Results for 'Deep Brain Stimulation'

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  1. Deep Brain Stimulation, Authenticity and Value.Pugh Jonathan, Maslen Hannah & Savulescu Julian - 2017 - Cambridge Quarterly of Healthcare Ethics 26 (4):640-657.
    Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient’s personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist (...)
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  2. Deep Brain Stimulation and the Search for Identity.Karsten Witt, Jens Kuhn, Lars Timmermann, Mateusz Zurowski & Christiane Woopen - 2013 - Neuroethics 6 (3):499-511.
    Ethical evaluation of deep brain stimulation as a treatment for Parkinson’s disease is complicated by results that can be described as involving changes in the patient’s identity. The risk of becoming another person following surgery is alarming for patients, caregivers and clinicians alike. It is one of the most urgent conceptual and ethical problems facing deep brain stimulation in Parkinson’s disease at this time. In our paper we take issue with this problem on two (...)
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  3.  50
    Deep Brain Stimulation, Continuity Over Time, and the True Self.Sven Nyholm & Elizabeth O’Neill - 2016 - Cambridge Quarterly of Healthcare Ethics 25 (4):647-658.
    One of the topics that often comes up in ethical discussions of deep brain stimulation (DBS) is the question of what impact DBS has, or might have, on the patient’s self. This is often understood as a question of whether DBS poses a “threat” to personal identity, which is typically understood as having to do with psychological and/or narrative continuity over time. In this article, we argue that the discussion of whether DBS is a “threat” to continuity (...)
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  4. Deep Brain Stimulation for Treatment Resistant Depression: Postoperative Feelings of Self-Estrangement, Suicide Attempt and Impulsive–Aggressive Behaviours.Frederic Gilbert - 2013 - Neuroethics 6 (3):473-481.
    The goal of this article is to shed light on Deep Brain Stimulation (DBS) postoperative suicidality risk factors within Treatment Resistant Depression (TRD) patients, in particular by focusing on the ethical concern of enrolling patient with history of self-estrangement, suicide attempts and impulsive–aggressive inclinations. In order to illustrate these ethical issues we report and review a clinical case associated with postoperative feelings of self-estrangement, self-harm behaviours and suicide attempt leading to the removal of DBS devices. Could prospectively (...)
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  5.  44
    Deep Brain Stimulation, Self and Relational Autonomy.Shaun Gallagher - 2021 - Neuroethics 14 (1):31-43.
    Questions about the nature of self and self-consciousness are closely aligned with questions about the nature of autonomy. These concepts have deep roots in traditional philosophical discussions that concern metaphysics, epistemology and ethics. They also have direct relevance to practical considerations about informed consent in medical contexts. In this paper, with reference to understanding specific side effects of deep brain stimulation treatment in cases of, for example, Parkinson’s Disease, Obsessive Compulsive Disorder, and Major Depressive Disorder, I’ll (...)
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  6.  40
    Deep Brain Stimulation, Historicism, and Moral Responsibility.Daniel Sharp & David Wasserman - 2016 - Neuroethics 9 (2):173-185.
    Although philosophers have explored several connections between neuroscience and moral responsibility, the issue of how real-world neurological modifications, such as Deep Brain Stimulation, impact moral responsibility has received little attention. In this article, we draw on debates about the relevance of history and manipulation to moral responsibility to argue that certain kinds of neurological modification can diminish the responsibility of the agents so modified. We argue for a historicist position - a version of the history-sensitive reflection view (...)
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  7. Deep Brain Stimulation, Authenticity and Value.Sven Nyholm & Elizabeth O’Neill - 2017 - Cambridge Quarterly of Healthcare Ethics 26 (4):658-670.
    In this paper, we engage in dialogue with Jonathan Pugh, Hannah Maslen, and Julian Savulescu about how to best interpret the potential impacts of deep brain stimulation on the self. We consider whether ordinary people’s convictions about the true self should be interpreted in essentialist or existentialist ways. Like Pugh et al., we argue that it is useful to understand the notion of the true self as having both essentialist and existentialist components. We also consider two ideas (...)
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  8.  41
    Deep Brain Stimulation: Inducing Self-Estrangement.Frederic Gilbert - 2018 - Neuroethics 11 (2):157-165.
    Despite growing evidence that a significant number of patients living with Parkison’s disease experience neuropsychiatric changes following Deep Brain Stimulation treatment, the phenomenon remains poorly understood and largely unexplored in the literature. To shed new light on this phenomenon, we used qualitative methods grounded in phenomenology to conduct in-depth, semi-structured interviews with 17 patients living with Parkinson’s Disease who had undergone DBS. Our study found that patients appear to experience postoperative DBS-induced changes in the form of self-estrangement. (...)
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  9. Effects of Deep Brain Stimulation on the Lived Experience of Obsessive-Compulsive Disorder Patients.Sanneke de Haan, Erik Rietveld, Martin Stokhof & Damiaan Denys - 2015 - PLoS ONE 10 (8):1-29.
    Deep Brain Stimulation (DBS) is a relatively new, experimental treatment for patients suffering from treatment-refractory Obsessive Compulsive Disorder (OCD). The effects of treatment are typically assessed with psychopathological scales that measure the amount of symptoms. However, clinical experience indicates that the effects of DBS are not limited to symptoms only: patients for instance report changes in perception, feeling stronger and more confident, and doing things unreflectively. Our aim is to get a better overview of the whole variety (...)
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  10.  28
    Deep Brain Stimulation Through the “Lens of Agency”: Clarifying Threats to Personal Identity From Neurological Intervention.Eliza Goddard - 2017 - Neuroethics 10 (3):325-335.
    This paper explores the impacts of neurological intervention on selfhood with reference to recipients’ claims about changes to their self-understanding following Deep Brain Stimulation for treatment of Parkinson’s Disease. In the neuroethics literature, patients’ claims such as: “I don’t feel like myself anymore” and “I feel like a machine”, are often understood as expressing threats to identity. In this paper I argue that framing debates in terms of a possible threat to identity—whether for or against the proposition, (...)
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  11. The Phenomenology of Deep Brain Stimulation-Induced Changes in Obsessive-Compulsive Disorder Patients: An Enactive Affordance-Based Model.Sanneke de Haan, Erik Rietveld, Martin Stokhof & Damiaan Denys - 2013 - Frontiers in Human Neuroscience 7:1-14.
    People suffering from Obsessive-Compulsive Disorder (OCD) do things they do not want to do, and/or they think things they do not want to think. In about 10 percent of OCD patients, none of the available treatment options is effective. A small group of these patients is currently being treated with deep brain stimulation (DBS). Deep brain stimulation involves the implantation of electrodes in the brain. These electrodes give a continuous electrical pulse to the (...)
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  12.  79
    The Ethics of Deep Brain Stimulation for the Treatment of Anorexia Nervosa.Hannah Maslen, Jonathan Pugh & Julian Savulescu - 2015 - Neuroethics 8 (3):215-230.
    There is preliminary evidence, from case reports and investigational studies, to suggest that Deep Brain Stimulation could be used to treat some patients with Anorexia Nervosa. Although this research is at an early stage, the invasive nature of the intervention and the vulnerability of the potential patients are such that anticipatory ethical analysis is warranted. In this paper, we first show how different treatment mechanisms raise different philosophical and ethical questions. We distinguish three potential mechanisms alluded to (...)
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  13. Authenticity or Autonomy? When Deep Brain Stimulation Causes a Dilemma.Felicitas Kraemer - 2013 - Journal of Medical Ethics 39 (12):757-760.
    While deep brain stimulation (DBS) for patients with Parkinson's disease has typically raised ethical questions about autonomy, accountability and personal identity, recent research indicates that we need to begin taking into account issues surrounding the patients’ feelings of authenticity and alienation as well. In order to bring out the relevance of this dimension to ethical considerations of DBS, I analyse a recent case study of a Dutch patient who, as a result of DBS, faced a dilemma between (...)
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  14.  36
    Deep Brain Stimulation to Reward Circuitry Alleviates Anhedonia in Refractory Major Depression.Thomas E. Schlaepfer, Michael X. Cohen, Caroline Frick, Markus Mathaus Kosel, Daniela Brodesser, Nikolai Axmacher, Alexius Young Joe, Martina Kreft, Doris Lenartz & Volker Sturm - unknown
    Deep brain stimulation to different sites allows interfering with dysfunctional network function implicated in major depression. Because a prominent clinical feature of depression is anhedonia--the inability to experience pleasure from previously pleasurable activities--and because there is clear evidence of dysfunctions of the reward system in depression, DBS to the nucleus accumbens might offer a new possibility to target depressive symptomatology in otherwise treatment-resistant depression. Three patients suffering from extremely resistant forms of depression, who did not respond to (...)
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  15. Deep Brain Stimulation and Revising the Mental Health Act: The Case for Intervention-Specific Safeguards.Jonathan Pugh, Tipu Aziz, Jonathan Herring & Julian Savulescu - forthcoming - British Journal of Psychiatry.
    Under the current Mental Health Act of England and Wales, it is lawful to perform deep brain stimulation in the absence of consent and independent approval. We argue against the Care Quality Commission's preferred strategy of addressing this problematic issue, and offer recommendations for deep brain stimulation-specific provisions in a revised Mental Health Act.
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  16.  46
    Deep Brain Stimulation in the Media: Over-Optimistic Media Portrayals Calls for a New Strategy Involving Journalists and Scientifics in the Ethical Debate.Frederic Gilbert & Ovadia Daniela - 2011 - Journal of Integrative in Neuroscience 5 (16).
    Deep brain stimulation (DBS) is optimistically portrayed in contemporary media. This already happened with psychosurgery during the first half of the twentieth century. The tendency of popular media to hype the benefits of DBS therapies, without equally highlighting risks, fosters public expectations also due to the lack of ethical analysis in the scientific literature. Media are not expected (and often not prepared) to raise the ethical issues which remain unaddressed by the scientific community. To obtain a more (...)
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  17.  83
    Deep Brain Stimulation in Children: Parental Authority Versus Shared Decision-Making.Farah Focquaert - 2013 - Neuroethics 6 (3):447-455.
    This paper discusses the use of deep brain stimulation for the treatment of neurological and psychiatric disorders in children. At present, deep brain stimulation is used to treat movement disorders in children and a few cases of deep brain stimulation for psychiatric disorders in adolescents have been reported. Ethical guidelines on the use of deep brain stimulation in children are therefore urgently needed. This paper focuses on the decision-making (...)
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  18.  10
    Deep Brain Stimulation and Postoperative Suicidality Among Treatment Resistant Depression Patients: Should Eligibility Protocols Exclude Patients with a History of Suicide Attempts and Anger/Impulsivity?Frédéric Gilbert - 2013 - American Journal of Bioethics Neuroscience 4 (1):28-35.
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  19.  14
    Deep Brain Stimulation in Parkinsonian Patients—Ethical Evaluation of Cognitive, Affective, and Behavioral Sequelae.Sabine Müller & Markus Christen - 2011 - American Journal of Bioethics Neuroscience 2 (1):3-13.
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  20.  61
    Self-Estrangement & Deep Brain Stimulation: Ethical Issues Related to Forced Explantation.Frederic Gilbert - 2015 - Neuroethics 8 (2):107-114.
    Although being generally safe, the use of Deep Brain Stimulation has been associated with a significant number of patients experiencing postoperative psychological and neurological harm within experimental trials. A proportion of these postoperative severe adverse effects have lead to the decision to medically prescribe device deactivation or removal. However, there is little debate in the literature as to what is in the patient’s best interest when device removal has been prescribed; in particular, what should be the conceptual (...)
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  21. Me, Myself and My Brain Implant: Deep Brain Stimulation Raises Questions of Personal Authenticity and Alienation.Felicitas Kraemer - 2013 - Neuroethics 6 (3):483-497.
    In this article, I explore select case studies of Parkinson patients treated with deep brain stimulation in light of the notions of alienation and authenticity. While the literature on DBS has so far neglected the issues of authenticity and alienation, I argue that interpreting these cases in terms of these concepts raises new issues for not only the philosophical discussion of neuro-ethics of DBS, but also for the psychological and medical approach to patients under DBS. In particular, (...)
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  22. Some Ethics of Deep Brain Stimulation.Joshua August Skorburg & Walter Sinnott Armstrong - 2020 - In Dan Stein & Ilina Singh (eds.), Global Mental Health and Neuroethics. London, UK: pp. 117-132.
    Case reports about patients undergoing Deep Brain Stimulation (DBS) for various motor and psychiatric disorders - including Parkinson’s Disease, Obsessive Compulsive Disorder, and Treatment Resistant Depression - have sparked a vast literature in neuroethics. Questions about whether and how DBS changes the self have been at the fore. The present chapter brings these neuroethical debates into conversation with recent research in moral psychology. We begin in Section 1 by reviewing the recent clinical literature on DBS. In Section (...)
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  23.  9
    Deep Brain Stimulation (DBS) Experiences: An Ethnographic Approach to Their Expression on the Internet Forums.Aurélien Troisoeufs - 2019 - Medicine, Health Care and Philosophy 22 (3):343-352.
    This contribution aims at describing the experiences of Deep Brain Stimulation as discussed on Internet forums. Since the 2000s, increasing attention has been paid to health practices associated with the use of the Internet, whether by medical professionals, public authorities or researchers in the social sciences. We know that Internet is used by patients with Parkinson’s disease, in order to discuss about their lived experiences. This contribution will present how these Internet users address the specific theme of (...)
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  24.  6
    Paediatric Deep Brain Stimulation: Ethical Considerations in Malignant Tourette Syndrome.Rosemary T. Behmer Hansen, Arjun Dubey, Cynthia Smith, Patrick J. Henry & Antonios Mammis - 2020 - Journal of Medical Ethics 46 (10):668-673.
    Gilles de la Tourette syndrome is a childhood neuropsychiatric disorder characterised by the presence of motor and vocal tics. Patients with malignant TS experience severe disease sequelae; risking morbidity and mortality due to tics, self-harm, psychiatric comorbidities and suicide. By definition, those cases termed ‘malignant’ are refractory to all conventional psychiatric and pharmacological regimens. In these instances, deep brain stimulation may be efficacious. Current 2015 guidelines recommend a 6-month period absent of suicidal ideation before DBS is offered (...)
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  25.  4
    Deep Brain Stimulation and Relational Agency: Negotiating Relationships.Robyn Bluhm & Laura Cabrera - 2020 - International Journal of Feminist Approaches to Bioethics 13 (1):155-161.
    Timothy Brown invites us to think about the ways in which people who are being treated with deep brain stimulation might come to interact with their devices. He suggests that a framework of relational agency can help us to understand both the benefits and the challenges of DBS because DBS systems are, while not full fellow agents, more than mere props; users must sometimes "negotiate and collaborate with their stimulators". We agree that it is important to develop (...)
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  26.  37
    Evidence-Based Neuroethics, Deep Brain Stimulation and Personality - Deflating, but Not Bursting, the Bubble.Jonathan Pugh, Laurie Pycroft, Hannah Maslen, Tipu Aziz & Julian Savulescu - 2018 - Neuroethics 14 (Suppl 1):27-38.
    Gilbert et al. have raised important questions about the empirical grounding of neuroethical analyses of the apparent phenomenon of Deep Brain Stimulation ‘causing’ personality changes. In this paper, we consider how to make neuroethical claims appropriately calibrated to existing evidence, and the role that philosophical neuroethics has to play in this enterprise of ‘evidence-based neuroethics’. In the first half of the paper, we begin by highlighting the challenges we face in investigating changes to PIAAAS following DBS, explaining (...)
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  27.  21
    Insight and the No‐Self in Deep Brain Stimulation.Laura Specker Sullivan - 2019 - Bioethics 33 (4):487-494.
    Ethical analyses of the effects of neural interventions commonly focus on changes to personality and behavior, interpreting these changes in terms of authenticity and identity. These phenomena have led to debate among ethicists about the meaning of these terms for ethical analysis of such interventions. While these theoretical approaches have different criteria for ethical significance, they agree that patients’ reports are concerning because a sense of self is valuable. In this paper, I question this assumption. I propose that the Buddhist (...)
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  28.  18
    The Ethics of Deep Brain Stimulation.Marcus Unterrainer & Fuat S. Oduncu - 2015 - Medicine, Health Care and Philosophy 18 (4):475-485.
    Deep brain stimulation is an invasive technique designed to stimulate certain deep brain regions for therapeutic purposes and is currently used mainly in patients with neurodegenerative disorders, such as Parkinson’s disease. However, DBS is also used increasingly for other experimental applications, such as the treatment of psychiatric disorders, weight reduction. Apart from its therapeutic potential, DBS can cause severe adverse effects, some that might also have a significant impact on the patient’s personality and autonomy by (...)
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  29.  19
    Learning From Deep Brain Stimulation: The Fallacy of Techno-Solutionism and the Need for ‘Regimes of Care’.John Gardner & Narelle Warren - 2019 - Medicine, Health Care and Philosophy 22 (3):363-374.
    Deep brain stimulation is an effective treatment for the debilitating motor symptoms of Parkinson’s disease and other neurological disorders. However, clinicians and commentators have noted that DBS recipients have not necessarily experienced the improvements in quality of life that would be expected, due in large part to what have been described as the ‘psychosocial’ impacts of DBS. The premise of this paper is that, in order to realise the full potential of DBS and similar interventions, clinical services (...)
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  30. Deep Brain Stimulation Impedance Decreases Over Time Even When Stimulation Settings Are Held Constant.David Satzer, Huiyan Yu, Meredith Wells, Mahesh Padmanaban, Matthew R. Burns, Peter C. Warnke & Tao Xie - 2020 - Frontiers in Human Neuroscience 14.
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  31. Unexpected Complications of Novel Deep Brain Stimulation Treatments: Ethical Issues and Clinical Recommendations.Hannah Maslen, Binith Cheeran, Jonathan Pugh, Laurie Pycroft, Sandra Boccard, Simon Prangnell, Alexander Green, James FitzGerald, Julian Savulescu & Tipu Aziz - forthcoming - Neuromodulation.
    Background -/- Innovative neurosurgical treatments present a number of known risks, the natures and probabilities of which can be adequately communicated to patients via the standard procedures governing obtaining informed consent. However, due to their novelty, these treatments also come with unknown risks, which require an augmented approach to obtaining informed consent. -/- Objective -/- This paper aims to discuss and provide concrete procedural guidance on the ethical issues raised by serious unexpected complications of novel deep brain (...) treatments. -/- Approach -/- We illustrate our analysis using a case study of the unexpected development of recurrent stereotyped events in patients following the use of deep brain stimulation (DBS) to treat severe chronic pain. Examining these unexpected complications in light of medical ethical principles, we argue that serious complications of novel DBS treatments do not necessarily make it unethical to offer the intervention to eligible patients. However, the difficulty the clinician faces in determining whether the intervention is in the patient's best interests generates reasons to take extra steps to promote the autonomous decision making of these patients. -/- Conclusion and recommendations -/- We conclude with clinical recommendations, including details of an augmented consent process for novel DBS treatment. (shrink)
     
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  32. Deep Brain Stimulation for Parkinson’s Disease: Why Earlier Use Makes Shared Decision Making Important.Jaime Montemayor, Harini Sarva, Karen Kelly-Blake & Laura Y. Cabrera - 2022 - Neuroethics 15 (2):1-11.
    IntroductionAs deep brain stimulation has shifted to being used earlier during Parkinson’s disease, data is lacking regarding patient specific attitudes, preferences, and factors which may influence the timing of and decision to proceed with DBS in the United States. This study aims to identify and compare attitudes and preferences regarding the earlier use of DBS in Parkinson’s patients who have and have not undergone DBS.MethodsWe developed an online survey concerning attitudes about DBS and its timing in PD. (...)
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  33.  13
    Incoming Ethical Issues for Deep Brain Stimulation: When Long-Term Treatment Leads to a ‘New Form of the Disease’.Frederic Gilbert & Mathilde Lancelot - 2021 - Journal of Medical Ethics 47 (1):20-25.
    Deep brain stimulation has been regarded as an efficient and safe treatment for Parkinson’s disease since being approved by the Food and Drug Administration in 1997. It is estimated that more than 150 000 patients have been implanted, with a forecasted rapid increase in uptake with population ageing. Recent longitudinal follow-up studies have reported a significant increase in postoperative survival rates of patients with PD implanted with DBS as compared with those not implanted with DBS. Although DBS (...)
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  34. “I Am Who I Am”: On the Perceived Threats to Personal Identity From Deep Brain Stimulation[REVIEW]Françoise Baylis - 2013 - Neuroethics 6 (3):513-526.
    This article explores the notion of the dislocated self following deep brain stimulation (DBS) and concludes that when personal identity is understood in dynamic, narrative, and relational terms, the claim that DBS is a threat to personal identity is deeply problematic. While DBS may result in profound changes in behaviour, mood and cognition (characteristics closely linked to personality), it is not helpful to characterize DBS as threatening to personal identity insofar as this claim is either false, misdirected (...)
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  35.  62
    Authenticity and Autonomy in Deep-Brain Stimulation.Alistair Wardrope - 2014 - Journal of Medical Ethics 40 (8):563-566.
    Felicitas Kraemer draws on the experiences of patients undergoing deep-brain stimulation to propose two distinct and potentially conflicting principles of respect: for an individual's autonomy , and for their authenticity. I argue instead that, according to commonly-invoked justifications of respect for autonomy, authenticity is itself in part constitutive of an analysis of autonomy worthy of respect; Kraemer's argument thus highlights the shortcomings of practical applications of respect for autonomy that emphasise competence while neglecting other important dimensions of (...)
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  36.  5
    Effective Deep Brain Stimulation for Obsessive-Compulsive Disorder Requires Clinical Expertise.Maarten van Westen, Erik Rietveld & Damiaan Denys - 2019 - Frontiers in Psychology 10.
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  37. Deep Brain Stimulation.Joseph J. Fins & S. G. Post - 2004 - Encyclopedia of Bioethics 2:629-634.
     
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  38. Deep Brain Stimulation of the Subthalamic Nucleus Modulates Reward-Related Behavior: A Systematic Review.Yvan M. Vachez & Meaghan C. Creed - 2020 - Frontiers in Human Neuroscience 14.
    Deep brain stimulation of the subthalamic nucleus is an effective treatment for the motor symptoms of movement disorders including Parkinson's Disease. Despite its therapeutic benefits, STN-DBS has been associated with adverse effects on mood and cognition. Specifically, apathy, which is defined as a loss of motivation, has been reported to emerge or to worsen following STN-DBS. However, it is often challenging to disentangle the effects of STN-DBSper sefrom concurrent reduction of dopamine replacement therapy, from underlying PD pathology (...)
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  39.  30
    Brainjacking in Deep Brain Stimulation and Autonomy.Jonathan Pugh, Laurie Pycroft, Anders Sandberg, Tipu Aziz & Julian Savulescu - 2018 - Ethics and Information Technology 20 (3):219-232.
    'Brainjacking’ refers to the exercise of unauthorized control of another’s electronic brain implant. Whilst the possibility of hacking a Brain–Computer Interface has already been proven in both experimental and real-life settings, there is reason to believe that it will soon be possible to interfere with the software settings of the Implanted Pulse Generators that play a central role in Deep Brain Stimulation systems. Whilst brainjacking raises ethical concerns pertaining to privacy and physical or psychological harm, (...)
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  40.  68
    Situating the Self: Understanding the Effects of Deep Brain Stimulation.Roy Dings & Leon de Bruin - 2016 - Phenomenology and the Cognitive Sciences 15 (2):151-165.
    The article proposes a theoretical model to account for changes in self due to Deep Brain Stimulation. First, we argue that most existing models postulate a very narrow conception of self, and thus fail to capture the full range of potentially relevant DBS-induced changes. Second, building on previous work by Shaun Gallagher, we propose a modified ‘pattern-theory of self’, which provides a richer picture of the possible consequences of DBS treatment.
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  41.  21
    Τhe Multiple Temporalities of Deep Brain Stimulation (DBS) in Greece.Marilena Pateraki - 2019 - Medicine, Health Care and Philosophy 22 (3):353-362.
    This contribution intends to explore patients’ lived experience, with a focus on the temporal dimension. On the basis of a qualitative study that led me to interview persons with Parkinson’s disease, caregivers, and medical professionals, I develop an empirical and philosophical investigation of the temporalities surrounding the implementation of deep brain stimulation in Greece. I raise the issue of access to DBS medical care, and show how distinct temporalities are implied when the patients face such a matter: (...)
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  42. Subthalamic Deep Brain Stimulation Lead Asymmetry Impacts the Parkinsonian Gait Disorder.Frederik P. Schott, Alessandro Gulberti, Hans O. Pinnschmidt, Christian Gerloff, Christian K. E. Moll, Miriam Schaper, Johannes A. Koeppen, Wolfgang Hamel & Monika Pötter-Nerger - 2022 - Frontiers in Human Neuroscience 16.
    BackgroundThe preferable position of Deep Brain Stimulation electrodes is proposed to be located in the dorsolateral subthalamic nucleus to improve general motor performance. The optimal DBS electrode localization for the post-operative improvement of balance and gait is unknown.MethodsIn this single-center, retrospective analyses, 66 Parkinson’s disease patients were assessed pre- and post-operatively by using MDS-UPDRS, freezing of gait score, Giladi’s gait and falls questionnaire and Berg balance scale. The clinical outcome was related to the DBS electrode coordinates in (...)
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  43. Health, Happiness and Human Enhancement—Dealing with Unexpected Effects of Deep Brain Stimulation.Maartje Schermer - 2013 - Neuroethics 6 (3):435-445.
    Deep Brain Stimulation (DBS) is a treatment involving the implantation of electrodes into the brain. Presently, it is used for neurological disorders like Parkinson’s disease, but indications are expanding to psychiatric disorders such as depression, addiction and Obsessive Compulsive Disorder (OCD). Theoretically, it may be possible to use DBS for the enhancement of various mental functions. This article discusses a case of an OCD patient who felt very happy with the DBS treatment, even though her symptoms (...)
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  44.  44
    No Going Back? Reversibility and Why It Matters for Deep Brain Stimulation.Jonathan Pugh - 2019 - Journal of Medical Ethics 45 (4):225-230.
    Deep brain stimulation (DBS) is frequently described as a ‘reversible’ medical treatment, and the reversibility of DBS is often cited as an important reason for preferring it to brain lesioning procedures as a last resort treatment modality for patients suffering from treatment-refractory conditions. Despite its widespread acceptance, the claim that DBS is reversible has recently come under attack. Critics have pointed out that data are beginning to suggest that there can be non-stimulation-dependent effects of DBS. (...)
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  45.  32
    Opening the Debate on Deep Brain Stimulation for Alzheimer Disease – a Critical Evaluation of Rationale, Shortcomings, and Ethical Justification.Merlin Bittlinger & Sabine Müller - 2018 - BMC Medical Ethics 19 (1):41.
    Deep brain stimulation as investigational intervention for symptomatic relief from Alzheimer disease has generated big expectations. Our aim is to discuss the ethical justification of this research agenda by examining the underlying research rationale as well as potential methodological pitfalls. The shortcomings we address are of high ethical importance because only scientifically valid research has the potential to be ethical. We performed a systematic search on MEDLINE and EMBASE. We included 166 publications about DBS for AD into (...)
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  46.  75
    The Burden of Normality: From 'Chronically Ill' to 'Symptom Free'. New Ethical Challenges for Deep Brain Stimulation Postoperative Treatment.Frederic Gilbert - 2012 - Journal of Medical Ethics 38 (7):408-412.
    Although an invasive medical intervention, Deep Brain Stimulation (DBS) has been regarded as an efficient and safe treatment of Parkinson’s disease for the last 20 years. In terms of clinical ethics, it is worth asking whether the use of DBS may have unanticipated negative effects similar to those associated with other types of psychosurgery. Clinical studies of epileptic patients who have undergone an anterior temporal lobectomy have identified a range of side effects and complications in a number (...)
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  47.  7
    Deep Brain Stimulation is No ON/OFF-Switch’: An Ethnography of Clinical Expertise in Psychiatric Practice.Maarten van Westen, Erik Rietveld, Annemarie van Hout & Damiaan Denys - forthcoming - Phenomenology and the Cognitive Sciences:1-20.
    Despite technological innovations, clinical expertise remains the cornerstone of psychiatry. A clinical expert does not only have general textbook knowledge, but is sensitive to what is demanded for the individual patient in a particular situation. A method that can do justice to the subjective and situation-specific nature of clinical expertise is ethnography. Effective deep brain stimulation for obsessive-compulsive disorder involves an interpretive, evaluative process of optimizing stimulation parameters, which makes it an interesting case to study clinical (...)
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  48.  6
    Deep Brain Stimulation, Authenticity and Value—CORRIGENDUM.Jonathan Pugh, Hannah Maslen & Julian Savulescu - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (1):179-179.
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  49.  7
    Pediatric Deep Brain Stimulation for Dystonia: Current State and Ethical Considerations.Katrina A. Muñoz, Jennifer Blumenthal-Barby, Eric A. Storch, Laura Torgerson & Gabriel Lázaro-muñoz - 2020 - Cambridge Quarterly of Healthcare Ethics 29 (4):557-573.
    Dystonia is a movement disorder that can have a debilitating impact on motor functions and quality of life. There are 250,000 cases in the United States, most with childhood onset. Due to the limited effectiveness and side effects of available treatments, pediatric deep brain stimulation has emerged as an intervention for refractory dystonia. However, there is limited clinical and neuroethics research in this area of clinical practice. This paper examines whether it is ethically justified to offer pDBS (...)
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  50. Pattern Theory of Self and Situating Moral Aspects: The Need to Include Authenticity, Autonomy and Responsibility in Understanding the Effects of Deep Brain Stimulation.Przemysław Zawadzki - 2022 - Phenomenology and the Cognitive Sciences 21 (3):559-582.
    The aims of this paper are to: identify the best framework for comprehending multidimensional impact of deep brain stimulation on the self; identify weaknesses of this framework; propose refinements to it; in pursuing, show why and how this framework should be extended with additional moral aspects and demonstrate their interrelations; define how moral aspects relate to the framework; show the potential consequences of including moral aspects on evaluating DBS’s impact on patients’ selves. Regarding, I argue that the (...)
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