Neuroethics scope at a glance

Neurochips: Considerations from a neurosurgeon's standpoint

A neurochip comprises a small device based on the brain-machine interfaces that emulate the functioning synapses. Its implant in the human body allows the interaction of the brain with a computer. Although the data-processing speed is still slower than that of the human brain, they are being developed. There is no ethical conflict as long as it is used for neural rehabilitation or to supply impaired or missing neurological functions. However, other applications emerge as controversial.

To the best of our knowledge, there have no been publications about the neurosurgical role in the application of this neurotechnological advance. Deliberation on neurochips is primarily limited to a small circle of scholars such as neurotechnological engineers, artists, philosophers, and bioethicists. Why do we address neurosurgeons? They will be directly involved as they could be required to perform invasive procedures.

Future neurosurgeons will have to be a different type of neurosurgeon. They will be part of interdisciplinary teams interacting with computer engineers, neurobiologist, and ethicists. Although a neurosurgeon is not expected to be an expert in all areas, they have to be familiar with them; they have to be prepared to determine indications, contraindications and risks of the procedures, participating in the decision-making processes, and even collaborating in the design of devices to preserve anatomic structures. Social, economic, and legal aspects are also inherent to the neurosurgical activity; therefore, these aspects should also be considered.

Assessment of accessibility to the diagnosis and treatment of brain tumors in Argentina: Preliminary results

Background:

As far as public health is concerned, brain tumors burden is significant despite their low incidence, because they comprise high direct costs (specific diagnostic resources, high complexity treatments, and rehabilitation) and high-unforeseen costs (labor leave, family, and social issues). Although the Argentine's Health System is supposed to provide healthcare to all the population, it would not guarantee equity of access for brain tumors treatment. In order to analyze this hypothesis we decided to carry out a survey to obtain data on access, availability and resources for tumor management in Argentina.

Methods:

An online questionnaire with eight dimensions and 29 queries was conducted addressing all professionals involved in tumor management. Two variables were generated: (1) type of medical center according to their financial support, and (2) the geographic region (GeoR). Analysis of association between these variables and the accessibility to different resources was performed with Chi-square and Fisher's exact test. Multivariate analyses through multiple logistic regression models were also tested.

Results:

One hundred and fourteen surveys were collected from 56 state-managed centers and 55 private/trade-union managed centers. Responders came from 15 provinces grouped into integrated GeoR. Results and analysis of each dimension were reported.

Conclusion:

The data obtained provides information about the accessibility to brain tumors treatment, exposing the unequal distribution of human and technologic resources in Argentina. This problem exceeds the limits of public health to become a bioethical problem. We think these results could be essentially associated to our health system fragmented structure, and the large geographical extension of our country. Finally, we believe that collaboration of professional associations working together with public and private sector authorities responsible for financial resources and logistic should bring a principle of solution.