Publications : Journal articles

Childhood: a suitable case for treatment?

August 5, 2022. Posted in

Authors: Ilina Singh

We examine the contemporary debate on attention deficit hyperactivity disorder, in which concerns about medicalisation and overuse of drug treatments are paramount. We show medicalisation in attention deficit hyperactivity disorder to be a complex issue that requires systematic research to be properly understood. In particular, we suggest that the debate on this disorder might be more productive and less divisive if longitudinal, evidence-based understanding of the harms and benefits of psychiatric diagnosis and misdiagnosis existed, as well as better access to effective, non-drug treatments. If articulation of the values that should guide clinical practice in child psychiatry is encouraged, this might create greater trust and less division.

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Handbook of Neuroethics

August 5, 2022. Posted in

Novel neurotechnologies, such as brain-computer interfaces (BCI), are generating significant scientific and popular interest. A certain BCI technology, neurofeedback (NF), is increasingly used for managing the symptoms of many conditions, most notably attention deficit hyperactivity disorder (ADHD). Although growing evidence suggests that the method is promising, there is no consensus in the scientific literature about its efficacy, and different sources offer contradictory evaluations. Although neurofeedback has received comparatively little scholarly attention from ethicists, it presents numerous dilemmas that warrant consideration. While the method is already widely used and its acceptability can be expected to grow, the precise mechanism of action and possible adverse effects of neurofeedback are poorly understood at present. The current regulatory landscape of neurofeedback devices seems inadequate, and in particular, the growing commercialization of BCIs and lack of oversight over EEG-based toys and games present a challenge for neuroethical analysis. After a brief discussion of ADHD, and the emergence of neurofeedback, this chapter provides an overview of assessments of NF’s efficacy and a brief survey of some of the ethical and social aspects of the method for pediatric ADHD. The questions covered include adverse effects, regulation, responsible communication, identity considerations, and the enhancement use of BCIs.

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Disciplinary Crossings.

August 5, 2022. Posted in

Authors: Ilina Singh

Eighteen months ago, I left a permanent professorship in a generously interdisciplinary department of sociology and took an impermanent, lower-paying job at a university where I had to apply to something called the “Committee on Distinction” to retain the title of “Professor.” Some people say, “That’s what happens when Oxford calls.” But it wasn’t just that. It was the opportunity to engage in a groundbreaking experiment: to embed and integrate ethics within the Oxford Department of Psychiatry and Neuroscience. It’s a dream job, for which I was willing to cross the disciplinary line into the medical sciences. In the United Kingdom, many bioethicists still work in departments outside science and medicine; similarly, those of us who work on neuroethics and psychiatric ethics tend to inhabit departments of philosophy, law, or sociology. I can report already that interdisciplinarity from this side feels and looks different.

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The Ethics of Excluding Potentially Off-Putting Details From the Recruitment Materials for Perspective Research Participants

August 5, 2022. Posted in

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Risk assessment tools in criminal justice and forensic psychiatry: The need for better data.

August 5, 2022. Posted in

Authors: Ilina Singh, Julian Savulescu

Violence risk assessment tools are increasingly used within criminal justice and forensic psychiatry, however there is little relevant, reliable and unbiased data regarding their predictive accuracy. We argue that such data are needed to (i) prevent excessive reliance on risk assessment scores, (ii) allow matching of different risk assessment tools to different contexts of application, (iii) protect against problematic forms of discrimination and stigmatisation, and (iv) ensure that contentious demographic variables are not prematurely removed from risk assessment tools.

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