Ethics in fMRI Studies A Review of the EMBASE and MEDLINE Literature

Functional magnetic resonance imaging (fMRI) has surfaced as a powerful method to study brain function in humans. While the involvement of neuroradiologists in fMRI studies in the clinical setting is obvious, in neuroscience research most of the investigators are not specialists trained in reading brain images. Advances in neuroimaging are increasingly intersecting with issues of ethical, legal, and social interest. Debate on fMRI is starting, mainly under the impetus of a new interdisciplinary field, neuroethics. The objective of this review is to bring forth reflection and discussion about ethical issues regarding fMRI, with emphasis to the perspective of the neuroradiologist. EMBASE (R) and MEDLINE (R) were searched for articles pertaining to ethics in fMRI, between 1991 and 2007. A total of 42 articles were retrieved, 95% published in the last 6 years. Only 10% were published in radiology journals. The major potential ethical issues identified in the reviewed articles concerned recruitment of vulnerable groups; informed consent; incidental findings; limitations of the technique, interpretation and validity of results; risks and safety; confidentiality and privacy; fMRI applications outside the laboratory (presurgical planning; diagnostic and predictive potential; forensic, security, military and commercial use); and public communication of research results. Not all the identified issues in this review were directly relevant to neuroradiologists in particular, but for sure some did. Neuroradiologists must find the time and energy to have an important role in identifying and solving ethical (and related) issues in fMRI, working in collaboration with ethicists, social scientists, clinicians, neuroscience researchers, patients, healthy volunteers, journalists, marketers, lawyers, and policy makers.