Tangles of Neurogenetics, Neuroethics, and Culture

Influencing discussions and use of neuroadvancements as professionals and citizens: Perspectives of Canadian speech-language pathologists and audiologists

BACKGROUND: Early involvement of stakeholders in neuroethics and neurogovernance discourses of neuroscientific and neurotechnological advancements is seen as essential to curtail negative consequences. Speech-language pathologists (SLPs) and audiologists (AUs) make use of neuroadvancements including cochlear implants, brain-computer interfaces, and deep-brain stimulation. Although they have a stake in neuroethics and neurogovernance discussions, they are rarely mentioned in having a role, whether as professionals or as citizens. OBJECTIVE: The objective of the study was to explore the role of SLPs and AUs as professionals and citizens in neuroethics and neurogovernance discussions and examine the utility of lifelong learning mechanisms to learn about the implications of neuroadvancements to contribute in a meaningful way to these discussions. METHODS: Semi-structured interviews conducted with 7 SLPs and 3 AUs were analyzed using thematic analysis. RESULTS: Participants stated that their roles expected from them as professionals and as citizens indicate the importance to be knowledgeable on ethical, legal, and social implications of neuroadvancements and that lifelong learning is not used to learn about these implications. CONCLUSION: More must be done to facilitate the participation of SLPs and AUs in neuroethics and neurogovernance discussions, which would enrich the neuroethics and neurogovernance discourses benefitting patients, professionals, and the public.

Alzheimer's Disease in the Latino Community: Intersection of Genetics and Social Determinants of Health

Alzheimer's disease (AD) is the most common type of dementia among individuals 65 or older. There are more than 5 million diagnosed cases in the US alone and this number is expected to triple by 2050. Therefore, AD has reached epidemic proportions with significant socioeconomic implications. While aging in general is the greatest risk factor for AD, several additional demographic factors that have contributed to the rise in AD in the US are under study. One such factor is associated with the relatively fast growth of the Latino population. Several reports indicate that AD is more prevalent among blacks and Latinos. However, the reason for AD disparity among different ethnic groups is still poorly understood and highly controversial. The Latino population is composed of different groups based on nationality, namely South and Central America, Mexico, and Caribbean Hispanics. This diversity among the Latino population represents an additional challenge since there are distinct characteristics associated with AD and comorbidities. In this review, we aim to bring attention to the intersection between social determinants of health and genetic factors associated with AD within the Latino community. We argue that understanding the interplay between identified social determinants of health, co-morbidities, and genetic factors could lead to community empowerment and inclusiveness in research and healthcare services, contributing to improved diagnosis and treatment of AD patients. Lastly, we propose that inserting a neuroethics perspective could help understand key challenges that influence healthcare disparities and contribute to increased risk of AD among Latinos.

Converging approaches to understanding early onset familial Alzheimer disease: A First Nation study

Objectives:

In 2007, a novel pathogenic genetic mutation associated with early onset familial Alzheimer disease was identified in a large First Nation family living in communities across British Columbia, Canada. Building on a community-based participatory study with members of the Nation, we sought to explore the impact and interplay of medicalization with the Nation’s knowledge and approaches to wellness in relation to early onset familial Alzheimer disease.

Methods:

We performed a secondary content analysis of focus group discussions and interviews with 48 members of the Nation between 2012 and 2013. The analysis focused specifically on geneticization, medicalization, and traditional knowledge of early onset familial Alzheimer disease, as these themes were prominent in the primary analysis.

Results:

We found that while biomedical explanations of disease permeate the knowledge and understanding of early onset familial Alzheimer disease, traditional concepts about wellness are upheld simultaneously.

Conclusion:

The analysis brings the theoretical framework of “two-eyed seeing” to the case of early onset familial Alzheimer disease for which the contributions of different ways of knowing are embraced, and in which traditional and western ways complement each other on the path of maintaining wellness in the face of progressive neurologic disease.

Neurogenetics in Peru: clinical, scientific and ethical perspectives

Neurogenetics, the science that studies the genetic basis of the development and function of the nervous system, is a discipline of recent development in Peru, an emerging Latin American country. Herein, we review the clinical, scientific and ethical aspects regarding the development of this discipline, starting with the first molecular diagnosis of neurogenetic diseases, to family and population-based genetic association studies. Neurogenetics in Peru aims to better explain the epidemiology of monogenic and complex neurodegenerative disorders that will help in implementing public health policies for these disorders. The characterization of Peru and its health system, legal issues regarding rare diseases and the historical milestones in neurogenetics are also discussed.