Ethical and Legal Considerations of Alternative Neurotherapies

Abstract

Neurotherapies for diagnostics and treatment—such as electroencephalography (EEG) neurofeedback, single-photon emission computerized tomography (SPECT) imaging for neuropsychiatric evaluation, and off-label/experimental uses of brain stimulation—are continuously being offered to the public outside mainstream healthcare settings. Because these neurotherapies share many key features of complementary and alternative medicine (CAM) techniques—and meet the definition of CAM as set out in Kaptchuk and Eisenberg—here we refer to them as “alternative neurotherapies.” By explicitly linking these alternative neurotherapy practices under a common conceptual framework, this paper draws attention to, and critically considers, the cross-cutting ethical and legal issues related to the provision of these services. The first section of this paper provides an updated empirical overview of uses of SPECT neuropsychiatric evaluations, EEG neurofeedback, and experimental/off-label forms of brain stimulation. Next, drawing on CAM bioethics scholarship, we highlight the pertinent ethical issues in the alternative neurotherapy context, including the truthful representation of evidence base, marketing to vulnerable populations, potential harms, provider competency, and conflicts of interest. Finally, we consider the principal legal issues at stake for the provision of alternative neurotherapies in the U.S., namely those related to licensing and scope-of-practice considerations. We conclude with recommendations for future research in this domain.

Keywords:

• Alternative medicine
• brain stimulation
• neurofeedback
• neuroimaging
• neurotherapies

This article is referred to by:

There Is No Such Thing as Alternative Medicine

Seeing the Forest for the Trees: The Importance of Unifying Ethical and Legal Considerations for Non-Validated Practice of Neurotherapies

Are Alternative Neurotherapies Exempted from Using Current Scientific Evidence?

DISCLOSURE STATEMENT

The authors have no relevant financial or non-financial competing interests to report.

Additional information

Funding

This study was supported by the Office of the Director, National Institutes of Health (NIH) under grant number DP5OD026420.