I Miss Being Me: Phenomenological Effects of Deep Brain Stimulation

Gilbert, Frédéric; Goddard, Eliza; Viaña, John Noel M.; Carter, Adrian; Horne, Malcolm

doi:10.1080/21507740.2017.1320319

Cited by 112 publications

(91 citation statements)

References 53 publications

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“…The study results revealed contrasting phenomenological effects. Some patients experienced the DBS intervention as phenomenologically deteriorative and often reported a feeling of undesired self-estrangement; in one interviewee's words, the feeling that they "can't be the real me anymore" (Gilbert et al 2017). Other patients, however, reported restorative phenomenological effects as they argued that the DBS allowed them to "return almost to the person I was before" (Gilbert et al 2017).…”

Section: Neuroenhancement Technology and Subjectivitymentioning

confidence: 99%

“…These include, for example, memory assessment scales such as the list acquisition scale or the immediate visual recognition scale (Williams 1991), the standardized mini-mental state scale examination (Molloy and Standish 1997), the pairedassociates learning test (Talpos et al 2014), reaction time tests (Randall et al 2005), and many others (Repantis 2013;Battleday and Brem 2015). In contrast, metric B is used more commonly among studies that employ qualitative methods such as interviews, self-reports and openquestion surveys (Vargo and Petróczi 2016;Gilbert et al 2017;Maier et al 2013;Franke et al 2012).…”

Section: Introductionmentioning

confidence: 99%

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Enhanced Cognition, Enhanced Self? On Neuroenhancement and Subjectivity

Ferretti

Ienca

2018

J Cogn Enhanc

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This paper investigates the implications of neuroenhancement from a first-person and phenomenological perspective that focuses on the role of the human brain and body as mediators of subjective experience. This analysis is conducted both on historical-philosophical and empirical grounds. At the historical-philosophical level, this article examines the frameworks of phenomenology and embodied cognition to explore how these theoretical approaches link the materiality of the body (including that of exogenous integrations such as implants) to the way in which subjects perceive themselves and experience reality. At the empirical level, the article attempts to corroborate this philosophical stance by critically assessing the emerging body of scientific evidence on the phenomenological effects of neuroenhancement technologies. Based on a narrative mini-review, this paper will argue that the quantitative enhancement of a cognitive or other physical function of the human body does not necessarily result in an equal qualitative improvement of a subject's phenomenological experience. Indeed, a physical alteration designed to quantitatively augment a specific human capability may have ambivalent effects on how the subject experientially perceives that modification. This indeterminacy between the quantitative and qualitative dimension of neuroenhancement seems to challenge the thesis that any objectively measured improvement of a cognitive or other physical function of the human body directly corresponds to better personal and psychological well-being.

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Section: Neuroenhancement Technology and Subjectivitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Enhanced Cognition, Enhanced Self? On Neuroenhancement and Subjectivity

Ferretti

Ienca

2018

J Cogn Enhanc

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“…Whether post-aDBS effects on agency and identity are positive or negative outcomes will depend on whether patients and relatives experience post-aDBS changes in agency or identity as improvements compared to the intractable pre-aDBS pathological state. Importantly, even if post-aDBS changes in agency or identity are seen as overall net benefits in terms of symptom management and quality of life, there may be specific components of these changes that are considered intolerable or unacceptable by patients or relatives (Gilbert et al 2017). Thus, it is essential to empirically examine these issues to develop a comprehensive understanding of how aDBS impacts agency and identity and to help develop ways of maximizing the clinical utility of aDBS.…”

Section: Changes In Agency or Personal Identity Are Not Intrinsicallymentioning

confidence: 99%

Should We Be Concerned About Preserving Agency and Personal Identity in Patients With Adaptive Deep Brain Stimulation Systems?

2017

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“…In Gilbert et al's study investigating patient attitudes to DBS treatment for Parkinson's disease, Gilbert and colleagues noted that patients can experience selfestrangement following treatment, but that this phenomenon can involve either "deteriorative estrangement" or "restorative estrangement" (Gilbert et al 2017). Both forms of estrangement involve experiencing an involuntary shift in one's character, in this case following DBS treatment.…”

mentioning

confidence: 98%

“…Both forms of estrangement involve experiencing an involuntary shift in one's character, in this case following DBS treatment. In deteriorative estrangement, this is experienced as a deterioration of the patient's self, and is qualitatively experienced as a sense of powerlessness; in contrast, in restorative estrangement, the shift in one's character is experienced as restoring elements that were central to the self that existed prior to the onset of disease (Gilbert et al 2017). They suggest that there is a correlation between how patients preoperatively perceive themselves with respect to their illness, and their experiences of estrangement (Gilbert et al 2017).…”

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confidence: 99%

Clarifying the Normative Significance of ‘Personality Changes’ Following Deep Brain Stimulation

Pugh

2020

Sci Eng Ethics

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There is evidence to suggest that some patients who undergo Deep Brain Stimulation can experience changes to dispositional, emotional and behavioural states that play a central role in conceptions of personality, identity, autonomy, authenticity, agency and/or self (PIAAAS). For example, some patients undergoing DBS for Parkinson's Disease have developed hypersexuality, and some have reported increased apathy. Moreover, experimental psychiatric applications of DBS may intentionally seek to elicit changes to the patient's dispositional, emotional and behavioural states, in so far as dysfunctions in these states may undergird the targeted disorder. Such changes following DBS have been of considerable interest to ethicists, but there is a considerable degree of conflict amongst different parties to this debate about whether DBS really does change PIAAAS, and whether this matters. This paper explores these conflicting views and suggests that we may be able to mediate this conflict by attending more closely to what parties to the debate mean when they invoke the concepts lumped together under the acronym PIAAAS. Drawing on empirical work on patient attitudes, this paper outlines how these different understandings of the concepts incorporated into PIAAAS have been understood in this debate, and how they may relate to other fundamental concepts in medical ethics such as well-being and autonomy. The paper clarifies some key areas of disagreement in this context, and develops proposals for how ethicists might fruitfully contribute to future empirical assessments of apparent changes to PIAAAS following DBS treatment.

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I Miss Being Me: Phenomenological Effects of Deep Brain Stimulation

Cited by 112 publications

References 53 publications

Enhanced Cognition, Enhanced Self? On Neuroenhancement and Subjectivity

Enhanced Cognition, Enhanced Self? On Neuroenhancement and Subjectivity

Should We Be Concerned About Preserving Agency and Personal Identity in Patients With Adaptive Deep Brain Stimulation Systems?

Clarifying the Normative Significance of ‘Personality Changes’ Following Deep Brain Stimulation

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