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  • imagine.

  • Imagine a brain technology that can lift the darkness from a person with depression.

  • Has no medicine has been able to do?

  • Imagine a brain technology that can give voice to thought.

  • For a person who has suffered a brain injury and has lost the ability to communicate.

  • Imagine a brain technology that can enable a child who's been unable to engage with the world the opportunity to do so.

  • Thes rain technologies are coming at us an incredibly fast rate.

  • You might be familiar with some of them, for example, deep brain stimulation for Parkinson's disease that helps reduce the tremors that patients suffer or surgeries for drug resistant epilepsy in Children.

  • Some of these techniques are reversible.

  • Some are not reversible, permanent and temporary, somewhere highly invasive, and some are entirely non invasive.

  • Are we ready for these technologies?

  • Are we ready for the ethical maze, the hopes and benefits and the risks that they pose thes air challenging questions and wants to which I have devoted my life?

  • I started out as a student in the basic brain sciences.

  • I was really interested in language and information processing and decision making, and then I started to see how closely our brain technologies and our neuroscience was touching us, individuals and societies every day, every moment of our lives, in ways we had never seen before at home, in the classroom, in the workplace and in the courtroom.

  • And so I made a career shift.

  • And today I have the privilege of leading an amazing team of researchers at the University of British Columbia who asked questions that are very specific to this broad question that I've just ask you about the vexing challenges of brain technologies.

  • We ask questions like, Can brain signals really tell us about responsibility?

  • Guilt for innocence?

  • Are they trustworthy?

  • How do we perceive risk and benefits in older people who may be suffering some memory loss, or in Children whose brains and bodies are still developing?

  • How did we manage the extraordinary amount of data that are being collected every day on us?

  • How do we ensure our privacy?

  • How do we think about who's getting these data and where are they going?

  • And so, as we think about these specific questions, we also think about our rights as humans, our rights as people, and I want you to think about your rights as well.

  • What do you perceive to be your rights in terms of access to health care to brain wellness and health?

  • Wellness?

  • How do you think about yourself, Visa, the others, your communities, your families, your loved ones?

  • And how do you think about best practice?

  • What practices are most meaningful?

  • You to you, your definitions of best might be very different than mine.

  • But that's actually where the conversation begins, and that's where we'll go from here.

  • These themes that I've just shared with you, we can encompass them in this way under questions about what's the possibility?

  • What are rights, too?

  • Health, accessibility and what do we think about when we think about accountability in this space?

  • So let's go to our three examples now that I lead with the darkness of depression, the risk of post traumatic stress disorder.

  • And we think of our veterans on this very special weekend, and we honor our heroes.

  • We think about obsessive compulsive disorder, brain technologies that can now restore quality of life to individual suffering from these devastating mental health disorders.

  • We're not the first to think about them in the 15 hundreds and 16 hundreds the ancients had an interesting technique called transformation.

  • It was pretty crude.

  • They would bore little holes into the skulls of people's brains not under anesthesia, usually, and release the evil spirits thought to be underlying mental illness or another art that we have from the 18th century.

  • We have depictions also of this technique called Traffic Nation, in which this stone of madness was released from the brain again to release mental illness.

  • Fast forward.

  • About 300 years, we moved from Traffic Nation toe.

  • A many of you will know a cycle surgery.

  • It was applied to relieve depression in particular and largely among women in North America, in an effort to bring quality of life, but also to alleviate the crowding in the might.

  • Many a psychiatric asylums that we had in this country.

  • They had positive benefits for sure.

  • Some were used pretty rogue, and in that context they had some ill effects.

  • And there were abuses, particularly when there was a tent at an attempt to use them for social control.

  • So about so for about 40 years, this form of psycho surgery went pretty dark.

  • We didn't see them anymore, and in fact, in certain countries they were abandoned altogether and remain so today, starting in about the year 2000 Psycho surgeries back, it's back with good techniques and good ethics oversight.

  • So it's really starting to bring back the hope that these interventions can provide for those among our mental health population about 30% who are actually resistant to drugs.

  • In this context, we're also starting to see the introduction the technique called deep brain stimulation to modulate cells in the brain that might also alleviate depression.

  • And we have been very interested in understanding what is the public think about this come back and the introduction of these very events technologies into age old problems of mental health disorders.

  • So one of the ways we've been embarked on studying this is we looked at the media.

  • What is the media have been publishing?

  • News media?

  • What is the news media have been publishing about mental health disorders and brain technologies?

  • Why are we interested in the media?

  • Well, we know that the media influences public opinion and public opinion influences policy makers, this policy makers who help decide what access to care we get, what's prohibited, what's allowed and ultimately who will pay.

  • So what is the media been reporting for the past 20 years or so about mental health disorders and technologies?

  • Well, a great deal of hope and optimism for these technologies, very interesting.

  • And we've looked at thousands of articles from sources worldwide.

  • We were also very interested in looking at what readers and the public have said about these technologies, and we found equal amounts of hope but particularly hope for the reversible techniques, like deep brain stimulation and a lot of historical caution and fear for the a blade of techniques that are irreversible.

  • And all this.

  • Against the backdrop of what media has been reporting, a Canadian media has been reporting in terms of focus on the capacity and of people with mental health disorders.

  • It's actually considered to a big brain procedure.

  • And the public and readers are telling us Canadian readers and Khalid in public or telling us about authenticity.

  • When are we are cells, or when are we different when the brain electrodes turned on or off?

  • By contrast, U.

  • S press focuses a lot on regulations.

  • It focuses a lot on right to try, and interestingly, it focuses on exceptions to rules.

  • So what do we take as neuro ethicists?

  • In this context, what we feel is that we have a duty to interface with frontline health care providers neurosurgeons to breathe the views off the public to them so that they can understand when they're interfacing with their patients and making helping patients make decisions about risk and benefit invasiveness and non evasiveness.

  • They understand what the thinking is out there, and we have a duty.

  • Is no SS ethicist to work with people like you and the public to really help bring health science literacy to the table so that we can reduce the stigma and the fears around old techniques and ensure that those who might benefit the most have access to them and have access to the support that they rightly deserve.

  • Let's go to our next example Accessibility, Accessibility to communication.

  • A person who has suffered a brain injury or a stroke and has not suddenly locked in has no ability to interact with the outside world or has lost the ability to access words to express themselves, or even has lost the ability to express that they're still conscious.

  • Half a bar after a brain injury when a clinical exam would suggest that they have no consciousness at all.

  • We've had these technologies around for quite some time, using electrical signals and blood flow signals from the brain.

  • We can read imagination, surprise and maybe even signals of consciousness.

  • But these are not simple techniques by any means.

  • They require a huge amount of interpretation and computation.

  • They're not simple windows on the brain, but be that as it may, in what context might they be most beneficial?

  • I would suggest to you that in the context of enabling a person to express hunger or pain, that benefit is on equivocal.

  • But I would also suggest to you that there are situations in which we have to be very thoughtful about how we blight this technology.

  • For example, would we want to use technology mediated communication to enable somebody to report abuse or neglect?

  • Does this communication belong in the courtroom?

  • Would we want to enable a person to change their will, redirect and inheritance or enter into contractual relationship using communication technology mediated communication?

  • Would we want to enable a person who's thought does not have a voice through communication through technology to be ableto ask from medical aid and dying.

  • So as new ethicists, we take these questions.

  • And here in this context, we think about them for neurological psychiatric disorders.

  • And we place not on Lee Outcomes at the forefront.

  • But we think about the consequences, and we try to provide the very best guidance against these backdrops of these very, very vexing quick Let's go to our third example accountability.

  • This is an example of completely noninvasive brain technologies sold in the open market place directly to consumers.

  • Their electrical.

  • There are electrodes they could be sewn into a baseball cap that could be worn as a headset a little bit like my microphone.

  • And the claims about them is that they can help individuals reduce anxiety, be calmer, have better memory, better attention and maybe in the context of youth who are vulnerable, who are unable to engage with the outside world, maybe even used some of mind control technology to play games, mind games and other games with others Sounds pretty fabulous, and I think the potential is there.

  • We do have some concerns about this technology, though, that I want to share with you the first concern is that they're still, in some cases limited scientific evidence to prove and underlie the claims that are made about some devices.

  • In some cases, it exists, but it doesn't exist in all, we definitely have testimonials of benefit.

  • But testimonials are not.

  • Science testimonials are not evidence.

  • We do see some claims about some claims and warnings about safety, for example, but we feel we're not seeing enough of them.

  • We're not seeing warnings about too much youth of the technology.

  • We're not seeing warnings that would ensure that a person, a youth child or even an adult doesn't use this technology in you of conventional drug therapy or psychological support.

  • And we feel for populations for whom these technologies are being marketed.

  • Those warnings need to be absolutely explicit, and today they're largely absent.

  • So we're not work as, nor ethicists.

  • We try to bring these kinds of guidance to the innovators themselves as well as our regulatory agencies, because as these products are marketed for wellness rather than for health, which would require health Canada or U.

  • S FDA approval, they're working against the slippery slope of benefit of wellness and less about health.

  • This in 2021 is projected to be a $20 billion market.

  • What we would like to see is as much an investment in the ethical aspect of this innovation as in the innovation.

  • So so let me summarize for you.

  • This is a large landscape and I've given you only three examples from it.

  • We talked about mental health disorders, and we talked about intervening both invasively and non invasively.

  • We've seen I've shared with you that the media is really hopeful, optimistic and is conveying those messages to the public.

  • We've learned from our research that the public there's a little bit more cautious.

  • We've learned from our second example of using technology to give voice to thought accessibility to the outside world.

  • Where is we?

  • Weren't all toe have benefits of good technology.

  • What we know at this point is that not all applications are appropriate, and until we have a little bit more guidance, a little bit more computational power, we want to be careful how we actually use and apply that technology.

  • And I would suggest you in the context of accessibility.

  • We want to put patients and people before profit.

  • Let's look at our themes again possibility to innovate.

  • Really, The possibilities are endless.

  • They reside on Lee within the imagination of our researchers and are ever evolving computer power accessibility by all means.

  • We want to focus on ensuring that disparities in health care for the brain from neurologic disorders and psych psychiatric disorders are minimized.

  • Everyone across our beautiful country should have access equal and good health care.

  • And accountability is really the cornerstone of it all.

  • So I'll conclude by saying, if we're going to modulate the brain neuro ethics needed we cannot get it wrong.

  • We must get it right.

  • Thank you.

imagine.

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心の変調|ジュディ・イレス|TEDxAbbotsford (Modulating the Mind | Judy Illes | TEDxAbbotsford)

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    林宜悉 に公開 2021 年 01 月 14 日
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