improves memory, most likely will join them. Whether such drugs are good for individuals, or for society, is an open question, one that demands far more public discussion.

Brain Diseases↗
PubMed2001

Enhancement of fibrinolytics with a laser-induced liquid jet.

BACKGROUND AND OBJECTIVE: There are several problems inherent in the treatment of cerebral embolisms, such as the narrow therapeutic time window and the severe side effects of fibrinolytic drugs. There is thus need of a new method of removing a cerebral thrombus more rapidly using smaller amounts of fibrinolytics. STUDY DESIGN/MATERIALS AND METHODS: The liquid-jet generator was made by insertion of an optical fiber (diameter: 0.6 mm) into a balloon catheter (6 Fr). A pulsed holmium (Ho) YAG laser (pulse duration time = 350 micros) was used as a laser source. The maximum penetration depth of a liquid jet generated with this device into a gelatin artificial thrombus was measured at various stand-off distances (L; distance between the optical fiber end and the catheter exit). Based on the result, a stand-off distance of 13 mm was chosen to investigate the enhancement of urokinase (UK) efficacy by only a single operation of the liquid-jet device in artificial thrombi made of human blood. RESULTS: Maximum penetration depth increased in proportion to L and reached a maximum value (9 mm) when L was around 13 mm. Fibrinolysis rates (%) after incubation with a small amount of UK for 10 and 30 minutes were predominantly raised by a single use of the laser-induced liquid jet (5.4 +/- 2.4 vs. 22.6 +/- 6.1 and 7.3 +/- 3.8 vs. 38.3 +/- 5.6, respectively (mean +/- SD, P < 0.001)). CONCLUSIONS: A laser-induced liquid jet effectively promoted fibrinolysis in vitro with use of only a small amount of fibrinolytics.

Analysis of Variance↗
PubMed2005

Judgments of the fairness of using performance enhancing drugs.

Undergraduates (total N=185) were asked about performance-affecting drugs. Some drugs supposedly affected athletic performance, others memory, and other attention. Some improved performance for anyone who took them, others for the top 10% of performers, others for the bottom 10%, and finally, yet other drugs worked only on the bottom 10% who also showed physical abnormalities. Participants were asked about the fairness of allowing the drug to be used, about banning it, and about whether predictions of future performance based on testing with or without the drug were better. The study found that participants appreciated the "interaction effect," that they felt it was less unfair to allow the drug if it affected the bottom 10% than if it affected everyone, and they were more eager to have the drug banned if it affected everyone. Participants were least tolerant of drugs that affected athletic performance and most tolerant of those that affected attention.

Analysis of Variance↗
PubMed2005

Forthcoming ethical issues in biological psychiatry.

Ethical issues in biological psychiatry are framed by (i) progress in the neurosciences, and (ii) a changing socio-cultural context. With regard to forthcoming neurotechniques to modify specifically defined brain functions by pharmacological substances with selective effects, by activating neuroplasticity including neurogenesis, or by implantation of neuronal tissues or computer-brain interfaces, etc., ethical problems will develop (i) at the border between therapy of diseases and enhancement of abilities in healthy people with regard to effects on society (e.g., social justice: equal access, loss of societal diversity) as well as on human value systems (e.g., personality, efforts, conditio humana), and (ii) at the border between the medical system and the wellness market with regard to financing what by whom? Ethical dilemmas in psychiatry develop (i) between the individual's best and the common good (demanded from outside medicine), (ii) among different ethical principles (inside medicine), iii) if solutions are influenced by personal reasons without observing ethical principles. Ethical guidelines are necessary for ethical orientation, but may protect against misconduct only (i) if psychiatrists are educated in ethics and (ii) if psychiatric acting is under continuous debate (by ethical review boards or the public). Thus, if we psychiatrists will become ethically sensitive by reflecting and perhaps solving our current ethical dilemmas we will be prepared to deal with forthcoming ethical issues in biological psychiatry.

Biological Psychiatry↗
PubMed2002

Enhanced guided bone regeneration with a resorbable chamber containing demineralized bone matrix.

BACKGROUND: The effectiveness of a nonporous poly-DL-lactide tubular chamber in guiding bone regeneration through a long bone defect had already been assessed in an experimental model using the rabbit radius. The injection of bone marrow stem cells into the chamber had proven to enhance bone regeneration. METHODS: The present study reports on the development of the above research project in a subsequent stage. Demineralized bone matrix (DBM) obtained by milling New Zealand rabbit femoral and tibial diaphyses was placed into a tubular chamber. A 10-mm defect was bilaterally created in the radii of 10 rabbits. On the left side (chamber side) the defect was treated by means of a poly-DL-lactide chamber filled with DBM, whereas DBM alone was used on the right side (control). RESULTS: Controls were performed at 3 and 6 months by radiographs and histomorphometry and demonstrated better bone growth on the chamber side versus the control side. A comparison with the results previously obtained by stem cell injection into the chamber revealed significant acceleration of bone regrowth in the first 3 months because of the addition of DBM to the chamber. However, no significant difference was found between the two sides after 6 months. CONCLUSION: These results have confirmed the effectiveness of the chamber as a container for the factors promoting bone regeneration, probably because the osteogenetic activity is maintained in situ.

Absorbable Implants↗
PubMed2006

["Medicine of desire" between commercialization and patient-centeredness].

DEFINITION OF THE PROBLEM: Ample evidence points to an emerging new self-understanding within medical practice, away from the established goals of medicine towards greater responsiveness to individual preferences. ARGUMENTS: The altered self-understanding of medical practice unfettered by indications grounded in concepts of disease can be conceptually characterized as desire-driven medicine, or "medicine of desire." This raises the question of morally justifiable limits for the normative governance of a medicine of desire. CONCLUSION: In liberal societies, only two forms of argumentation seem promising for setting limits to the provision and consumption of what a medicine of desire has to offer: Arguments that place expected benefit into the perspective of risks, and arguments that probe the coherence of desires and their fulfillment against the background of a person's conception of a good life for that person.

Attitude to Health↗
PubMed2002

Protein therapeutics: promises and challenges for the 21st century.

Recent advances in massively parallel experimental and computational technologies are leading to radically new approaches to the early phases of the drug production pipeline. The revolution in DNA microarray technologies and the imminent emergence of its analogue for proteins, along with machine learning algorithms, promise rapid acceleration in the identification of potential drug targets, and in high-throughput screens for subpopulation-specific toxicity. Similarly, advances in structural genomics in conjunction with in vitro and in silico evolutionary methods will rapidly accelerate the number of lead drug candidates and substantially augment their target specificity. Taken collectively, these advances will usher in an era of predictive medicine, which will move medical practice from reactive therapy after disease onset, to proactive prevention.

Animals↗