Identifying the Presence of Ethics Concepts in Chronic Pain Research: A Scoping Review of Neuroscience Journals

Neuroethics 15 (2):1-17 (2022)
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Abstract

Background Chronic pain is a pervasive and invisible condition which affects people in a myriad of ways including but not limited to their quality of life, autonomy, mental and physical health, social mobility, and productivity. There are many ethical implications of neuroscience research on chronic pain, given its potential to reduce suffering and improve the lived experience of people in pain. While a growing body of research studies the etiology, neurophysiology, and management of chronic pain, it is unknown to what degree neuroscience research in this area engages with relevant ethics concepts. Aim To explore the presence of ethics concepts in empirical chronic pain neuroscience literature to advance knowledge regarding the ethics of chronic pain management. Methods We conducted a hybrid bibliometric analysis and scoping review of chronic pain neuroscience articles published between 1999 and 2021 to identify the presence of ethics concepts. We selected articles from the top, middle, and bottom 20 neuroscience journals ranked by Impact Factor. We conducted a database search of Web of Science and a hand-search using PubMed, Google Scholar, and the reference lists of included articles. Findings Our database search yielded 2779 results from which 46 articles met inclusion criteria. An additional 13 articles were hand-retrieved using PubMed and Google Scholar in accordance with the inclusion criteria, totaling 59 articles. We identified four main ethics themes in our analysis: 1) Quality of Life (n = 46), 2) Autonomy (n = 5), 3) Transparency (n = 4), and 4) Beneficence and Non-Maleficence (n = 4). Conclusion Most neuroscience papers do not include a discussion of ethics related to chronic pain conditions. Those that do tend to merely state rather than define or contextualize a particular ethics concept. Given the potential ethical implications of neuroscience research for people living with chronic pain, we argue that to maximize its public health benefit, neuroscience researchers should consider the ethical relevance of their work within their scientific publications. This may generate further ethical reflection within the field, to improve pain management.

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