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  1. An Instrument to Capture the Phenomenology of Implantable Brain Device Use.Frederic Gilbert, Brown, Dasgupta, Martens, Klein & Goering - 2021 - Neuroethics 14 (S3):333-340.
    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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  • An Instrument to Capture the Phenomenology of Implantable Brain Device Use.Frederic Gilbert, Brown, Dasgupta, Martens, Klein & Goering - 2021 - Neuroethics 14 (3):333-340.
    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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  • 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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  • Deflating the “DBS Causes Personality Changes” Bubble.Frederic Gilbert, J. N. M. Viaña & C. Ineichen - 2018 - Neuroethics 14 (Suppl 1):1-17.
    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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  • ‘Woe Betides Anybody Who Tries to Turn me Down.’ A Qualitative Analysis of Neuropsychiatric Symptoms Following Subthalamic Deep Brain Stimulation for Parkinson’s Disease.Philip E. Mosley, Katherine Robinson, Terry Coyne, Peter Silburn, Michael Breakspear & Adrian Carter - 2021 - Neuroethics 14 (1):47-63.
    Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease can lead to the development of neuropsychiatric symptoms. These can include harmful changes in mood and behaviour that alienate family members and raise ethical questions about personal responsibility for actions committed under stimulation-dependent mental states. Qualitative interviews were conducted with twenty participants following subthalamic DBS at a movement disorders centre, in order to explore the meaning and significance of stimulation-related neuropsychiatric symptoms amongst a purposive sample of persons (...)
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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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  • Ethical Implications of Closed Loop Brain Device: 10-Year Review.Swati Aggarwal & Nupur Chugh - 2020 - Minds and Machines 30 (1):145-170.
    Closed Loop medical devices such as Closed Loop Deep Brain Stimulation and Brain Computer Interface are some of the emerging neurotechnologies. New generations of implantable brain–computer interfaces have recently gained success in human clinical trials. These implants detect specific neuronal patterns and provide the subject with information to respond to these patterns. Further, Closed Loop brain devices give control to the subject so that he can respond and decide on a therapeutic goal. Although the implants have improved subjects’ quality of (...)
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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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  • Deep Brain Stimulation Through the “Lens of Agency”: Clarifying Threats to Personal Identity From Neurological Intervention.Eliza Goddard - 2017 - Neuroethics 10 (3):325-335.
    This paper explores the impacts of neurological intervention on selfhood with reference to recipients’ claims about changes to their self-understanding following Deep Brain Stimulation for treatment of Parkinson’s Disease. In the neuroethics literature, patients’ claims such as: “I don’t feel like myself anymore” and “I feel like a machine”, are often understood as expressing threats to identity. In this paper I argue that framing debates in terms of a possible threat to identity—whether for or against the proposition, is mistaken and (...)
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  • Is the Personal Identity Debate a “Threat” to Neurosurgical Patients? A Reply to Müller Et Al.Sven Nyholm - 2018 - Neuroethics 11 (2):229-235.
    In a recent article, Sabine Müller, Merlin Bittlinger, and Henrik Walter launch a sweeping attack against what they call the "personal identity debate" as it relates to patients treated with deep brain stimulation (DBS). In this critique offered by Müller et al., the so-called personal identity debate is said to: (a) be metaphysical in a problematic way, (b) constitute a threat to patients, and (c) use "vague" and "contradictory" statements from patients and their families as direct evidence for metaphysical theories. (...)
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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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  • 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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  • Bonding Brains to Machines: Ethical Implications of Electroceuticals for the Human Brain.Jens Clausen - 2013 - Neuroethics 6 (3):429-434.
    Novel neurotechnologies like deep brain stimulation and brain-computer interfaces promise clinical benefits for severely suffering patients. Nevertheless, such electroceuticals raise several ethical issues on different levels: while on the level of clinical neuroethics issues with direct relevance for diagnosis and treatment have to be discussed, on the level of research neuroethics questions regarding research and development of these technological devices like investigating new targets and different diseases as well as thorough inclusion criteria are dealt with. On the level of theoretical (...)
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  • Reasons for Comfort and Discomfort with Pharmacological Enhancement of Cognitive, Affective, and Social Domains.Laura Y. Cabrera, Nicholas S. Fitz & Peter B. Reiner - 2015 - Neuroethics 8 (2):93-106.
    The debate over the propriety of cognitive enhancement evokes both enthusiasm and worry. To gain further insight into the reasons that people may have for endorsing or eschewing pharmacological enhancement, we used empirical tools to explore public attitudes towards PE of twelve cognitive, affective, and social domains. Participants from Canada and the United States were recruited using Mechanical Turk and were randomly assigned to read one vignette that described an individual who uses a pill to enhance a single domain. After (...)
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  • Me, Myself and My Brain Implant: Deep Brain Stimulation Raises Questions of Personal Authenticity and Alienation.Felicitas Kraemer - 2013 - Neuroethics 6 (3):483-497.
    In this article, I explore select case studies of Parkinson patients treated with deep brain stimulation in light of the notions of alienation and authenticity. While the literature on DBS has so far neglected the issues of authenticity and alienation, I argue that interpreting these cases in terms of these concepts raises new issues for not only the philosophical discussion of neuro-ethics of DBS, but also for the psychological and medical approach to patients under DBS. In particular, I suggest that (...)
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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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  • Brain-Brain Integration in 2035: Metaphysical and Ethical Implications.Soraj Hongladarom - 2015 - Journal of Information, Communication and Ethics in Society 13 (3/4):205-217.
    Purpose – The purpose of this study is to think ahead into the year 2035 and reflect on the ethical implications of brain-to-brain linking. Design/methodology/approach – Philosophical argument. Findings – It is quite likely that the direction of technological research today is heading toward a closer integration of mind and machine in 2035. What is interesting is that the integration also makes mind-mind or brain-brain integration possible too. There is nothing in principle that would prevent hooking up more than one (...)
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  • Becoming More Oneself? Changes in Personality Following DBS Treatment for Psychiatric Disorders: Experiences of OCD Patients and General Considerations.Sanneke De Haan, Erik Rietveld, Martin Stokhof & Damiaan Denys - 2017 - PLoS ONE 12 (4):1-27.
    Does DBS change a patient’s personality? This is one of the central questions in the debate on the ethics of treatment with Deep Brain Stimulation (DBS). At the moment, however, this important debate is hampered by the fact that there is relatively little data available concerning what patients actually experience following DBS treatment. There are a few qualitative studies with patients with Parkinson’s disease and Primary Dystonia and some case reports, but there has been no qualitative study yet with patients (...)
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  • Situating the Self: Understanding the Effects of Deep Brain Stimulation.Roy Dings & Leon de Bruin - 2016 - Phenomenology and the Cognitive Sciences 15 (2):151-165.
    The article proposes a theoretical model to account for changes in self due to Deep Brain Stimulation. First, we argue that most existing models postulate a very narrow conception of self, and thus fail to capture the full range of potentially relevant DBS-induced changes. Second, building on previous work by Shaun Gallagher, we propose a modified ‘pattern-theory of self’, which provides a richer picture of the possible consequences of DBS treatment.
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  • Informed Consent in Implantable BCI Research: Identifying Risks and Exploring Meaning.Eran Klein - 2016 - Science and Engineering Ethics 22 (5):1299-1317.
    Implantable brain–computer interface technology is an expanding area of engineering research now moving into clinical application. Ensuring meaningful informed consent in implantable BCI research is an ethical imperative. The emerging and rapidly evolving nature of implantable BCI research makes identification of risks, a critical component of informed consent, a challenge. In this paper, 6 core risk domains relevant to implantable BCI research are identified—short and long term safety, cognitive and communicative impairment, inappropriate expectations, involuntariness, affective impairment, and privacy and security. (...)
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  • Self and Embodiment: A Bio-Phenomenological Approach to Dementia.Stephan Millett - 2011 - Dementia 10 (4):509-522.
    Loss of self is widely regarded to be a consequence of dementia, and this perceived loss presents a variety of problems - not least because a clear understanding of the concept of self is elusive. This paper suggests a way to cut through problems that arise because we rely on conceptions of self in our understanding of the effects of dementia. It is proposed that we can avoid reliance on the concept of self through an approach based in in bio-phenomenology. (...)
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  • Stimulating the Self: The Influence of Conceptual Frameworks on Reactions to Deep Brain Stimulation.Giulio Mecacci & W. F. G. Haselager - 2014 - American Journal of Bioethics Neuroscience 5 (4):30-39.
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  • Comparison of Philosophical Concerns Between Professionals and the Public Regarding Two Psychiatric Treatments.Laura Yenisa Cabrera, Marisa Brandt, Rachel McKenzie & Robyn Bluhm - forthcoming - Ajob Empirical Bioethics:1-15.
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  • On the Ambiguity of ‘the Same Person’.Vilius Dranseika - 2017 - American Journal of Bioethics Neuroscience 8 (3):184-186.
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  • Positive Outcomes and Causal Insufficiency Do Not Rule Out the Risk of DBS-Related Identity Changes.Giulio Mecacci & Pim Haselager - 2017 - American Journal of Bioethics Neuroscience 8 (2):128-129.
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  • I Miss Being Me: Phenomenological Effects of Deep Brain Stimulation.Frederic Gilbert, Eliza Goddard, John Noel M. Viaña, Adrian Carter & Malcolm Horne - 2017 - American Journal of Bioethics Neuroscience 8 (2):96-109.
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  • Thinking Ahead on Deep Brain Stimulation: An Analysis of the Ethical Implications of a Developing Technology.Veronica Johansson, Martin Garwicz, Martin Kanje, Lena Halldenius & Jens Schouenborg - 2014 - American Journal of Bioethics Neuroscience 5 (1):24-33.
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  • Time to Reconsider Deep Brain Stimulation.Ron Berghmans - 2013 - American Journal of Bioethics Neuroscience 4 (1):36-37.
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