An Investigation of the Ethical Issues Presented by the Use of Neuroscience and Genomics in the Diagnosis and Treatment of Psychosis: The Need for Integrated Bioethics

Abstract

In recent years, technological innovation has rekindled the interest in the neurobiology of psychosis. The convergence of neuroscience, next-generation genomics, and data science holds promise to revolutionise how we understand and treat psychotic illness. Yet, moral challenges arise from this endeavour. This thesis presents an ethico-legal investigation into how technology is reshaping neurobiological approaches to psychosis. I first survey the literature on the ethical, legal, and social issues that characterise neuroscientific and genomic approaches to psychosis. In Article one, I argue that we ought to respond to technological convergence by developing an integrated approach focused on the assessment of individual vulnerabilities. I then discuss empirical findings from my fieldwork: in Article two, I show that researchers and health professionals contend that substantial moral challenges arise from having access to neurobiological information because this affects individuals' identity; in Article three, I show that mental health carers demand novel and effective interventions, yet they argue that technological innovation could benefit or harm those who suffer from psychosis depending on whether their needs are appropriately assessed and met. In Article four, I investigate how we should regulate the use of machine learning for psychosis prediction with reference to the jurisdiction of England and Wales; I argue that this is dependent upon the interpretation of the notions of 'risk' and 'harm' in research regulation and mental health law. I conclude by discussing some methodological challenges of empirical ethics in psychiatry, by reflecting on the theoretical implications of the concepts of vulnerability, identity, and care for ethical theory, and by examining the significance of the rise of artificial intelligence for bioethics. Overall, I argue that we ought to work towards a more nuanced understanding of the ethics of technological innovation in psychiatry. We need improved collaboration between ethico-legal scholars and social actors, as well as the revised notions and moral principles that can emerge from this collaboration, in order to ensure that our increased understanding of the neurobiology of psychosis might truly benefit, and not harm, those who suffer from mental illness.

Date of Award	1 Aug 2021
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Soren Holm (Supervisor) & Neil Allen (Supervisor)