Abstract
BACKGROUND: Deep brain stimulation is an approved and effective neurosurgical
intervention for motor disorders such as PD and ET. Deep brain stimulation
may also be effective in treating a number of psychiatric disorders,
including treatment refractory depression and OCD. Although DBS is
a widely accepted therapy in motor disorders, it remains an invasive
and expensive procedure. The ethical and social challenges of DBS
need further examination, and discussion and emerging applications
of DBS in psychiatry may also complicate the ethical landscape of
DBS. METHODS: To identify and characterize current and emerging issues
in the use of DBS, we reviewed the neurosurgical literature on DBS
as well as the interdisciplinary medical ethics and relevant psychological
and sociological literatures. We also consulted the USPTO database,
FDA regulations and report decisions, and the business reports of
key DBS manufacturers. RESULTS: Important ethical and social challenges
exist in the current and extending practice of DBS, notably in patient
selection, informed consent, resource allocation, and in public understanding.
These challenges are likely to be amplified if emerging uses of DBS
in psychiatry are approved. CONCLUSIONS: Our review of ethical and
social issues related to DBS highlights that several significant
challenges, although not insurmountable, need much closer attention.
A combination of approaches previously used in neuroethics, such
as expert consensus workshops to establish ethical guidelines and
public engagement to improve public understanding, may be fruitful
to explore.
- allocation,resource
- allocation:
- brain
- consent,informed
- consent:
- deep
- disease,parkinson
- disease:
- disorder,obsessive-compulsive
- disorder:
- ethics
- ethics,essential
- ethics,obsessive-compulsive
- ethics,public
- medical,humans,informed
- opinion,resource
- selection,patient
- selection:
- stimulation,deep
- stimulation:
- therapy,ethics,
- therapy,parkinson
- therapy,patient
- tremor,essential
- tremor:
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