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MRIs and the Perception of Risk

Published online by Cambridge University Press:  06 January 2021

Steven Goldberg*
Affiliation:
Georgetown University Law Center

Extract

The most important safety decision concerning MRIs was to change the name of the procedure. In the late 1970s, the procedure known as nuclear magnetic resonance (NMR) became magnetic resonance imaging (MRI) because of the negative connotations the word “nuclear” invited. Since then, the use of MRIs has flourished. The procedure is now routinely conducted to make medical diagnoses and to study the brain functioning of healthy volunteers participating in research studies devised by, among others, neuroscientists and economists.

There is nothing intrinsically wrong with changing a procedure's name to respond to a public perception of risk, especially when experts do not share that perception. Yet, while MRIs rarely injure patients or test subjects, there is reason to believe that they have important health and safety consequences not captured in standard informed consent forms. These concerns ironically involve perception of risk. On the one hand, unexpected incidental findings of clinically significant conditions in volunteer research subjects raise a host of ethical concerns.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics and Boston University 2007

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References

1 See discussion infra Part III.

2 See discussion infra Part IV.

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4 This account of the scientific origins of MRI technology is drawn from two sources. The National Academy of Sciences has produced a series of articles on basic research entitled Beyond Discovery. See http://www.beyonddiscovery.org/content/view.article.asp?=60 (last visited September 21, 2006). The article on Magnetic Resonance Imaging is my primary source. See Roberta Conlan, A Life-Saving Window on the Mind and Body: The Development of Magnetic Resonance Imaging, Beyond Discovery, Mar. 9, 2001, http://www.beyonddiscovery.org/content/view.txt.asp?a=129 [hereinafter NAS] (last visited September 21, 2006). To a lesser degree, I relied on the far more detailed account in the leading text on the history of MRIs, James Mattson & Merrill Simon, The Story of MRI: The Pioneers of NMR and Magnetic Resonance in Medicine (1996) [hereinafter Mattson].

5 NAS, supra note 4.

6 Id.

7 Id.

8 Id.

9 Id.

10 Id.

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13 Id.

14 See id.

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18 NAS, supra note 4; Siegfried, supra note 15.

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20 NAS, supra note 4.

21 Meaney, supra note 3, at 277.

22 NAS, supra note 4.

23 Meaney, supra note 3, at 277.

24 Id. The leading text on the history of MRIs says the name change was undertaken “primarily to avoid the misleading implication that the technology uses radioactive materials.” Mattson, supra note 4, at 613. .

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40 The report of the workshop, which was sponsored by the American Association for the Advancement of Science and the Dana Foundation, may be found at Neuroscience and the Law: Brain, Mind, and the Scales of Justice (Brent Garland ed., 2004).

41 See id. at 107-108 (discussing future use of functional MRIs without mention of dangers).

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46 See, e.g., Curtis v. MRI Imaging Serv. II, 956 P.2d 960, 961 (Or. 1998); Cassidy, supra note 16, at 37.

47 For an example of standard informed consent language used for MRI research, see Standard Informed Consent Language for MRI Related Research, Memorial Hospital of Rhode Island Committee for Use of Human Subjects in Research, http://www.brainscience.brown.edu/MRF/MR.Risks.pdf (last visited Sept. 25, 2006).

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49 Id.

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