Neuroethics of neuromodulation: An update

Abstract

This article reviews neuroethics issues that arise with the development, translation, and use of technologies for neuromodulation. Three electronic databases (PubMed, Embase, and PhilPapers) were searched for relevant articles published between 1/1/16 – 6/26/18. We focus on pressing ethical issues related to the use of deep brain stimulation (DBS), adaptive DBS (aDBS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and associated technologies. The neuroethics issues we address include privacy, continued access to devices, device removal, do-it-yourself neurostimulation, neuroenhancement, media coverage, changes in personal identity and agency, informed consent, and neuromodulation in minors. This review should be of assistance to a variety of stakeholders, including neurotechnology developers, as they make important decisions that will drive these neurotechnologies.

Cognitive and Emotional Mapping With SEEG

“…Overall, virtual and augmented reality paradigms will increase our ability to study complex phenomena in a highly controlled manner, and should lead to further insights into the neural substrates of complex behavior of all sorts, which will be helpful for better understanding disease states, navigating neurosurgical procedures to provide optimal benefit with the greatest sparing of function, enhancing our ability to use neuromodulation procedures to treat disease (e.g., seizures, depression) and potentially enhance/restore neurological function, and create the opportunity to develop brain-machine interfaces (259), such as those that have allowed the creation of a bionic prosthetic limb. Of note, all of these "futuristic" advances also call for the need for close collaboration with neuroethicists, discussion between cognitive psychologists and neuroscientists, and potentially input from neurophilosophy, to determine the best path forward in these new frontiers [e.g., (260)].…”

Invasive Electrophysiology for Circuit Discovery and Study of Comorbid Psychiatric Disorders in Patients With Epilepsy: Challenges, Opportunities, and Novel Technologies

“…At a minimum, data obtained from PWE using systems such as the ones described in this report will drive further advances in technologies and techniques that will increasingly become available for investigating and treating patients with primary major psychiatric illnesses. Of course, each technology has its own set of limitations including safety, tolerability, signal integrity, user acceptability, and required technological literacy, privacy, and access (Zuk et al, 2018 ). Such integrated and ambulatory approaches may prove especially useful in applications such as MDD or Alzheimer’s disease where trials for DBS therapies have shown delayed or limited efficacy (Holtzheimer et al, 2017 ; Leoutsakos et al, 2018 ; Crowell et al, 2019 ).…”

Pediatric Deep Brain Stimulation for Dystonia: Current State and Ethical Considerations

“…5 Furthermore, there has been limited examination of the ethical challenges and implications of this practice. 6 We examine whether it is currently ethically justifiable to offer DBS for pediatric patients with refractory dystonia as well as the most ethically pressing considerations that need to be addressed.…”