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Diversifying the Bioethics Funding Landscape: The Case of TMS

Fabi and Goldberg (2022) investigate how funding availability influences the landscape of bioethics as a field, and (inadvertently) perpetuates forms of social and epistemic injustice while limiting diversity. We propose that it would be worthwhile to specify ways in which the diversity of bioethics scholarship can be promoted, specifically in terms of the review and rating process. Our suggestion is that these should be a system akin to the National Institutes of Health (NIH) mechanisms for promoting “early career” researchers and that current mechanisms, such as the mandatory inclusion of a “Plan for Enhancing Diverse Perspectives”, are not sufficient. Additionally, we would like to bolster Fabi and Goldberg’s argument by reflecting on the kinds of neuroethics research being supported by the NIH Brain Research Through Advancing Neurotechnologies (BRAIN) Initiative. Namely, the requirement that ethical scholarship has to address the cutting edge of technology means that technologies that are still in development and not yet approved treatments (Voarino et al. 2017) are being given priority. One such example is transcranial direct current stimulation (tDCS), which is explored by multiple BRAIN Neuroethics grants, while another neuromodulation technique, transcranial magnetic stimulation (TMS), a Food and Drug Administration (FDA)-approved therapeutic used to treat thousands of people has received no funds for sustained ethical analysis. We conclude by specifying the mechanisms (e.g., reformulation of “innovation” scores) which would increase the diversity of topics and methodologies being funded in bioethics research. Fabi and Goldberg argue that there is a strong moral justification for changing the allocation of funding streams in bioethics to support more diverse scholarship. However, stating that something ought to be done does not provide guidance on how this may be accomplished (Dubljevi c 2019). Philanthropic and industry funding of bioethics scholarship is largely unregulated (Fabbri et al. 2018) and permits a “lack of transparency and reliance on informal systems of personal networks and relationships” in funders’ decision-making processes (Pratt and Hyder 2017, 457). However, most funded bioethics scholarship is actually supported by the U.S. government. Sharp and colleagues (Sharp et al. 2008) conducted a survey on the funding disclosures in major bioethics journals: 45% of published articles reported at least one source of research funding, while only 14% reported two or more funding sources, and 64% of funders were U.S. government agencies. In certain areas of governmental bioethics funding, most notably the NIH BRAIN Initiative Neuroethics funding mechanism (RFA-MH21-205), there is a requirement to include a “Plan for Enhancing Diverse Perspectives” (PEDP) as part of the application. This may be viewed as the government’s response to just the kinds of concerns that Fabi and Goldberg raise. However, even though the PEDP is touted as an instrument for providing an integrated view of how the enhancement of diverse perspectives is envisioned and supported throughout the duration of the bioethics research project, this one-page document does not provide guidance on how diversity should be achieved at a holistic level.