Legal and ethical issues of using brain imaging to diagnose pain.
Pain Rep 2016;
1:e577. [PMID:
29392197 PMCID:
PMC5741289 DOI:
10.1097/pr9.0000000000000577]
[Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 09/15/2016] [Accepted: 09/17/2016] [Indexed: 12/20/2022] Open
Abstract
Pain, by definition, is a subjective experience, and as such its presence has usually been based on a self-report. However, limitations of self-reports for pain diagnostics, particularly for legal and insurance purposes, has led some to consider a brain-imaging–based objective measure of pain. This review will provide an overview of (1) differences between pain and nociception, (2) intersubject variability in pain perception and the associated brain structures and functional circuits, and (3) capabilities and limitations of current brain-imaging technologies. I then discuss how these factors impact objective proxies of pain. Finally, the ethical, privacy, and legal implications of a brain-imaging–based objective measure of pain are considered as potential future technological developments necessary to create a so-called “painometer test.”
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