Ayden Jacob

The Academy of Medical Ethics in Bio-Innovation

Google has unveiled a new project it has been working on: Google Genomics , a proposal for a web-based application programming interface (API) designed to import, process, store, and search genomic...

Researchers have developed an innovation which will change the way we manage heart disease by enabling the detection of abnormal heart characteristics at an early stage of a forthcoming disease. Engineers have created a 3-D elastic membrane made of a soft, flexible, silicon material that is  shaped to match the heart's epicardium. This material can potentially be infused with sensors to detect pH levels and ventricular arrhythmia. "Each heart is a different shape, and current devices are one-size-fits-all and don't at all conform to the geometry of a patient's heart," says Efimov, the Lucy & Stanley Lopata Distinguished Professor of Biomedical Engineering. "With this application, we image the patient's heart through MRI or CT scan, then computationally extract the image to build a 3-D model that we can print on a 3-D printer. We then mold the shape of the membrane that will constitute the base of the device deployed on the surface of the heart."

The Biggest Problem in Mental Health Treatment 

Viktor Frankl, Logotherapy Inventor

      Living an unexamined life in a generation infiltrated with new health policies and technologies enables the unjust to progress without scrutiny. Thus, to refine the status quo of psychiatric treatment necessitates a dialogue which encourages criticism leading to change. It is not only our duty to highlight the deficient methods of caring for the mentally ill, but our obligation must inculcate suggestions for tangible improvements in how we view and treat individuals suffering from a mental health disorder. A holistic understanding of the root of a problem is an imperative element in forming a productive solution. Thus, a basic explanation of the biggest problem in mental health care is necessary.        You know someone suffering from a brain disorder. Yes, you. Every person has a family member or friend struggling with a disease rooted in the chemistry of the brain. Whether you know someone with schizophrenia or depression, the prevalence of mental illness in our communities is palpable. And yet, our willingness to treat these patients with the same empathy as someone with a cardiovascular disease is limited. That our communities are guilty of misunderstanding individuals with a mental health disorder is not our biggest problem. Our biggest problem is not how the community views these individuals, but how medical society interacts with these needy patients.         The trap of psychiatry rests in the inability of the diseased to fully grasp the depths of their abnormal state of health. The trap of the mind comes forth when a clear paralysis of cognition is demonstrated. The trap of medicine exists at the intersection of these two mysteries, thereby producing our biggest problem.       The common denominator between every disease and disorder is consciousness. Whether it be a heart attack or a broken bone, the patient is conscious that they have currently entered an ill-state ; a person is cognizant of their illness, and this awareness prompts them to seek medical attention. The equation is quite simple: the brain is informed of internal damage that requires medical assistance. Subsequently, your brain informs your mind that you are currently sick, and hence need to obtain a particular type of intervention to reprogram your body to a healthy state of being.       Yet, can one become aware of their sickness if the diseased organ is the very place which produces conscious thought?       A sane person retains their cognitive abilities throughout a medical illness; however, a psychiatric patient is robbed of the ability to fully grasp that they are in need of help. Medicine has produced a fact in the last 10 years: the neuronal circuitry in psychiatric patients is abnormal. The brain simply does not work. And yet, we not only expect for these unfortunate patients to seek proper medical care, but we make it a perquisite for psychiatric patients to initiate their treatment.     The unifying commonality of awareness between all disease states excludes psychiatric illness. Nevertheless, we illogically obligate them to produce the same qualifications as any other sick person : they must willingly request treatment. Simultaneously, though, we are the ones who have professed that the mentally ill harbor within their skulls a dysfunctioning brain. The same white coats who have revealed the abnormality of psychiatric brains will refuse to treat these brains without their consent. This is the biggest problem the mental health community faces.       As we develop new technologies and better pharmaceuticals to treat mentally ill patients, it is our responsibility to concurrently push for an evolution in how these interventions are administered. The community of patients that refuses to get help may very well be the exact population we need to be targeting. Health advocates, friends and family members are incapable of providing solutions to these patients, for the patient does not consciously recognize his illness. Certainly, the ethics of consent proves to be the grand obstacle in our journey towards implementing a new set of laws governing mental healthcare policy. A physician swears to actively do no harm unto a patient, and yet we live in a time when doing nothing is the greatest medical harm of all. Shall we remain idle and silent, perhaps even indifferent, as persons with tremendous needs become sicker? Is it ethical for us to remain content with the current state of affairs? Ask yourself: perhaps withholding treatment that would most likely improve the brains of these patients is the greatest harm we may be inflicting. The time has come for us to change these laws, offering a better chance of treating the most complex organ in the universe.  These mental wounds inflict perpetual damage which continuously steals

             the ability of the brain to realize it is wounded evermore.                                        

                    How will someone suffering from a disease they are                                          unable to recognize ever heal?

Psychosurgery 

Surgical Intervention for Mental: Is is real? 

The introduction of innovative biomedical technologies, as well as enhanced neuropharmacologic therapies, has provided the mental health community with the ability to treat mental health patients with quality care. Understanding the neurobiological basis of psychiatric disease may afford us with the ability to further our comprehension of the underlying mechanisms in these diseases, and thereby develop improved methodologies of treatment. A very limited percentage of patients are eligible for neurosurgical intervention to treat their brain-based mental disorder. This extreme practice of psychosurgery illustrates how the biomedical community identifies neuro-substrate regions of the brain which may account for specific psychiatric disorders, and subsequently modify them in an attempt to alter behavior.  Chaotic. Extreme. Barbaric. Irresponsible.

These are the descriptions which the critic may impose on this art of medicine. Yet, the neuroscience community understands that every true medical breakthrough is met with its initial skepticism and resistance. And, if we are to fight the war on mental health with our complete repertoire of therapeutic interventions, than a comprehensive analysis on the evolution of this risky treatment option is warranted.  Our modern understanding of functional neuroanatomy, combined with advances in stereotactic technology and functional imaging, creates a setting in which neurosurgery may offer a minimally invasive and highly selective treatment option for a variety of psychiatric illnesses. 

Currently, the accepted therapeutic approach to most psychiatric disease involves a combination of well-supervised psychotherapy, pharmacological intervention and even in some instances, electroconvulsive therapy.  However, despite these modern treatment methods, many patients fail to respond to treatments sufficiently, and unfortunately remain severely disabled by their disease. Consequently, the performance of surgery to control the haunting symptoms of a disturbed mind may very well be a viable option in the future of psychiatric treatment. 

The Aims of Neuroethics in Clinical Medicine and Scientific Research 

         Bioethics and Neuroethics. Two roads that share some common ground, but each leading you into a complex arena of ethical issues quite different from the other. We are bewildered at the complexity of our brains, and we have nothing concrete to say about the workings of the conscious mind. However, as we push the envelope in neuro-based therapies, we are guided by an ever-developing set of ethics. Sociologists, philosophers, scientists and physicians each need to contribute to Neuroethics, as it will guide our generation into the new realm of neuro-therapeautics. Within this section, we will explore what neuroethics truly is, and what it has to say about the current state of neurobiolgical disease. We aim to refine our definitions of psychiatric disease, and shed light onto the moral guidelines behind neuro-interventional procedures. Further, we look to critique the current mental-health system, and provide realistic guidelines for a better community of mental-health advocates. A deeper insight into how the biomedical community views the most respected organ in the universe is provided by leading thinkers in the field of psychiatry, neurosurgery and radiology. As technology begins to cut its way into the brain, literally, we must build up a field that inculcates the values and standards necessary to ethically guide these innovations. The limitations to how the brain must be treated are set by Neuroethics, and the rules by which hospitals and research centers alike must follow are administered by this developing field. Neuroethics does not belong to the domain of medicine alone. It is a synthesis of thought between the humanitarian scholar and the researcher alike; it is a deeper look into the relationship between the mind and the body. More importantly, Neuroethics is the platform by which we may open a dialogue between utterly opposite fields of study, and incorporate them into a painted beauty of art which illustrates the ever-growing nature of medicine, and its impact on every arena in the known universe.