Document Detail


Preparing the ethical future of deep brain stimulation.
MedLine Citation:
PMID:  19608246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Emily Bell; Ghislaine Mathieu; Eric Racine
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-07-15
Journal Detail:
Title:  Surgical neurology     Volume:  72     ISSN:  1879-3339     ISO Abbreviation:  Surg Neurol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-01-19     Completed Date:  2010-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  577-86; discussion 586     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Inc. All rights reserved.
Affiliation:
Neuroethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada.
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MeSH Terms
Descriptor/Qualifier:
Deep Brain Stimulation / ethics*
Essential Tremor / therapy*
Ethics, Medical*
Humans
Informed Consent / ethics
Obsessive-Compulsive Disorder / therapy*
Parkinson Disease / therapy*
Patient Selection / ethics
Public Opinion
Resource Allocation / ethics
Grant Support
ID/Acronym/Agency:
//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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