Ethical issues in neuroscience research on substance dependence treatment and prevention

Previous chapters have presented the latest findings in neuroscience research, and have pointed to potential treatment and prevention strategies. However, there are many ethical implications of the research itself, as well as the treatment and prevention strategies, that must be considered. The rapid pace of change in the field of neuroscience brings with it a host of new ethical issues, which need to be addressed. This chapter considers the important ethical and human rights issues that are raised by neuroscience research on psychoactive substance dependence.

Ethical considerations for drug abuse epidemiological research

The mortality and morbidity caused by alcohol, tobacco and illicit drug misuse represents a significant public health burden (Ezzati et al., 2002). A key part of the public health response is the collection of epidemiological and social science data to define at-risk populations to identify opportunities for intervention and to evaluate the effectiveness of policies in preventing or treating drug misuse and drug-related harm. The systematic use of epidemiological and social science research methods to study illicit drug use is barely 40 years old in the United States and United Kingdom, which have pioneered this approach. Because of the sensitive nature of epidemiological research on illicit drug use a unique set of ethical challenges need to be explicitly addressed by the field. Although ethics guidelines have been proposed (Council for International Organizations of Medical Sciences, 1991), scholarship on the ethics of epidemiology is scant, and consensus on core values not yet achieved (Coughlin, 2000).

Case fatality after an acute cardiac event: the effect of smoking and alcohol consumption

The objective of this study was to use a population-based register of acute cardiac events to investigate the association between survival after an acute event and history of smoking and alcohol consumption. The population was all residents of the Lower Hunter Region of Australia aged 25 to 69 years who suffered myocardial infarction or sudden cardiac death between 1986 and 1994. Among 10,170 events, 2504 resulted in death within 28 days. After adjusting for sex, age and medical history, current smokers had a similar risk of dying after an acute cardiac event to never-smokers [odds ratio (OR)=1.10, 95% confidence interval (CI) 0.94-1.29]. People who consumed more than 8 alcoholic drinks per day on more than 2 days per week (OR=1.93, 95% CI 1.39-2.69) and former moderate to heavy drinkers (OR=4.59, 95% CI 3.65-5.76) were more likely to die than people who were nondrinkers. The results of this large community study, suggesting no effect of smoking on case fatality and an increased risk of death after an acute cardiac event for heavy drinkers and former moderate to heavy drinkers, highlight the importance of a population view of case fatality. These results can also shed some light on reasons for the paradoxical results from clinical trials. (C) 2001 Elsevier Science Inc. All rights reserved.

Domestic objects and the taste epiphany - A resource for consumption methodology

The presentation of an aesthetic identity involves the accomplishment of a coherent, plausible narrative which links one's choices to desired characteristics of the self. As symbolic evidence of a person's taste, material culture is a vital component of a successful narrative. Via case studies of pivotal household objects, this paper uses face-to-face interview data as a way of investigating processes of aesthetic choice. Household objects are interpreted as material elements imbricated in the presentation of a socially plausible and internally consistent aesthetic self. Narrative analysis, and the concept of the epiphany-object, are proposed as useful ways of accounting for tastes in domestic material culture. Methodological questions of truth-telling and authenticity in the face-to-face context are considered, and the sociological problem of taste is scrutinized in light of ideas about social accountability and textual identity.

Coffee and alcohol consumption and the risk of pancreatic cancer in two prospective United States cohorts

Although most prospective cohort studies do not support an association between coffee consumption and pancreatic cancer, the findings for alcohol are inconsistent. Recently, a large prospective cohort study of women reported statistically significant elevations in risk of pancreatic cancer for both coffee and alcoholic beverage consumption. We obtained data on coffee, alcohol, and other dietary factors using semiquantitative food frequency questionnaires administered at baseline (1986 in the Health Professionals Follow-Up Study and 1980 in the Nurses’ Health Study) and in subsequent follow-up questionnaires. Data on other risk factors for pancreatic cancer, including cigarette smoking, were also available. Individuals with a history of cancer at study initiation were excluded from all of the analyses. During the 1,907,222 person-years of follow-up, 288 incident cases of pancreatic cancer were diagnosed. The data were analyzed separately for each cohort, and results were pooled to compute overall relative risks (RR). Neither coffee nor alcohol intakes were associated with an increased risk of pancreatic cancer in either cohort or after pooling the results (pooled RR, 0.62; 95% confidence interval, 0.27–1.43, for >3 cups of coffee/day versus none; and pooled RR, 1.00; 95% confidence interval, 0.57–1.76, for >=30 grams of alcohol/day versus none). The associations did not change with analyses examining different latency periods for coffee and alcohol. Similarly, no statistically significant associations were observed for intakes of tea, decaffeinated coffee, total caffeine, or alcoholic beverages. Data from these two large cohorts do not support any overall association between coffee intake or alcohol intake and risk of pancreatic cancer.