Arianna Manzini


Arianna is a Wellcome Trust-funded DPhil student at Oxford, supervised by Prof. Ilina Singh (Department of Psychiatry) and Dr Nina Hallowell (Ethox Centre). Within the BeGOOD team, her research is an empirical bioethics study situated at the intersection between the ethics of neuropsychiatric genomics, the scholarship on biological citizenship, and the literature on childhood participation. Her thesis uses autism genomics as a case study to investigate the moral attitudes that young people, i.e. ‘developing’ genomic citizens, hold in the context of the application of genomic science to psychiatric conditions. Arianna developed the methodological design of her research in consultation with the NeurOx Young People’s Advisory Group, which she has contributed to set up as part of Citizens: EIE, and she conducted focus groups with young people between 13-18 years old, recruited from schools and youth groups in the UK

Arianna holds an undergraduate degree in Philosophy from Università Vita-Salute San Raffaele, Milan (2014); an MA in Philosophy, Politics, and Economics of Health from University College London (2015); and an Erasmus Mundus MSc in Bioethics from KU Leuven (2016).

Publications

  • Is coercion ever beneficent? Public health ethics in early intervention and prevention for mental health

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    Early intervention in mental health seeks to improve the wellbeing of as many people as possible, by intervening at an early stage in the onset of illness, or by taking preventative action in ‘at risk’ populations. The paradigm is rhetorically powerful, and it is easy to talk in terms of it helping to deliver rights to health and realise social justice. However, in spite – or perhaps because – of the apparently unarguable desirability of such goals, it is harder to discuss rights to dissent. In this respect the risk of coercion is an issue that should be discussed, especially because of the stigmatizing effect that the labelling associated with early intervention may have in mental health contexts. Here we explore this issue, with a particular focus on its practical and ethical implications in relation to UK policy for treating Attention Deficit Hyperactivity Disorder and mild Conduct Disorder in young people.

  • Co-producing research with youth: The NeurOx young people’s advisory group model.

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    CONTEXT: The 1989 UN Convention on the Rights of the Child states that children have the right to be heard in all matters affecting them. The Convention inspired a surge in research that investigates young people's perspectives on health and wellness-related concerns and that involves children as 'co-researchers'. Young people's advisory groups (YPAGs) are a widely used method to enable young people's involvement in all research stages, but there is a lack of academic literature to guide researchers on how to set up, run and evaluate the impact of such groups. OBJECTIVE: In this paper, we provide a step-by-step model, grounded in our own experience of setting up and coordinating the Oxford Neuroscience, Ethics and Society Young People's Advisory Group (NeurOx YPAG). This group supports studies at the intersection of ethics, mental health and novel technologies. Our model covers the following stages: deciding on the fit for co-production, recruiting participants, developing collective principles of work, running a meeting and evaluating impact. RESULTS: We emphasize that throughout this process, researchers should take a critical stance by reflecting on whether a co-production model fits their research scope and aims; ensuring (or aspiring to) representativeness within the group; valuing different kinds of expertise; and undertaking on-going evaluations on the impact of the group on both the young people and the research. CONCLUSION: Adopting a critical and reflective attitude can increase researchers' capacity to engage youth in democratic and inclusive ways, and to produce research outputs that are aligned with the target audience's needs and priorities.

  • Can Your Phone Be Your Therapist? Young People’s Ethical Perspectives on the Use of Fully Automated Conversational Agents (Chatbots) in Mental Health Support.

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    Over the last decade, there has been an explosion of digital interventions that aim to either supplement or replace face-to-face mental health services. More recently, a number of automated conversational agents have also been made available, which respond to users in ways that mirror a real-life interaction. What are the social and ethical concerns that arise from these advances? In this article, we discuss, from a young person's perspective, the strengths and limitations of using chatbots in mental health support. We also outline what we consider to be minimum ethical standards for these platforms, including issues surrounding privacy and confidentiality, efficacy, and safety, and review three existing platforms (Woebot, Joy, and Wysa) according to our proposed framework. It is our hope that this article will stimulate ethical debate among app developers, practitioners, young people, and other stakeholders, and inspire ethically responsible practice in digital mental health.

  • Parental Responsibility in the Context of Neuroscience and Genetics

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    Parental Responsibility in the Context of Neuroscience and Genetics, by Kristien Hens, Daniela Cutas, and Dorothee Horstkötter. Cham, Switzerland: Springer International Publishing; 2017. 246 pp.

  • Predictive Psychiatric Genetic Testing in Minors: An Exploration of the Non-Medical Benefits

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    Predictive genetic testing for susceptibility to psychiatric conditions is likely to become part of standard practice. Because the onset of most psychiatric diseases is in late adolescence or early adulthood, testing minors could lead to early identification that may prevent or delay the development of these disorders. However, due to their complex aetiology, psychiatric genetic testing does not provide the immediate medical benefits that current guidelines require for testing minors. While several authors have argued non-medical benefits may play a crucial role in favour of predictive testing for other conditions, little research has explored such a role in psychiatric disorders. This paper outlines the potential non-medical benefits and harms of psychiatric genetic testing in minors in order to consider whether the non-medical benefits could ever make such testing appropriate. Five non-medical themes arise in the literature: psychological impacts, autonomy/self-determination, implications of the biomedical approach, use of financial and intellectual resources, and discrimination. Non-medical benefits were prominent in all of them, suggesting that psychiatric genetic testing in minors may be appropriate in some circumstances. Further research needs to empirically assess these potential non-medical benefits, incorporate minors in the debate, and include normative reflection to evaluate the very purposes and motivations of psychiatric genetic testing in minors.