Neuroethics of Humanitarian Settings
Neuroethics is founded on centuries of discussion of the ethical issues associated with the mind and behavior of humans. This can term the concerns of social policy implications of neuroscience, and while our world embarks on both technological and medical advances on the neurological basis, more and more studies are touching upon personal and societal phenomena (Hurlemann & Marsh 2016). However, with varying fields and honorary initiatives in place, research and implications of neuroscience and its disciplinaries undertook with a focus in illustrating the high prevalence of altruistic behaviors and evaluation in refugees in the current humanitarian settings is crucial and pivotal to the public health crisis in emergencies of migration. Unfortunately, ethics have yet to be set in place for researchers who delve into the topic of therapy for immediate humanitarian conflict effects on refugees’ minds, predominantly mental disorders, as pre-existing standards are disproportionate and lack inclusivity of differing cultural nuances of migration.
Post-Traumatic Stress Disorder (PTSD), a psychiatric condition that develops in some people who have experienced or witnessed a traumatic event, has disproportionately affected the world’s demographic of refugees. In the modern setting of the humanitarian field, forcibly displaced people make up 68.6 million of the population, and the high risk of PTSD has been estimated to be 30.6% by a meta-analysis of 181 studies (Chow). In this cause, it is identified that refugees suffer a lack of proper research coverage and sufficient data to conclude there must be better policies set in place to mobilize their unique neurobiological disorders. The vast proportion of mental health research, at ninety percent, has focused on the relatively small proportion of the world’s population that lived in high-income countries, currently at ten percent, and the current clinical neuroscience research primarily focuses on westernized, educated, rich, industrial populations (Stein & Giordano 2015). Refugees must be treated in a way that takes into account the neural correlations of cultural differences. According to Chow (unkown), studies have shown that some aspects of PTSD symptomatology are particular to its population.
Global mental health and disorders have disparities within the services provided across different settings, and sometimes do not accommodate the needs of modern conflicts, which bring about the concerns of inclusivity. Neuroethics is concerned with the social and legal implications of neuroscientific advances, thus includes the “pillars of healthcare disparities and the unequal access to benefits” and wellness in such advances. It is vital to address these disparities in the context of the widely amissed population of refugees and ensure that neuroscience research is not misused to fortify asymmetrical relationships between specific individuals, groups, and nations (Stein & Giordano 2015). Because PSTD manifests differently in various groups, and that the refugee status is a consequence of political and militant forces pertaining to certain cultures and societies, it is also vital to include and highlight insights into the nature of PTSD specifically for refugees, which is known as cultural neuroscience.
The American Psychological Association strongly recommends four interventions for treating PTSD, which only includes variations of cognitive-behavioral therapy (CBT), cognitive processing therapy(CPT), and prolonged exposure therapy (PET) that deal with relationships, trauma-related beliefs, and negative patterns of thoughts and behaviors (Chow). These guidelines do not however maximize the “therapeutic efficacy” of certain groups of individuals, such as refugees in this case. To effectively respond to inclusive standards that cover refugees, it is recommended that clinicians focus on improving quality beyond just symptom management by using strategies set forth by the acceptance and commitment therapy model. This model is intended to remove “hindrances” from sub-group patients’ progression of life by helping them accept their negative emotions, and accepting that these emotions are appropriate responses to life experiences of displacement and war conflicts.
This need for personalized and culturally sensitive neurological interventions of PTSD must be acknowledged in the realm of neuroethics and research as growing integrations of new advancements are set forth as the humanitarian crisis grows exponentially. Based on observations, neural circuits are unique in refugees that may vary upon both pre-existing and developing cultural differences (Chow).In order to accommodate specific and unique sub-groups mainly refugees, there must be practically quantitative and qualitative evidence to support that refugees have been disproportionately exposed to PTSD and the existing cultural models must be further modified to equip clinicians when addressing social and psychological needs through therapy when working with displaced peoples.
- Hurlemann, R., & Marsh, N. (2016). Neue Einblicke in die Psychobiology Altruistischer Entscheidungen [New insights into the neuroscience of human altruism]. Der Nervenarzt, 87(11), 1131–1135. https://doi.org/10.1007/s00115-016-0229-3
- Stein, D.J., Giordano, J. (2015) Global mental health and neuroethics. BMC Med 13, 44. https://doi.org/10.1186/s12916-015-0274-y
- Chow, C. (unknown). The Neuroscience of Cultural Sensitivity: A new Paradigm of PTSD Treatment for Refugees. University of Pennsylvania https://neuroethics.upenn.edu/wp-content/uploads/2019/08/Carolyn-Chow-White-Paper.pdf