Incidental finding on ultrasound1/15/2024 ![]() But in many cases, the clinical significance of an incidental finding is unknown. For some incidental findings, it is relatively straightforward to determine when this requirement is met (e.g., when a researcher is highly confident that the finding represents a brain tumor). Essentially, beneficence requires that researchers look for incidental findings - and subsequently disclose them - when doing so is likely to be beneficial to the participant, and the costs are easily bearable relative to the potential benefit. While considerations of autonomy and beneficence are certainly relevant to this discussion, they offer only limited practical guidance. Rather than focussing on whether disclosure is or is not consistent with the interests of participants, we consider what participants are owed as a matter of distributive justice. In this paper, we take a different approach to addressing the problem of how best to manage incidental findings. While these positions have been well-articulated in the literature, little progress has been made in resolving this debate. Conversely, opposition to disclosure has tended to focus on the burden this would place on researchers and the health system, and the risks of unnecessary harm that disclosure places on participants. Various arguments have been presented attempting to justify an obligation to look for incidental findings and to disclose them to participants, including the researcher’s ancillary care obligations, the participant’s right to control information about themselves, and more general concerns of beneficence and autonomy. 1 Two related questions dominate the discussion: to what extent should neuroimaging researchers look for incidental findings, and what should be disclosed to participants when an incidental finding is discovered. How these findings should be dealt with is a source of continuing debate amongst neuroimaging researchers and bioethicists. As the number of research studies using neuroimaging - particularly MRI (magnetic resonance imaging) but also CT (computed tomography), and PET-CT (positron emission tomography-computed tomography) - has grown, the sheer volume of scans being generated means that incidental findings have become increasingly common. Neuroimaging scans taken in the course of research regularly yield “incidental findings”: observations of potential clinical significance in healthy volunteers or patients, which are unrelated to the purpose or variables of the study.
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