Cerebrum Fall 2021

ACADEMIC ESSAY Continued Access to Invasive Neural Devices: Lessons from the AIDS Epidemic I N 1987, AS AIDS BEGAN TO TAKE HOLD IN THE US, the compound azidothymidine (AZT) was entered into phase I clinical trials. At the time, a positive HIV diagnosis was a life sentence. So, when participants receiving AZT started to improve, many argued that AZT be made immediately available to all HIV-positive patients. This classic case was the origin of the debate around “expanded access,” or whether there is a By Nathan Luke Higgins, Monash University (Australia) moral obligation for researchers to make experimental compounds available to extremely vulnerable patients. As the AIDS epidemic reached its nadir in the 1990s, desperation for anti-retroviral drugs safer and more effective than AZT drove pharmaceutical companies to conduct trials of novel compounds in nations hard-hit by AIDS, such as South Africa, Uganda, and Zimbabwe. These trials, conducted in predominantly low-income nations, raised a separate but related ethical dilemma: Is there a moral obligation, once the trial has ended, to provide continued access to a beneficial medication? In 2000, the Joint United National Program on HIV/ AIDS issued a guideline that specifically addressed continued access, namely that “any HIV preventative vaccine demonstrated to be safe and effective (…) should be made available to all participants in the trial in which it was tested.” The debate over continued access has since diversified, and has been recognized in international ethical documentation, such as the Declaration of Helsinki, and by the Council for International Organization of Medical Sciences and World Health Organization. In recent years, statements released by pharmaceutical companies suggest convergence on the conditions under which continued access to drugs ought to be offered to participants. l

HIGH SCHOOL Exploring the Ethical Implications of Neurotheological Studies By Rafael Hiu Nok Au (Hong Kong) “ T HE KINGDOM OF GOD IS WITHIN YOU.” The renowned biblical saying has been proclaimed by not only prophets, but recently also endorsed by some neuroscientists. As the development of neuroscience increasingly provides more and more scientific explanations for things we think and feel, some neuroscientists propose that spiritual and religious beliefs must have some sort of neuroscientific basis. The notion has evolved into a separate branch of study—neurotheology — where neuroscientists attempt to explain religious experience and behavior in neuroscientific terms. As an example, a study carried out by Newberg et al. investigated the effects of a type of Islamic prayer, which is described to evoke feelings of “surrender” and “connectedness with God,” on brain activity by measuring changes in cerebral blood flow (CBF) using single-photon emission computed tomography. Compared to a less intense Islamic prayer, the target sample displayed decreased CBF in the prefrontal cortex and related frontal lobe structures, and increased CBF in the caudate nucleus, insula, thalamus, and globus pallidus. l

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