As the evolution of human kind is turning into a more sophisticated, advanced, and technological orientation every day, the need to further understand the biological structure of human species is given further attention. The ground-breaking discovery of the Functional Magnetic Resonance Imaging (fMRI) provides medical scientists to carefully observe the biological structure of the infants and children to which they have never done before. Researches on different aspect of human anatomy of infants and children are conducted and being conducted all over the world to provide cure and prevention for different kinds of diseases to which the results offer a future with harmonious life and disease-free environment.
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This paper will briefly discuss the brain imaging researches conducted and being conducted to infants and children through the use fMRI and will closely look at the ethical issues of subjecting the children into this kind of research.
Functional Magnetic Resonance Imaging (fMRI) is technological equipment that basically scans images of the brain for proper clinical diagnosis through the use of magnetic resonance. For the purpose of this paper, I have compiled a short list (table below) of fMRI researches executed on infants and children. Most of these researches can be found on the internet such as sciencedaily.com, bri.ucla.edu, nih.gov, cshconnection.org, pediatricsstroke.org, and researchaustralia.com.au. The studies invite infants and children with varying ages to participate and undergo fMRI.
Conducted and On-going Researches on Brain Magnetic Resonance Imaging on Children
|Research Title||Description||Ages of Participants||Requirements of Participants||Source|
|Early Language Focal Lesion Study – Project in Cognitive and Neural Development, UCSD||This study in particular looks at typically developing children and children who have had strokes in-utero or very early in life It would like to show how the brain reorganizes after early stroke. |
This is a longitudinal study that requires the participants to return every 4 to 6 months.
|2-5 years old||Children who suffered congenital stroke between the ages of 7-24 months.||http://www.pediatricstroke.org/research/researchUCSD2.htm(Retrieved December 23, 2007)|
|The Brain Imaging Center at Washington University, St. Louis||The study looks at how the brain works when learning language. More specifically, to understand which regions of the brain contribute to development to children who suffered a stroke and compare them to children who have not.||6 yrs. old and up||Children who experienced a perinatal stroke (a stroke that occurred before, during, or just after birth)||http://www.pediatricstroke.org/research/research_wustl.htm (Retrieved December 23, 2007)|
|Childhood Stroke Study |
(University of California, Children’s Hospital and Health Center, San Diego)
|The study was designed to provide more information regarding emotions, behavior, and thinking in children and adolescents who experienced a stroke.||5-16 yrs. old||Children who suffered a stroke before age 14.||http://www.pediatricstroke.org/research/researchUCSD.htm (Retrieved December 23, 2007)|
|Longitudinal mapping of cortical thickness and clinical outcome in children and adolescents with attention deficit/hyperactivity disorder. (May 2005- ongoing)||This study determines whether regional differences in cortical thickness or cortical changes across time characterize ADHD and predict or reflect its clinical outcome.||8 years old||Participants with ADHD and follow-up clinical evaluations (mean follow-up, 5.7 years).||http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=16651511&query_hl=1&itool=pubmed_docsum|
|Neonatal MRI to Predict Neurodevelopmental Outcomes in Preterm Infants (finished study)||Following the infants from birth to age 2, the researchers were able to grade those abnormalities to predict the risk of severe cognitive delays, psychomotor delays, cerebral palsy, or hearing or visual impairments that may be visible by age 2.||Preterm infants||167 preterm infants in New Zealand and Australia and at St. Louis Children’s Hospital||http://www.sciencedaily.com/releases/2006/08/060818020821.htm|
Human Exposure to fMRI
MRI (magnetic resonance image) employs a strong static and a “switched” magnetic field that obtain tissue images in selected parts of the body by magnetic orientation. The equipment is open at both ends that structures like a large tube-like magnet that emits magnetic waves to scan the human anatomy and blood flow. Substantive evidence suggests that magnetic fields to which humans are exposed for diagnostic purposes result in no serious harm. However, this data is based on studies in which field intensities were at a lower level compared to those that are currently produced by new imagers. Magnetic levels to which patients are exposed fall at Tesla 2 or lower while current imagers operate at strengths between 1.5. to 4 Tesla. (Tesla is the basic unit reflecting the intensity of the static magnetic field to which an object is exposed).
According to the Canadian Guidelines for Ethics Approval of Research Protocols Involving Human Exposure to Magnetic Resonance Imaging of 2005, studies gathered and performed on magnetic field exposure of up to 10 Tesla and from clinical evidence of well over 100 million clinical MRIs, with exception of individuals carrying ferroimplants and fetuses, infants, and young children, there is a substantial margin of safety with human exposure up to 4 Tesla. Although medical practitioners said that it is safe and accurate, too much exposure to magnetic waves and misuses my cause harm to the subject. Hence, the process requires specific, careful and strict attention.
As seen in the table above, fMRIs are performed to infants and children who have had certain conditions such as congenital stroke, cerebral palsy, physiological underdevelopment, etc. in order to find medical solutions for the greater good. However, a study headed by Terrie E. Inder, M.D., associate professor of pediatrics, of radiology and of neurology at Washington University School of Medicine in St. Louis, found that performing MRI scans on pre-term infants’ brains dramatically assist in predicting the babies’ future developmental outcomes (Science Daily, August 18, 2006). The researchers studied 167 preterm infants in New Zealand and Australia and at St. Louis Children’s Hospital.
Is it Ethical?
When studies are done involving infants and children, bioethics is not far from the picture. Bioethics deals with whether science or scientific applications determines social consequence, whether it can be harmful or not. Bioethics involves the rights and responsibilities of human beings as well as qualities such as truth, love, communication, and understanding by consensus.
First, speaking of rights and responsibilities, infants and children have rights like any other person. It is a fact that parents should consider the needs and wellbeing of their children. However, children’s rights have always been bypassed by parents due to a misconception that children have no right, no political power, and no financial independence. In such cases, responsible parental behavior should stem from identifying the dangers that they may pose to their children.
Second, information regarding studies and researches may not be sufficient or inadequate for parents to conduct a suitable decision. If parents subject their child to a study involving fMRI without proper and sufficient biological and technological information about the study then it is an intentional violation of rights. Another consideration is if information offered might be doubtful to which parents might not fully grasped the extent of the repercussion especially the unpredicted longitudinal effects, whether mental, physical, and psychological. As Irina Pollard wrote in her book:
In all free societies citizens enjoy a right of informed consent; it follows, therefore, that potential parents have the right to access information – to be informed how best to balance risk/benefit equations.
Third, infants and children who undergo medical and scientific research when exposed to social reality find themselves unable to cope and adapt socially and psychologically. Most of the infants and children, as shown in the table above, have prior medical conditions that require rigorous treatments. Sometimes, these children create an environment of their own in contrast to the environment of a healthy and normal child. For a child subjected to experiments and tests, emotional and psychological stresses deter their abilities to function in a society as well as coexist with other healthy children. Hence, their experiences affect their perception of life and society.
Last, it seems that knowledge and technology are too much to bear for the sake of the children. Undoubtedly, it is important to seek further knowledge that provides better solutions to all painstaking diseases. However, in search of this knowledge comes the hard truth that thousands of infants and children are treated like guinea pigs or mice. For the benefit of a better future, the well being of infants and children are at stake. Thus, the price of knowledge is too high for the children of today.
As a future medical practitioner, I stand to reason that if and only if it is necessary for infants and children to undergo fMRI procedures for the greater cost of medical breakthrough then I submit to it. However, as an individual actively conforming to the society, infants and children should not be excessively subjected to fMRI procedures without proper consideration and knowledge of the risk factors that are detrimental for their mental and personal development.
Asia-Pacific Perspectives on Ethics of Science and Technology. United Nation Educational Science and Cultural Organization: UNESCO Bangkok Regional Unit for Social and Human Science in Asia and the Pacific, 2007. Web.
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Brain Maturity May Lag In Kids With ADHD.
Early Language Focal Lesion Study: Project in Cognitive and Neural Development, UCSD.
Harding, P. GUIDELINE 2-G-004 HSREB: Guidelines for Ethics Approval of Research Protocols Involving Human Exposure to Magnetic Resonance Imaging. Canada: Health Science Research Ethics Boards, 2005.
In Life, Love and Children: a Practical Introduction to Bioscience Ethics and Bioethics. Boston MA: Kluwer Academic, 2002a. Web.
Magnetic Resonance Imaging (MRI). Zerati, E: 2007. Web.
MRI Scans in Premature Infants Can Predict Future Developmental Delays. Washington University School of Medicine: ScienceDaily, 2006. Published daily. Web.
The Brain Imaging Center at Washington University, St. Louis. For the Sake of the Children