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  1. Losing Meaning: Philosophical Reflections on Neural Interventions and Their Influence on Narrative Identity.Muriel Leuenberger - forthcoming - Neuroethics:1-15.
    The profound changes in personality, mood, and other features of the self that neural interventions can induce can be disconcerting to patients, their families, and caregivers. In the neuroethical debate, these concerns are often addressed in the context of possible threats to the narrative self. In this paper, I argue that it is necessary to consider a dimension of impacts on the narrative self which has so far been neglected: neural interventions can lead to a loss of meaning of actions, (...)
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  • Deep Brain Stimulation, Self and Relational Autonomy.Shaun Gallagher - 2021 - 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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  • The Memory-Modifying Potential of Optogenetics and the Need for Neuroethics.Agnieszka K. Adamczyk & Przemysław Zawadzki - 2020 - NanoEthics 14 (3):207-225.
    Optogenetics is an invasive neuromodulation technology involving the use of light to control the activity of individual neurons. Even though optogenetics is a relatively new neuromodulation tool whose various implications have not yet been scrutinized, it has already been approved for its first clinical trials in humans. As optogenetics is being intensively investigated in animal models with the aim of developing novel brain stimulation treatments for various neurological and psychiatric disorders, it appears crucial to consider both the opportunities and dangers (...)
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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 - 2020 - 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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  • Neurotechnology Ethics and Relational Agency.Sara Goering, Timothy Brown & Eran Klein - 2021 - Philosophy Compass 16 (4):e12734.
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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 - forthcoming - Phenomenology and the Cognitive Sciences:1-20.
    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 for obsessive-compulsive disorder involves an interpretive, evaluative process of optimizing stimulation parameters, which makes it an interesting case to study clinical expertise. The aim of (...)
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  • Pattern Theory of Self and Situating Moral Aspects: The Need to Include Authenticity, Autonomy and Responsibility in Understanding the Effects of Deep Brain Stimulation.Przemysław Zawadzki - forthcoming - Phenomenology and the Cognitive Sciences:1-24.
    The aims of this paper are to: identify the best framework for comprehending multidimensional impact of deep brain stimulation on the self; identify weaknesses of this framework; propose refinements to it; in pursuing, show why and how this framework should be extended with additional moral aspects and demonstrate their interrelations; define how moral aspects relate to the framework; show the potential consequences of including moral aspects on evaluating DBS’s impact on patients’ selves. Regarding, I argue that the pattern theory of (...)
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  • The Sense of Agency in OCD.Judit Szalai - 2019 - Review of Philosophy and Psychology 10 (2):363-380.
    This paper proposes an integrated account of the etiology of OCD that accommodates both dysfunctional cognitions and sensorimotor features of compulsive action. It is argued that cognitive/metacognitive theories do not aspire to address all obsessive-compulsive phenomenal properties and that empirical evidence concerning some of these requires the incorporation of motor deficits as an independent factor in a plausible conception of OCD. The difference in agency attribution between obsessive-compulsive persons and schizophrenia patients with delusions of control is also accounted for in (...)
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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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  • It Just Doesn’t Feel Right: OCD and the ‘Scaling Up’ Problem.Adrian Downey - 2020 - Phenomenology and the Cognitive Sciences 19 (4):705-727.
    The ‘scaling up’ objection says non-representational ecological-enactive accounts will be unable to explain ‘representation hungry’ cognition. Obsessive-compulsive disorder presents a paradigmatic instance of this objection, marked as it is by ‘representation hungry’ obsessive thoughts and compulsive behavior organized around them. In this paper I provide an ecological-enactive account of OCD, thereby demonstrating non-representational frameworks can ‘scale up’ to explain ‘representation hungry’ cognition. First, I outline a non-representational account of mind— a predictive processing operationalization of Sean Kelly’s theory of perception. This (...)
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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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  • The Ecological-Enactive Model of Disability: Why Disability Does Not Entail Pathological Embodiment.Juan Toro, Julian Kiverstein & Erik Rietveld - 2020 - Frontiers in Psychology 11.
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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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  • Understanding Phenomenological Differences in How Affordances Solicit Action. An Exploration.Roy Dings - 2018 - Phenomenology and the Cognitive Sciences 17 (4):681-699.
    Affordances are possibilities for action offered by the environment. Recent research on affordances holds that there are differences in how people experience such possibilities for action. However, these differences have not been properly investigated. In this paper I start by briefly scrutinizing the existing literature on this issue, and then argue for two claims. First, that whether an affordance solicits action or not depends on its relevance to the agent’s concerns. Second, that the experiential character of how an affordance solicits (...)
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  • Threats to Neurosurgical Patients Posed by the Personal Identity Debate.Sabine Müller, Merlin Bittlinger & Henrik Walter - 2017 - Neuroethics 10 (2):299-310.
    Decisions about brain surgery pose existential challenges because they are often decisions about life or death, and sometimes about possible personality changes. Therefore they require rigorous neuroethical consideration. However, we doubt whether metaphysical interpretations of ambiguous statements of patients are useful for deriving ethical and legal conclusions. Particularly, we question the application of psychological theories of personal identity on neuroethical issues for several reasons. First, even the putative “standard view” on personal identity is contentious. Second, diverse accounts of personal identity (...)
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  • Changes in Personality Associated with Deep Brain Stimulation: A Qualitative Evaluation of Clinician Perspectives.Cassandra J. Thomson, Rebecca A. Segrave & Adrian Carter - forthcoming - Neuroethics.
    Gilbert et al. argue that the neuroethics literature discussing the putative effects of Deep Brain Stimulation on personality largely ignores the scientific evidence and presents distorted claims that personality change is induced by the DBS stimulation. This study contributes to the first-hand primary research on the topic exploring DBS clinicians’ views on post-DBS personality change among their patients and its underlying cause. Semi-structured interviews were conducted with sixteen clinicians from various disciplines working in Australian DBS practice for movement disorders and/or (...)
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  • An Instrument to Capture the Phenomenology of Implantable Brain Device Use.Frederic Gilbert, Brown, Dasgupta, Martens, Klein & Goering - forthcoming - Neuroethics.
    One important concern regarding implantable Brain Computer Interfaces is the fear that the intervention will negatively change a patient’s sense of identity or agency. In particular, there is concern that the user will be psychologically worse-off following treatment despite postoperative functional improvements. Clinical observations from similar implantable brain technologies, such as deep brain stimulation, show a small but significant proportion of patients report feelings of strangeness or difficulty adjusting to a new concept of themselves characterized by a maladaptive je ne (...)
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  • Deep Brain Stimulation: Inducing Self-Estrangement.Frederic Gilbert - 2018 - Neuroethics 11 (2):157-165.
    Despite growing evidence that a significant number of patients living with Parkison’s disease experience neuropsychiatric changes following Deep Brain Stimulation treatment, the phenomenon remains poorly understood and largely unexplored in the literature. To shed new light on this phenomenon, we used qualitative methods grounded in phenomenology to conduct in-depth, semi-structured interviews with 17 patients living with Parkinson’s Disease who had undergone DBS. Our study found that patients appear to experience postoperative DBS-induced changes in the form of self-estrangement. Using the insights (...)
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  • DBS and Autonomy: Clarifying the Role of Theoretical Neuroethics.Peter Zuk & Gabriel Lázaro-Muñoz - forthcoming - Neuroethics:1-11.
    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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  • An Instrument to Capture the Phenomenology of Implantable Brain Device Use.Frederic Gilbert, Brown, Dasgupta, Martens, Klein & Goering - forthcoming - Neuroethics:1-8.
    One important concern regarding implantable Brain Computer Interfaces is the fear that the intervention will negatively change a patient’s sense of identity or agency. In particular, there is concern that the user will be psychologically worse-off following treatment despite postoperative functional improvements. Clinical observations from similar implantable brain technologies, such as deep brain stimulation, show a small but significant proportion of patients report feelings of strangeness or difficulty adjusting to a new concept of themselves characterized by a maladaptive je ne (...)
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  • Deflating the “DBS Causes Personality Changes” Bubble.Frederic Gilbert, J. N. M. Viaña & C. Ineichen - forthcoming - Neuroethics.
    The idea that deep brain stimulation induces changes to personality, identity, agency, authenticity, autonomy and self is so deeply entrenched within neuroethics discourses that it has become an unchallenged narrative. In this article, we critically assess evidence about putative effects of DBS on PIAAAS. We conducted a literature review of more than 1535 articles to investigate the prevalence of scientific evidence regarding these potential DBS-induced changes. While we observed an increase in the number of publications in theoretical neuroethics that mention (...)
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