Who Should Hold the Remote for the New Me? Cognitive, Affective, and Behavioral Side Effects of DBS and Authentic Choices Over Future Personalities

Fragments of Selves and The Importance of Emotionality: Ethicolegal Challenges in Assessing Capacities, Consent, and Communicating with MCS Patients and the Need for Guidelines

“…Furthermore, as recovery takes place, reintegration is likely to produce inconsistent states of being. For instance, neuromodulation technologies such as deep brain stimulation (DBS) or transcranial magnetic stimulation, aimed at resetting neuromechanisms like the information-processing subsystems underpinning consciousness, are associated with the potential for personality change (Mackenzie 2011a;2011b). During neurorehabilitation and recovery, MCS patients' states of consciousness are likely to alter and fluctuate.…”

Authenticity Versus Autonomy in Choosing the New Me: Beyond IEC and NIEC in DBS

“…Restricting exploration of patient choice to enhancement or decision-making capacity excludes ethically complex situations such as determining the degree of control which patients using DBS should have to choose amongst variations of personal characteristics to craft identities, as opposed to enhancing specific abilities, the impact on the family/carers of personality changes post-treatment, issues with the authenticity of consent procedures and the implications of preferences for post-treatment states by patients where these are viewed as problematic by families/carers and/or by clinicians (Mackenzie 2011a;2011b;Mackenzie and Watts 2011).…”

Deep Brain Stimulation for Psychopaths—A No Brainer

“…Neuromodulation to increase empathy and amygdala sensitivity to fear would be insufficient to eradicate psychopathy without post-treatment counseling to arrive at a revised, subjectively acceptable, code of moral conduct. Furthermore, questions of autonomy and authentic identity underpinning valid consent are fundamental to ethical questions surrounding shaping identities through personality-altering interventions like DBS (Mackenzie 2014(Mackenzie , 2011a(Mackenzie , 2011b. Focquart and Schermer argue the consent process for direct interventions to provide moral enhancement, such as neuromodulation by DBS, should address the possibility of compromised autonomy and identity, and there should be post-intervention counseling to allow the participant choice over whether to endorse or reject the changes (Focquaert & Schermer 2015).…”

“…Neuromodulatory settings on DBS devices would need to be adjustable, in effect reversible, and choices over who made the decisions over settings, and on what grounds, be addressed before and after intervention as part of a continuing consent process (Mackenzie 2014(Mackenzie , 2011a(Mackenzie , 2011b. Prisoners might well prefer lower settings of sensitivity to affective empathy and fear than the norm, unless they were provided with effective protections or placed in a social environment where these unfamiliar emotions could be experienced safely.…”