Banking (on) the Brain

Lead Research Organisation: University of Edinburgh
Department Name: Sch of Law

Abstract

The Banking (On) The Brain Project (Project) is a multi-disciplinary study that will integrate the learning of - and generate new knowledge relevant to - a range of arts and humanities (A&H) fields. Through close association with scientific researchers, it will determine whether and how discourses emerging from popular culture and humanities disciplines (such as anthropology, history, law, philosophy, and so on) are taken up by, or encoded in, law through its regulation of biomedicine. The Project will investigate key issues relating to the interaction of culture, law, regulation, and science, using brain banking as a case study. It will explore several questions vital to the idea of 'science in culture', namely:

1. What is the nature, value and limits of brain banking and its regulation?
2. What roles do imagination, engagement, and cultural concepts play in supporting and informing (or thwarting) the brain banking endeavour?
3. What might the regulation of brain banking - as an instance of an emerging medically-valued scientific practice - tell us about the culture-law-science nexus and the interactions between these domains?

The answers to these questions will uncover new understandings about the regulation and practice of brain-banking, and will serve as a platform for the design of a longer and larger interdisciplinary project relevant to AHRC themes.

By engaging with a diverse range of A&H and scientific partners (through a series of cross-cutting literature reviews and interdisciplinary workshops), the Project will permit these experts to explore working together to create new epistemologies for collaborative enquiry concerning the cultural and scientific importance attributed to the human brain. In addition, it will show clearly how A&H disciplines can be applied to enduring problems in scientific discovery and its regulation, and it will evidence how science, law and other A&H traditions learn from each other. A central aim of the research will be to create impact within the brain banking community, and we will strive to ensure a project legacy through knowledge-exchange activities that will be ongoing long after the funding for the study is over.

Planned Impact

Both the second Project Workshop and the ultimate Public Symposium will provide key fora for reflections on the Project's impacts to date, and the identification of pathways that can be followed long after the research has been concluded.

POLICY COMMUNITY
We will use a range of communication approaches throughout (and beyond) the Project so as to maximise the potential impacts of the research. We will communicate our research through our existing contacts in the central and devolved UK parliaments and international parliaments, government bodies and departments. Our research will be communicated to our contacts both informally and through formal research briefings. Project findings will be publicised in the Innogen and Script newsletters, and the open access online journal, SCRIPTed, which are read by a wide range of groups that include key policymakers and policy organisations. Throughout the course of the research we will seek to identify and target key policy stakeholders with interests and investments in brain banking organisation and procedures per se. Importantly, the impact of this research will not be limited to the UK; we will disseminate findings and plans for follow-on research to existing and extensive policy and academic contacts around the world, including those in Asia and Latin America, where interest in biobanking, including brain banking, is rising. In this way, impact will be achieved well beyond the confines of the domestic and European setting, thereby adding value to the project investment.

SCIENTISTS AND HEALTH PROFESSIONALS
Through previous research, we have established links with a number of leading scientists and biomedical organisations. In addition to the mechanisms listed above, we expect that one of the key ways in which scientists and health professionals interested in the themes of our research will encounter the research is through the internet. Accordingly, we will build a Project website linked to sites of the Mason Institute, the ESRC Genomics Network, the AHRC Script Centre, the ESRC Innogen Centre, the Centre for Population Health Sciences, and the MRC Brain Bank Network. All of these sites (with the exception of the Mason Institute site, which is just now being built) already represent important conduits for information to both external and internal audiences. Our final report - where we outline our reflections, key findings and plans to proceed - will be published on that dedicated web-page as well as in SCRIPTed. One of the Project Co-Investigators, Prof. James Ironside, is Director of the MRC Brain Bank Network; he will be an important ambassador for the Project within the brain banking community. Again, the research will also be disseminated to known scientific contacts beyond the UK and Europe.

PATIENT GROUPS & PUBLICS
The Project Team has established links with a range of patient and other voluntary organisations, including British Neuropathological Society, Dementia Scotland, Epilepsy Scotland, and patient groups represented by the MRC Brain Bank Network. We intend to create impact within these communities in similar ways to those described above, as well as through more informal emails and meetings. In particular, we will seek opportunities to present our research in accessible ways at patient group meetings. We will also seek to develop new contacts with organisations such as the Alzheimer's Society, and others which have created or are creating disease-specific brain banks. Capitalising on our existing contacts, we will reach public interest groups (Comment on Reproductive Ethics and the Genetic Alliance), students (Edinburgh International Science Festival, inclusion of findings into taught courses), interested members of the public (press releases, Cafe Scientifique, British Science Association, etc.).

Publications

10 25 50
 
Description Through cross-disciplinary investigations and discussions, the Project explored arts & humanities and scientific interactions and the governance of Brain Banking. Structuring questions and findings:

1. To what extent does science reflect A&H conceptions of the brain? The brain has been an object of inquiry for centuries. Views of the importance and function of the brain have changed: Galen considered it a set of cavities occupied by animal spirits; Descartes was more concerned with the mind, consciousness and the soul; he was critiqued by those who framed the brain as an anatomical object. Mid-18th century scholars associated brain function with thought and electricity. Mid-19th century scholars began isolating parts of the brain associated with specific functions (speech). Modern BBing is reflective of the 'biomedicalisation' of society, a phenomenon advanced by the medico-scientific complex and popular desires for deliverance from all manner of conditions and states-of-being. Although A&H and cultural representations of the brain do not obviously influence scientific practitioners, A&H conceptions have exerted a subtle influence on scientific thinking about the brain. What has emerged from their long-time interaction is a conception of the brain as the seat of 'self' (brain function is conflated with 'self'). Neuroscience, of which BBing is a component, draws on the dominant medical paradigm of 'disease': physiological malfunctions can be separated from the person, causatively identified, and symptomatically relieved. BBing also adopts/advances the primary scientific ideology of atomism: the idea that we learn about nature and ourselves by reducing the object of study to its smallest components. Indeed, advances in imaging are leading to claims that it may be the 'gorse' of neural connections that are key.

2. To what extent do these conceptions shape the law? Perhaps surprisingly given the sociological/cultural importance attributed to the brain, the brain has not featured strongly in legal scholarship. It has been the subject of debate regarding brain stem death, and its importance is reflected in awards for brain injuries, but it is treated like any other tissue/organ when it comes to regulation of science. UK legislation does not explicitly mention the brain, and the law has mostly remained steadfastly focused on the self (as subject) rather than the brain (as object); it focuses on capacity and vulnerability and the need for conscious reflection. It resists the neuroscience fixation on brain as self by continuing to rely on 'illnesses of the mind', which permit wider sources of evidence than brain structure/function evidence.

3. To what extent might scientific knowledge impact on popular understandings of the brain and/or inform/influence the law? Scientific metaphors associating the brain with machinery, particularly computers, and modularity, are dominating popular representations. Images of brains held in hands, bandaged brains, brains inserted with usb sticks are common. But genuine public understanding of neurologic knowledge is questionable, partly because it is the more radical and contested claims that are most widely disseminated. Claims that challenge principles fundamental to the law include claims that neuroscience will:
• demonstrate that 'we are our brains';
• alter conceptions of rationality and free will;
• permit technological/technical assessment of truthfulness/guilt;
• allow the measurement of intellectual functionality;
• prove the existence of 'dangerous minds'.
Such claims exert a strong influence on public expectations and demonstrate that debates around 'neurolaw' need further and improved input from A&H.


With respect to the regulation of BBs, we found:

• BBing is governed primarily by the Human Tissue Act 2004 (England, Wales, Northern Ireland) and the Human Tissue Act (Scotland) 2006.

• The HTA 2004 erects a licensing scheme with which BBs must comply. The HT(S)A 2006 does not, but Healthcare Improvement Scotland has recently erected a non-statutory accreditation system designed to demonstrate the 'highest possible professional standards'.

• The HTA 2004 relies on 'consent' whereas the HT(S)A 2006 relies on 'authorisation'. The latter is seen as a departure from passive acceptance; it is more active, reflecting the idea that consent for unspecified future studies cannot be 'informed' and is not properly 'consent'. Both consent/authorisation form characterises donation as a 'gift'.

• In practice, these divergences make no difference; practices are not standardised, but they are harmonised, a primary motivation being to facilitate tissue sharing within the UK.

• BBs in both jurisdictions are members of, and work to standards agreed by, the MRC Brain Banks Network, which formulates common policies and procedures so as to ensure high standards of operation. Its Codes, combined with actor practices, produce a governance framework that exceeds hard law: statutory provisions around consent/authorisation are very specific, placing decisional power with donors. However, practice more closely follows guidelines and the practicalities of promoting respect and harmony between doctor/nurse and patient/family. Thus, whilst legislation offers no veto for relatives of a deceased who has consented/authorised to the use of his/her brain/tissue, the Code urges caution, stating that the impact of going ahead in light of familial opposition should be considered (and BBers never proceed in the face of family discord).

• BBs must obtain approvals from NHS Research & Development and relevant Research Ethics Committees. REC oversight tends to focus on issues of consent/authorisation, compliance of use with originally claimed/anticipated purposes, and third party access, which is also addressed by the Acts. While BBers cannot monitor how (foreign) researchers handle tissue or data provided from UK BBs, BBers come to know regular users and their practices/legislation.

There are ELSIs relevant to BBing that reflect those in other forms of banking (eg: procurement, storage, access, unknown purpose), but there appears to be little dialogue between such banks.
Exploitation Route Our ambition is to secure follow-on funding so that we can work closely with banking practitioners in enhancing vertical and horizontal communication and governance frameworks.
Sectors Healthcare,Pharmaceuticals and Medical Biotechnology

URL http://masoninstitute.org/our-research/banking-on-the-brain/
 
Description 'Body Bits: Social and Ethical Aspects of Donating Human Materials' 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation paper presentation
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Held at Surgeons' Hall Museum, The Royal College of Surgeons of Edinburgh, 2 September 2013, this was Part 3 of a suite of events sponsored by the Wellcome Trust for £1300.

N/A
Year(s) Of Engagement Activity 2013
 
Description 12th World Congress of Bioethics 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Presentation with Aisling McMahon: 'Banking (On) The Brain: From Consent to Authorisation and the Transformative Potential of Solidarity'

Modern technologies and ambitions for biomedicine have resulted in the rise of new models of medical research, including population biobanking. One example of biobanking is brain banking, which refers to the collection and storage of brain and spinal cord samples for research into neurological diseases intended to benefit individuals and society more broadly. Obviously, brain banking involves taking brains and tissue from deceased people, a fact which complicates the task of recruiters and which makes consent a relatively poor tool for stakeholders. This paper will contextualise brain banking, considering the public health issues at stake. It will then explore the legal definitions and demands of , and actual processes around, 'consent' in England/Wales/Northern Ireland and 'authorisation' in Scotland, articulating and evaluating their conceptual and practical differences. It then argues for an expanded but improved operation of 'authorisation' in the brain banking (and broader biobanking) setting, adopting the socio-moral value of 'solidarity' as our foundation and the improvement of the 'public good' as our legitimate
objective.
Year(s) Of Engagement Activity 2014
 
Description Biomedical Ethics Film Festival, Filmhouse Cinema 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact 'The Manchurian Candidate: Social and Ethical Reflections' - presentation with Martin Pickersgill (Edinburgh, School of Molecular, Genetic, and Population Health Sciences)
Year(s) Of Engagement Activity 2012
 
Description Brain Banking: Ethical Issues and Legal Solutions 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation paper presentation
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Participant in International Conference Presentation at the 51st meeting of the American College of Neuropsychopharmacology: 'Practical, Societal, Ethical, and Legal Challenges for Modern Brain and Biobanking: Experiences from America and Europe'

N/A
Year(s) Of Engagement Activity 2012
URL http://www.acnp.org/annualmeeting/programbooks.aspx
 
Description Kent Critical Law Society Annual Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Presentation on 'Regulating Risks in Health and Brain Banking'
Year(s) Of Engagement Activity 2013
 
Description Leaving your Brain to Science: Engaging with Law and Ethics 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Held at the University of Edinburgh, on 25 March 2014, this was part of the AHRC Technoscience, Law and Society series of events.

N/A
Year(s) Of Engagement Activity 2014
URL http://annerowlingclinic.com/events/leaving-your-brain-to-science
 
Description Network Workshop (Edinburgh) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact This was a review of the international regulatory environment applicable to human tissue use, with an emphasis on the findings of the project.
Year(s) Of Engagement Activity 2014
 
Description Twelfth World Congress of Bioethics 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Reported project findings to a diverse international audience.
Year(s) Of Engagement Activity 2014
 
Description XXth World Congress of Psychiatric Genetics 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Conference presentation: 'Brain Banking: Ethical Issues and Legal Solutions'
Year(s) Of Engagement Activity 2012
URL http://meeting.ispg.net/