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A Day in the Life of a Neuroethicist: Amanda Merner

Amanda Merner is a Postdoctoral Research Fellow in Neuroethics at the Harvard Medical School.


1. What’s the first thing you do when you get to work in the morning?


What we all do at the start of a day, open up my emails, take a look at my calendar, and project management software to see if I received any emails that would update my calendar for the day and get a sense of what my time will look like. I also check in with the team to see how everyone is doing and ask if there are any things not on my calendar that they may need my assistance with so I can block that time for them.


2. What’s your work routine like?


The majority of my time is spent doing project management type tasks for the research projects in the lab, working on grant applications, data analysis, and writing manuscripts. I typically have some meetings on the calendar for each of the research projects where we check in on the status of research activities and find ways to facilitate moving the projects forward. I also spend some time on mentoring activities each week, including meeting with mentees in psychology (my home field), and neuroethics discussing manuscripts and projects they're working on, and graduate applications, etc.


3. Are you involved in the theoretical, investigative, or the practical/translational aspect of neuroethics? Describe your research area briefly.


Yes, I have two main lines of research related to neuroethics in addition to my work in psychology/affective neuroscience. The first relates to the ethical, legal, and social implications of genomics for psychiatric conditions, where I investigate clinician and patient perspectives on the use of polygenic risk scores in clinical care. The second line of work (and the one that introduced me to neuroethics while in graduate school--my neuroethics first love) is the ethical, legal, and social implications of novel neurotechnologies. Within this domain, I collaborate with my previous mentor at Cleveland Clinic where we have been working on a study examining personality change in the context of deep brain stimulation using prospective longitudinal mixed-methods research strategies, as well as a study on surgical decision-making with respect to considerations of risk, invasiveness, and efficacy for DBS or MRIgFUS. Our ultimate goal for the DBS work is to create a patient-centered outcome measure that assesses the functional and psychosocial outcomes that are most important to patients. At my current position, I have also worked on personality change in the context of DBS for neuropsychiatric disorders from the patient perspective, and currently am working on a new project examining post-trial obligations for experimental neural implants in which we'll be interviewing past DBS clinical trial patients, their families, and clinicians, as well as industry/insurance partners to determine a path forward for securing post-trial care for these participants.



4. What’s a challenge that you face on a daily basis as a neuroethicist?


I think one of the most challenging aspects of being in neuroethics, which is also a strength of the field, is the interdisciplinary nature of the work. As an experimental psychologist who has focused on the neuroscience and has worked primarily in clinical settings, my training experiences, and the lens I view research and research topics through, is very different than the philosophers and others from the humanities and other fields who have had different training experiences. There are often times at the conceptual stages of research where we're talking about the same concept, but using different language to discuss it because of our training areas, which can create confusion/miscommunication. At the level of research design, I'm trained in qualitative/quantitative/mixed-methods, but I default to quantitative methods often, and many colleagues default to qualitative methods, so we often have to strike up a middle ground and lean back on the research questions at hand to really guide us forward when executing the research. And when writing, we have to integrate everyone's views into a single, cohesive manuscript. At each stage of research (which is my day-to-day work), the interdisciplinary aspect of the work in neuroethics can be challenging and requires curiosity and patience to learn about all of the different ways of tackling neuroethics questions. But that is also what makes the field so interesting and fun to work in.



5. How do you determine what questions deserve the most focus and attention in your work?


For me personally, I want to tackle questions that will have impact NOW. Although I appreciate and value the anticipatory work of many of my close colleagues, I think there are many pressing neuroethical issues that need to be addressed now to improve patient care, and quality of life for patients engaging with neurotechnologies (which in my work encompasses neurotechnologies such as genetic testing for neuro/psychiatric disorders and implantable neural devices like DBS). We need patient-centered outcome metrics for many of these conditions, we need better informed consent processes, we need more education about these technologies for patients and families to inform themselves when making decisions about their care. We need post-trial access for participants who agree to be in investigational trials. So I try to find ways to study things that at the end we have a deliverable product beyond just the journal articles. Whether it is a new measure to assess outcomes, a decision-aid, a new informed consent process, or pilot program to address some challenge, I try to focus on finding actionable ways forward for the issues I study.


6. What do you wish more people understood about being a neuroethicist? Whether it be from a schooling, interest, or day-in-the-life point of view? Describe neuroethics in your own words.


I wish more people knew about the field of neuroethics and its importance to developing technologies in a thoughtful, responsible way. I also think that many people still view neuroethics as a philosophy-dominated field that is concerned only with anticipatory ethical work, and as Wexler and Specker-Sullivan wrote, that it is a field "concerned about being concerned." I think particularly now, and with more trainees entering the field, it is very interdisciplinary and many researchers are conducting research to find actionable solutions to some of the ethical issues in biotechnology/neurotechnology development. So, I wish people knew and appreciated the translational work and the value of integrating ethics into technology development. And that neuroethicists aren't there to be the "ethics police", so to speak. We are there to work in partnership with technology developers to help them consider the end users more closely (and from a different perspective) in the development stages.


7. What skills or training do you most frequently use in your work and how do you suggest more people gain these skills if they want to contribute to the field?


I was trained as an experimentalist in psychology/affective neuroscience. So my training is very research methods and statistics heavy, with a strong neuroscience background. I think this is helpful because I am able to contextualize my research questions from the perspective of the neuroscience underlying a technology. I think (at least I hope), this allows me to ask questions that are informed by the real capabilities and limitations of a technology (rather than being entirely theoretical), which lends itself to asking more relevant research questions. Training in advanced research methods and statistics/data science also allows me to go beyond interviews and surveys only, and use big data techniques to approach these ethical questions. For those looking to gain experience in these areas, I would suggest they seek out additional certificate programs during graduate training, or internship opportunities that would expose them to different learning opportunities. There are also lots of free resources online for those who want to learn about different research methodologies and analytical techniques. A final area that I have found to be incredibly helpful is training opportunities that allow you to interact with the end-users of a technology. For me, this was patients receiving DBS or MRIgFUS. It was extremely helpful for me to interact with the patient population being served by these technologies because it helps orient me to their concerns and values, and helps inform my research questions to make sure that the research outputs are helpful to patients and families. For experience here, I would recommend trainees reach out to ethicists who are embedded in clinical settings to see what opportunities there are for research or for shadowing. Many times there are researchers in these areas with too much work and not enough time, and they welcome a student/trainee to help out with data collection/analysis etc.



8. What do you love most about your work? What keeps you motivated?


Conducting research in the clinical space, I think my favorite part is being able to give patients and care partners/families a voice when it comes to these technologies. There has been a great push for patient-centered care, but it is rare to see patients and families actually consulted when a technology is being developed or implemented. But, through our research, we can gather data from as many patients and care partners as possible and then take those findings to the technology developers, clinicians, policymakers, etc. and show them what the patients are actually saying, and work to find ways to improve patient care and make it truly patient-centered.



9. What’s one thing you wished you did differently in your career trajectory?

I wish I would have gotten more experience on the industry side of neuroethics (and I continue to seek out these opportunities). As technologies continue to expand, it is critical that neuroethicists learn to view the technology development process from the perspectives of the companies developing these technologies so we can find ways to meaningfully, and seamlessly align with companies to ensure the ethical implications are considered. I think often times we see neuroethics in its academic state, but don't look to the translational and applied states. However, if we find ways to embed ethicists within the neurotech companies, we can ensure ethical implications are considered at every step before the product even comes to market, which would be a much more effective and proactive approach to neuroethics.



10. What’s one thing you could advice the next generation of neuroethicists?


Diversify your research and training experiences as much as possible so that you have as many tools in your toolbox as you can when you're trying to conduct research in neuroethics. The more you know about the basic science underlying the technologies, the end users of the technology, and the research methodologies and analytical techniques, the better. This also includes collaboration experiences--I think it's very important to expand training experiences to include collaborations with as many different fields and stakeholders as possible so that you can learn to work effectively in the highly interdisciplinary field of neuroethics, and learn to translate between the jargon from different disciplines. This will make you the most effective researcher you can be, and will also make you a good collaborator.



11. What’s the last thing you do when you leave work in the evening?


Check in with my labmates to see if there were any blockers to getting tasks done and help troubleshoot, and check my email and my project management software for the next day to see what I'll be working on, and adjust tasks as needed to meet any changing timelines.


 

This post is part of the Neuroethics Today blog series 'A Day in the Life of a Neuroethicist' where we bring you answers to questions by junior and senior neuroethicists about a day in their life to give you a better idea of what neuroethicists do, what have they learned throughout their trajectory, and ways that you can do it too.

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