Science and Engineering Ethics 26 (3):1655-1680 (2020)

Authors
Jonathan Pugh
Oxford University
Abstract
There is evidence to suggest that some patients who undergo Deep Brain Stimulation can experience changes to dispositional, emotional and behavioural states that play a central role in conceptions of personality, identity, autonomy, authenticity, agency and/or self. For example, some patients undergoing DBS for Parkinson’s Disease have developed hypersexuality, and some have reported increased apathy. Moreover, experimental psychiatric applications of DBS may intentionally seek to elicit changes to the patient’s dispositional, emotional and behavioural states, in so far as dysfunctions in these states may undergird the targeted disorder. Such changes following DBS have been of considerable interest to ethicists, but there is a considerable degree of conflict amongst different parties to this debate about whether DBS really does change PIAAAS, and whether this matters. This paper explores these conflicting views and suggests that we may be able to mediate this conflict by attending more closely to what parties to the debate mean when they invoke the concepts lumped together under the acronym PIAAAS. Drawing on empirical work on patient attitudes, this paper outlines how these different understandings of the concepts incorporated into PIAAAS have been understood in this debate, and how they may relate to other fundamental concepts in medical ethics such as well-being and autonomy. The paper clarifies some key areas of disagreement in this context, and develops proposals for how ethicists might fruitfully contribute to future empirical assessments of apparent changes to PIAAAS following DBS treatment.
Keywords No keywords specified (fix it)
Categories (categorize this paper)
ISBN(s)
DOI 10.1007/s11948-020-00207-3
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy


Upload a copy of this paper     Check publisher's policy     Papers currently archived: 70,079
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - Oxford University Press.
Reasons and Persons.Derek Parfit - 1984 - Oxford University Press.
Freedom of the Will and the Concept of a Person.Harry Frankfurt - 1971 - Journal of Philosophy 68 (1):5-20.
The Constitution of Selves.Marya Schechtman (ed.) - 1996 - Cornell University Press.

View all 43 references / Add more references

Citations of this work BETA

View all 6 citations / Add more citations

Similar books and articles

The Ethics of Deep Brain Stimulation.Marcus Unterrainer & Fuat S. Oduncu - 2015 - Medicine, Health Care and Philosophy 18 (4):475-485.
Stimulating Brains, Altering Minds.W. Glannon - 2009 - Journal of Medical Ethics 35 (5):289-292.

Analytics

Added to PP index
2020-03-20

Total views
11 ( #852,053 of 2,506,037 )

Recent downloads (6 months)
1 ( #416,828 of 2,506,037 )

How can I increase my downloads?

Downloads

My notes