Deep brain stimulation, personal identity and policy

Mathews, Debra J. H.

doi:10.3109/09540261.2011.632624

Cited by 23 publications

(18 citation statements)

References 24 publications

(30 reference statements)

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“…But since these issues have received thorough treatment elsewhere (e.g. [5,12,13,18]), I focus instead on other, perhaps more foundational, aspects of agency. The question of free will or self-authorship is distinct from the question of identity.…”

Section: The Folk Conception Of Agencymentioning

confidence: 99%

“…The mania caused by the stimulation deprived the man of rationality, and thus undermined his rational agency in a straightforward way. Indeed, Mathews, who mentions this case, characterizes it as a choice between mental competence with motor deficits, and incompetence and restoration of motor control [5].…”

Section: (C) Reasons-responsiveness/rationalitymentioning

confidence: 99%

“…Of all the techniques discussed here, DBS is the most highly developed for use in clinical settings. DBS was FDA approved for treatment for Parkinson's disease in 1997 and was granted a limited approval for obsessive compulsive disorder (OCD) in 2009 [5]. It is being used in clinical trials for, among other things, treatment-resistant depression (TRD), Tourette's syndrome, addiction, anorexia and chronic pain [6].…”

Section: (D) Deep Brain Stimulationmentioning

confidence: 99%

“…That would be a mistake. 5 Imagine, for example, that the neuroscientist is not evil, and merely wants to ensure that Harry is able to carry out his decision. Unfortunately for Harry, the neural circuit that would allow him to implement his willing is damaged: there is a disconnection that prevents his will from issuing in action.…”

Section: Interventions and Agencymentioning

confidence: 99%

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Agency and intervention

Roskies

2015

Phil. Trans. R. Soc. B

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One contribution of 15 to a theme issue 'Controlling brain activity to alter perception, behaviour and society'. Novel ways to intervene on brain function raise questions about agency and responsibility. Here, I discuss whether direct brain interventions, and in particular, deep brain stimulation, pose a threat to agency in individual cases, or to our general conceptualization of what it is to be a responsible agent. While I do not currently see evidence that these interventions constitute a global challenge to our concept of agency, they do have the potential to diminish agency in individuals. I consider whether the lack of evidence for a global challenge ratifies our folk conceptions, or is a necessary consequence of them. In closing, I propose that our theoretical understanding of agency and our therapeutic approaches could be improved with a more nuanced, multidimensional view of agency.

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Section: The Folk Conception Of Agencymentioning

confidence: 99%

Section: (C) Reasons-responsiveness/rationalitymentioning

confidence: 99%

Section: (D) Deep Brain Stimulationmentioning

confidence: 99%

Section: Interventions and Agencymentioning

confidence: 99%

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Agency and intervention

Roskies

2015

Phil. Trans. R. Soc. B

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“…Taking antibiotics or having a tooth removed will not be personally transformative. Conversely, deep brain stimulation, having one's sight or hearing restored, chemotherapy, organ transplantation (especially facial allograft transplantation), having one's legs amputated, successful IVF, and antidepressants such as Prozac are likely to be personally transformative (Glannon 2009;Maguire and McGee 1999;Matthews 2011;Svenaeus 2012;Swindell 2007). 15 It is likely that undergoing these treatments will alter an important element of one's self and represent an experience that is epistemologically novel.…”

Section: Can a Patient's Regret Be Prevented?mentioning

confidence: 99%

The Role of Regret in Medical Decision-making

McQueen¹

2017

Ethic Theory Moral Prac

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In this paper, I explore the role that regret does and should play in medical decision-making. Specifically, I consider whether the possibility of a patient experiencing post-treatment regret is a good reason for a clinician to counsel against that treatment or to withhold it. Currently, the belief that a patient may experience post-treatment regret is sometimes taken as a sufficiently strong reason to withhold it, even when the patient makes an explicit, informed request. Relatedly, medical researchers and practitioners often understand a patient's post-treatment regret to be a significant problem, one that reveals a mistake or flaw in the decision-making process. Contrary to these views, I argue that the possibility of post-treatment regret is not necessarily a good reason for withholding the treatment. This claim is justified by appealing to respect for patient autonomy. Furthermore, there are occasions when the very reference to post-treatment regret during medical decision-making is inappropriate. This, I suggest, is the case when the decision concerns a Bpersonally transformative treatment^. This is a treatment that alters a person's identity. Because the treatment is transformative, neither clinicians nor the patient him/herself can ascertain whether post-treatment regret will occur. Consequently, I suggest, what matters in determining whether to offer a personally transformative treatment is whether the patient has sufficiently good reasons for wanting the treatment at the time the decision is made. What does not matter is how the patient may subsequently be changed by undergoing the treatment.

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Ethics of neuromodulation in psychiatry

Fins

Pohl

2015

Neuromodulation in Psychiatry

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Deep brain stimulation, personal identity and policy

Cited by 23 publications

References 24 publications

Agency and intervention

Agency and intervention

The Role of Regret in Medical Decision-making

Ethics of neuromodulation in psychiatry

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