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Ethical Considerations

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Fundamentals and Clinics of Deep Brain Stimulation

Abstract

Since its first applications in humans, DBS has triggered a plethora of ethical questions and concerns and stimulated extensive ethical debates as to its significance and desirability. The main ethical goal is to guide and support responsible decision-making in clinical DBS treatment, as well as related medical research, and to raise awareness about salient ethical issues.

Traditional medical ethics consists of the three basic principles of respect for autonomy, beneficence/nonmaleficence and justice. In the context of DBS, these principles require specific attention as to what exactly it means to “respect autonomy,” to safeguard beneficence and nonmaleficence, and to live up to the requirements of justice. Taking the risks and side effects of DBS into account and comparing this treatment to possible alternative treatments is crucial. Given the increasing interest in applying DBS to psychiatric disorders, research ethical questions have been put on the agenda. The status of the brain also gave rise to the expression of profound ethical concerns, particularly regarding potential changes in patients’ personal identity. However, different understandings of this very concept lead to diverging evaluations of the ethical value of potentially identity-modifying techniques. Independent ethical substudies or integral add-on projects in DBS research can advance systematic ethical thought regarding ongoing research endeavors and upcoming new applications.

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Authors and Affiliations

  1. Department of Health, Ethics and Society, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands

    Dorothee Horstkötter

  2. Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), School of Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands

    Guido de Wert

Authors
  1. Dorothee Horstkötter
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  2. Guido de Wert
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Correspondence to Dorothee Horstkötter .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands

    Yasin Temel

  2. Department of Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands

    Albert F.G. Leentjens

  3. Department of Neurology, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Noord-Holland, The Netherlands

    Rob M.A. de Bie

  4. Department of Neurosurgery, Grenoble University Hospital Center, Grenoble, France

    Stephan Chabardes

  5. Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada

    Alfonso Fasano

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Horstkötter, D., de Wert, G. (2020). Ethical Considerations. In: Temel, Y., Leentjens, A., de Bie, R., Chabardes, S., Fasano, A. (eds) Fundamentals and Clinics of Deep Brain Stimulation. Springer, Cham. https://doi.org/10.1007/978-3-030-36346-8_10

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  • DOI: https://doi.org/10.1007/978-3-030-36346-8_10

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