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  1. The Role of Family Members in Psychiatric Deep Brain Stimulation Trials: More Than Psychosocial Support.Marion Boulicault, Sara Goering, Eran Klein, Darin Dougherty & Alik S. Widge - 2023 - Neuroethics 16 (2):1-18.
    Family members can provide crucial support to individuals participating in clinical trials. In research on the “newest frontier” of Deep Brain Stimulation (DBS)—the use of DBS for psychiatric conditions—family member support is frequently listed as a criterion for trial enrollment. Despite the significance of family members, qualitative ethics research on DBS for psychiatric conditions has focused almost exclusively on the perspectives and experiences of DBS recipients. This qualitative study is one of the first to include both DBS recipients and their (...)
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  • Concerns About Psychiatric Neurosurgery and How They Can Be Overcome: Recommendations for Responsible Research.Sabine Müller, Ansel van Oosterhout, Chris Bervoets, Markus Christen, Roberto Martínez-Álvarez & Merlin Bittlinger - 2022 - Neuroethics 15 (1):1-26.
    BackgroundPsychiatric neurosurgery is experiencing a revival. Beside deep brain stimulation, several ablative neurosurgical procedures are currently in use. Each approach has a different profile of advantages and disadvantages. However, many psychiatrists, ethicists, and laypeople are sceptical about psychiatric neurosurgery.MethodsWe identify the main concerns against psychiatric neurosurgery, and discuss the extent to which they are justified and how they might be overcome. We review the evidence for the effectiveness, efficacy and safety of each approach, and discuss how this could be improved. (...)
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  • Recommendations for Responsible Development and Application of Neurotechnologies.Sara Goering, Eran Klein, Laura Specker Sullivan, Anna Wexler, Blaise Agüera Y. Arcas, Guoqiang Bi, Jose M. Carmena, Joseph J. Fins, Phoebe Friesen, Jack Gallant, Jane E. Huggins, Philipp Kellmeyer, Adam Marblestone, Christine Mitchell, Erik Parens, Michelle Pham, Alan Rubel, Norihiro Sadato, Mina Teicher, David Wasserman, Meredith Whittaker, Jonathan Wolpaw & Rafael Yuste - 2021 - Neuroethics 14 (3):365-386.
    Advancements in novel neurotechnologies, such as brain computer interfaces and neuromodulatory devices such as deep brain stimulators, will have profound implications for society and human rights. While these technologies are improving the diagnosis and treatment of mental and neurological diseases, they can also alter individual agency and estrange those using neurotechnologies from their sense of self, challenging basic notions of what it means to be human. As an international coalition of interdisciplinary scholars and practitioners, we examine these challenges and make (...)
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  • Narrative Devices: Neurotechnologies, Information, and Self-Constitution.Emily Postan - 2021 - Neuroethics 14 (2):231-251.
    This article provides a conceptual and normative framework through which we may understand the potentially ethically significant roles that information generated by neurotechnologies about our brains and minds may play in our construction of our identities. Neuroethics debates currently focus disproportionately on the ways that third parties may (ab)use these kinds of information. These debates occlude interests we may have in whether and how we ourselves encounter information about our own brains and minds. This gap is not yet adequately addressed (...)
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  • Deep Brain Stimulation and Relational Agency: Negotiating Relationships.Robyn Bluhm & Laura Cabrera - 2020 - International Journal of Feminist Approaches to Bioethics 13 (1):155-161.
    Timothy Brown invites us to think about the ways in which people who are being treated with deep brain stimulation might come to interact with their devices. He suggests that a framework of relational agency can help us to understand both the benefits and the challenges of DBS because DBS systems are, while not full fellow agents, more than mere props; users must sometimes "negotiate and collaborate with their stimulators". We agree that it is important to develop conceptual frameworks that (...)
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  • Clarifying the Normative Significance of ‘Personality Changes’ Following Deep Brain Stimulation.Jonathan Pugh - 2020 - Science and Engineering Ethics 26 (3):1655-1680.
    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. 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 (...)
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  • What we (Should) Talk about when we Talk about Deep Brain Stimulation and Personal Identity.Robyn Bluhm, Laura Cabrera & Rachel McKenzie - 2019 - Neuroethics 13 (3):289-301.
    A number of reports have suggested that patients who undergo deep brain stimulation may experience changes to their personality or sense of self. These reports have attracted great philosophical interest. This paper surveys the philosophical literature on personal identity and DBS and draws on an emerging empirical literature on the experiences of patients who have undergone this therapy to argue that the existing philosophical discussion of DBS and personal identity frames the problem too narrowly. Much of the discussion by neuroethicists (...)
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  • Evidence-Based Neuroethics, Deep Brain Stimulation and Personality - Deflating, but not Bursting, the Bubble.Jonathan Pugh, Laurie Pycroft, Hannah Maslen, Tipu Aziz & Julian Savulescu - 2018 - Neuroethics 14 (1):27-38.
    Gilbert et al. have raised important questions about the empirical grounding of neuroethical analyses of the apparent phenomenon of Deep Brain Stimulation ‘causing’ personality changes. In this paper, we consider how to make neuroethical claims appropriately calibrated to existing evidence, and the role that philosophical neuroethics has to play in this enterprise of ‘evidence-based neuroethics’. In the first half of the paper, we begin by highlighting the challenges we face in investigating changes to PIAAAS following DBS, explaining how different trial (...)
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  • Dynamical Relations in the Self-Pattern.Shaun Gallagher & Anya Daly - 2018 - Frontiers in Psychology 9.
    Abstract: The notion of a self-pattern, as developed in the pattern theory of self, which holds that the self is best explained in terms of the kind of reality that pertains to a dynamical pattern, acknowledges the importance of neural dynamics, but also expands the account of self to extra-neural (embodied and enactive) dynamics. The pattern theory of self, however, has been criticized for failing to explicate the dynamical relations among elements of the self-pattern; as such, it seems to be (...)
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  • Experimental and relational authenticity: how neurotechnologies impact narrative identities.Cristian Iftode, Alexandra Zorilă, Constantin Vică & Emilian Mihailov - 2022 - Phenomenology and the Cognitive Sciences:1-18.
    The debate about how neurotechnologies impact authenticity has focused on two inter-related dimensions: self-discovery and self-creation. In this paper, we develop a broader framework that includes the experimental and relational dimensions of authenticity, both understood as decisive for shaping one’s narrative identity. In our view, neurointerventions that alter someone’s personality traits will also impact her very own self-understanding across time. We argue that experimental authenticity only needs a minimum conception of narrative coherence of the self and that reversibility should remain (...)
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  • ‘Deep brain stimulation is no ON/OFF-switch’: an ethnography of clinical expertise in psychiatric practice.Maarten van Westen, Erik Rietveld, Annemarie van Hout & Damiaan Denys - 2021 - Phenomenology and the Cognitive Sciences 22 (1):129-148.
    Despite technological innovations, clinical expertise remains the cornerstone of psychiatry. A clinical expert does not only have general textbook knowledge, but is sensitive to what is demanded for the individual patient in a particular situation. A method that can do justice to the subjective and situation-specific nature of clinical expertise is ethnography. Effective deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) involves an interpretive, evaluative process of optimizing stimulation parameters, which makes it an interesting case to study clinical expertise. The (...)
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  • The Spectrum of Responsibility Ascription for End Users of Neurotechnologies.Andreas Schönau - 2021 - Neuroethics 14 (3):423-435.
    Invasive neural devices offer novel prospects for motor rehabilitation on different levels of agentive behavior. From a functional perspective, they interact with, support, or enable human intentional actions in such a way that movement capabilities are regained. However, when there is a technical malfunction resulting in an unintended movement, the complexity of the relationship between the end user and the device sometimes makes it difficult to determine who is responsible for the outcome – a circumstance that has been coined as (...)
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  • Researcher Perspectives on Ethical Considerations in Adaptive Deep Brain Stimulation Trials.Katrina A. Muñoz, Kristin Kostick, Clarissa Sanchez, Lavina Kalwani, Laura Torgerson, Rebecca Hsu, Demetrio Sierra-Mercado, Jill O. Robinson, Simon Outram, Barbara A. Koenig, Stacey Pereira, Amy McGuire, Peter Zuk & Gabriel Lázaro-Muñoz - 2020 - Frontiers in Human Neuroscience 14.
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  • Effective Deep Brain Stimulation for Obsessive-Compulsive Disorder Requires Clinical Expertise.Maarten van Westen, Erik Rietveld & Damiaan Denys - 2019 - Frontiers in Psychology 10.
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  • On the Significance of the Identity Debate in DBS and the Need of an Inclusive Research Agenda. A Reply to Gilbert, Viana and Ineichen.Anke Snoek, Sanneke de Haan, Maartje Schermer & Dorothee Horstkötter - 2019 - Neuroethics 14 (1):65-74.
    Gilbert et al. argue that the concerns about the influence of Deep Brain Stimulation on – as they lump together – personality, identity, agency, autonomy, authenticity and the self are due to an ethics hype. They argue that there is only a small empirical base for an extended ethics debate. We will critically examine their claims and argue that Gilbert and colleagues do not show that the identity debate in DBS is a bubble, they in fact give very little evidence (...)
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  • It’s Not Just Counting that Counts: a Reply to Gilbert, Viaña, and Ineichen.Robyn Bluhm & Laura Y. Cabrera - 2018 - Neuroethics 14 (1):23-26.
    Gilbert et al. argue that discussions of self-related changes in patients undergoing DBS are overblown. They show that there is little evidence that these changes occur frequently and make recommendations for further research. We point out that their framing of the issue, their methodology, and their recommendations do not attend to other important questions about these changes.
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  • Embodiment in Neuro-engineering Endeavors: Phenomenological Considerations and Practical Implications.Sadaf Soloukey Tbalvandany, Biswadjiet Sanjay Harhangi, Awee W. Prins & Maartje H. N. Schermer - 2018 - Neuroethics 12 (3):231-242.
    The field of Neuro-Engineering seems to be on the fast track towards accomplishing its ultimate goal of potentially replacing the nervous system in the face of disease. Meanwhile, the patients and professionals involved are continuously dealing with human bodily experience and especially how neuro-engineering devices could become part of a user’s body schema: the domain of ‘embodied phenomenology’. This focus on embodiment, however, is not sufficiently reflected in the current literature on ethical and philosophical issues in neuro-engineering. In this article (...)
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  • Neuroethics, Cognitive Technologies and the Extended Mind Perspective.Jan-Hendrik Heinrichs - 2018 - Neuroethics 14 (1):59-72.
    Current debates in neuroethics engage with extremely diverse technologies, for some of which it is a point of contention whether they should be a topic for neuroethics at all. In this article, I will evaluate extended mind theory’s claim of being able to define the scope of neuroethics’ domain as well as determining the extension of an individual’s mind via its so-called trust and glue criteria. I argue that a) extending the domain of neuroethics by this manoeuvre endangers the theoretical (...)
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  • Deep Brain Stimulation, Self and Relational Autonomy.Shaun Gallagher - 2018 - Neuroethics 14 (1):31-43.
    Questions about the nature of self and self-consciousness are closely aligned with questions about the nature of autonomy. These concepts have deep roots in traditional philosophical discussions that concern metaphysics, epistemology and ethics. They also have direct relevance to practical considerations about informed consent in medical contexts. In this paper, with reference to understanding specific side effects of deep brain stimulation treatment in cases of, for example, Parkinson’s Disease, Obsessive Compulsive Disorder, and Major Depressive Disorder, I’ll argue that it is (...)
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  • Is the Treatment Worse than the Disease?: Key Stakeholders’ Views about the Use of Psychiatric Electroceutical Interventions for Treatment-Resistant Depression.Laura Y. Cabrera, Robyn Bluhm, Aaron M. McCright & Eric D. Achtyes - 2024 - Neuroethics 18 (1):1-17.
    Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat psychiatric conditions. For depression therapy, PEIs include both approved treatment modalities, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS), and experimental neurotechnologies, such as deep brain stimulation (DBS) and adaptive brain implants (ABIs). We present results from a survey-based experiment in which members of four relevant stakeholder groups (psychiatrists, patients with depression, caregivers of adults with depression, and the general public) assessed whether treatment with one of (...)
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  • DBS and Autonomy: Clarifying the Role of Theoretical Neuroethics.Peter Zuk & Gabriel Lázaro-Muñoz - 2019 - Neuroethics 14 (1):83-93.
    In this article, we sketch how theoretical neuroethics can clarify the concept of autonomy. We hope that this can both serve as a model for the conceptual clarification of other components of PIAAAS and contribute to the development of the empirical measures that Gilbert and colleagues [1] propose.
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  • Experimental and relational authenticity: how neurotechnologies impact narrative identities.Cristian Iftode, Alexandra Zorilă, Constantin Vică & Emilian Mihailov - 2024 - Phenomenology and the Cognitive Sciences 23 (4):743-760.
    The debate about how neurotechnologies impact authenticity has focused on two inter-related dimensions: self-discovery and self-creation. In this paper, we develop a broader framework that includes the experimental and relational dimensions of authenticity, both understood as decisive for shaping one’s narrative identity. In our view, neurointerventions that alter someone’s personality traits will also impact her very own self-understanding across time. We argue that experimental authenticity only needs a minimum conception of narrative coherence of the self and that reversibility should remain (...)
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