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  1. 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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  • Incoming Ethical Issues for Deep Brain Stimulation: When Long-Term Treatment Leads to a ‘New Form of the Disease’.Frederic Gilbert & Mathilde Lancelot - forthcoming - Journal of Medical Ethics:medethics-2019-106052.
    Deep brain stimulation has been regarded as an efficient and safe treatment for Parkinson’s disease since being approved by the Food and Drug Administration in 1997. It is estimated that more than 150 000 patients have been implanted, with a forecasted rapid increase in uptake with population ageing. Recent longitudinal follow-up studies have reported a significant increase in postoperative survival rates of patients with PD implanted with DBS as compared with those not implanted with DBS. Although DBS tends to increase (...)
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  • Pediatric Deep Brain Stimulation for Dystonia: Current State and Ethical Considerations.Katrina A. Muñoz, Jennifer Blumenthal-Barby, Eric A. Storch, Laura Torgerson & Gabriel Lázaro-muñoz - 2020 - Cambridge Quarterly of Healthcare Ethics 29 (4):557-573.
    Dystonia is a movement disorder that can have a debilitating impact on motor functions and quality of life. There are 250,000 cases in the United States, most with childhood onset. Due to the limited effectiveness and side effects of available treatments, pediatric deep brain stimulation has emerged as an intervention for refractory dystonia. However, there is limited clinical and neuroethics research in this area of clinical practice. This paper examines whether it is ethically justified to offer pDBS to children with (...)
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  • Fostering the Trustworthiness of Researchers: SPECS and the Role of Ethical Reflexivity in Novel Neurotechnology Research.Paul Tubig & Darcy McCusker - forthcoming - Research Ethics:174701612095250.
    The development of novel neurotechnologies, such as brain-computer interface and deep-brain stimulation, are very promising in improving the welfare and life prospects many people. These include life-changing therapies for medical conditions and enhancements of cognitive, emotional, and moral capacities. Yet there are also numerous moral risks and uncertainties involved in developing novel neurotechnologies. For this reason, the progress of novel neurotechnology research requires that diverse publics place trust in researchers to develop neural interfaces in ways that are overall beneficial to (...)
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  • Bodily Felt Freedom: An Ethical Perspective on Positive Aspects of Deep Brain Stimulation.Julia Sophia Voigt - forthcoming - Neuroethics:1-13.
    The critical aspects of deep brain stimulation are usually the focus of the ethical debate about the implantation of electrodes into the brain of patients with Parkinson’s disease. Above all, potential postoperative side effects on personality caused by DBS mark the debate. However, rehabilitation of agility and mobility by DBS can be posited against critical aspects. Therefore, the purpose of this article is to emphasize the hitherto neglected positive aspects of that technology. A detailed study of the rehabilitation of controlled (...)
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  • Correcting the Brain? The Convergence of Neuroscience, Neurotechnology, Psychiatry, and Artificial Intelligence.Stephen Rainey & Yasemin J. Erden - forthcoming - Science and Engineering Ethics:1-16.
    The incorporation of neural-based technologies into psychiatry offers novel means to use neural data in patient assessment and clinical diagnosis. However, an over-optimistic technologisation of neuroscientifically-informed psychiatry risks the conflation of technological and psychological norms. Neurotechnologies promise fast, efficient, broad psychiatric insights not readily available through conventional observation of patients. Recording and processing brain signals provides information from ‘beneath the skull’ that can be interpreted as an account of neural processing and that can provide a basis to evaluate general behaviour (...)
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  • Does DBS Alienate Identity or Does It Simply Fail to Restore Identity Already Eroded by Illness?Anke Snoek - 2017 - American Journal of Bioethics Neuroscience 8 (2):114-115.
    This article critical examines Gilbert and colleagues’ study (Gilbert et al. 2017) claims on how deep brain stimulation (DBS) as a treatment for Parkinson’s disease (PD) can influence people’s self-concept.
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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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  • Deflating the Deep Brain Stimulation Causes Personality Changes Bubble: The Authors Reply.Frederic Gilbert, John Noel M. Viana & C. Ineichen - forthcoming - Neuroethics:1-12.
    To conclude that there is enough or not enough evidence demonstrating that deep brain stimulation causes unintended postoperative personality changes is an epistemic problem that should be answered on the basis of established, replicable, and valid data. If prospective DBS recipients delay or refuse to be implanted because they are afraid of suffering from personality changes following DBS, and their fears are based on unsubstantiated claims made in the neuroethics literature, then researchers making these claims bear great responsibility for prospective (...)
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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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  • 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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  • Embodiment and Estrangement: Results From a First-in-Human “Intelligent BCI” Trial.F. Gilbert, M. Cook, T. O’Brien & J. Illes - 2019 - Science and Engineering Ethics 25 (1):83-96.
    While new generations of implantable brain computer interface devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results (...)
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  • Discussions of DBS in Neuroethics: Can We Deflate the Bubble Without Deflating Ethics?Alexandre Erler - forthcoming - Neuroethics.
    Gilbert and colleagues are to be commended for drawing our attention to the need for a sounder empirical basis, and for more careful reasoning, in the context of the neuroethics debate on Deep Brain Stimulation and its potential impact on the dimensions of personality, identity, agency, authenticity, autonomy and self. While acknowledging this, this extended commentary critically examines their claim that the real-world relevance of the conclusions drawn in the neuroethics literature is threatened by the fact that the concepts at (...)
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  • Artificial Intelligence in Clinical Neuroscience: Methodological and Ethical Challenges.Marcello Ienca & Karolina Ignatiadis - 2020 - American Journal of Bioethics Neuroscience 11 (2):77-87.
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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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  • Pragmatism and the Importance of Interdisciplinary Teams in Investigating Personality Changes Following DBS.Cynthia S. Kubu, Paul J. Ford, Joshua A. Wilt, Amanda R. Merner, Michelle Montpetite, Jaclyn Zeigler & Eric Racine - forthcoming - Neuroethics:1-10.
    Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...)
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  • Pragmatism and the Importance of Interdisciplinary Teams in Investigating Personality Changes Following DBS.Cynthia S. Kubu, Paul J. Ford, Joshua A. Wilt, Amanda R. Merner, Michelle Montpetite, Jaclyn Zeigler & Eric Racine - forthcoming - Neuroethics:1-10.
    Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...)
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  • Pragmatism and the Importance of Interdisciplinary Teams in Investigating Personality Changes Following DBS.Cynthia S. Kubu, Paul J. Ford, Joshua A. Wilt, Amanda R. Merner, Michelle Montpetite, Jaclyn Zeigler & Eric Racine - forthcoming - Neuroethics:1-10.
    Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...)
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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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  • Wired Emotions: Ethical Issues of Affective Brain–Computer Interfaces.Steffen Steinert & Orsolya Friedrich - 2020 - Science and Engineering Ethics 26 (1):351-367.
    Ethical issues concerning brain–computer interfaces have already received a considerable amount of attention. However, one particular form of BCI has not received the attention that it deserves: Affective BCIs that allow for the detection and stimulation of affective states. This paper brings the ethical issues of affective BCIs in sharper focus. The paper briefly reviews recent applications of affective BCIs and considers ethical issues that arise from these applications. Ethical issues that affective BCIs share with other neurotechnologies are presented and (...)
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  • Brainjacking in Deep Brain Stimulation and Autonomy.Jonathan Pugh, Laurie Pycroft, Anders Sandberg, Tipu Aziz & Julian Savulescu - 2018 - Ethics and Information Technology 20 (3):219-232.
    'Brainjacking’ refers to the exercise of unauthorized control of another’s electronic brain implant. Whilst the possibility of hacking a Brain–Computer Interface has already been proven in both experimental and real-life settings, there is reason to believe that it will soon be possible to interfere with the software settings of the Implanted Pulse Generators that play a central role in Deep Brain Stimulation systems. Whilst brainjacking raises ethical concerns pertaining to privacy and physical or psychological harm, we claim that the possibility (...)
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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 - forthcoming - Neuroethics.
    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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  • Dimensions of Ethical Direct-to-Consumer Neurotechnologies.Karola V. Kreitmair - 2019 - American Journal of Bioethics Neuroscience 10 (4):152-166.
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  • Missing Oneself or Becoming Oneself? The Difficulty of What “Becoming a Different Person” Means.Sanneke de Haan - 2017 - American Journal of Bioethics Neuroscience 8 (2):110-112.
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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 - forthcoming - Neuroethics:1-10.
    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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  • Neuroessentialism, Our Technological Future, and DBS Bubbles.Maxence Gaillard - forthcoming - Neuroethics:1-7.
    Having reviewed a considerable body of scholarly work in neuroethics related to DBS, Gilbert, Viaña, and Ineichen identify a major flaw in the debate—a “bubble” in the literature—and propose new directions for research. This comment addresses the authors’ diagnosis: What exactly is the nature of this bubble? Here, I argue that there are at least two different orientations in the “DBS causes personality changes” bubble. According to a first narrative, DBS is a special technology because its direct, causal action on (...)
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  • Alienation, Quality of Life, and DBS for Depression.Peter Zuk, Amy L. McGuire & Gabriel Lázaro-Muñoz - 2018 - American Journal of Bioethics Neuroscience 9 (4):223-225.
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  • Patients’ Beliefs About Deep Brain Stimulation for Treatment-Resistant Depression.Ryan E. Lawrence, Catharine R. Kaufmann, Ravi B. DeSilva & Paul S. Appelbaum - 2018 - American Journal of Bioethics Neuroscience 9 (4):210-218.
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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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  • Of Meatballs And Invasive Neurotechnological Trials: Additional Considerations for Complex Clinical Decisions.John Noel M. Viaña, Adrian Carter & Frederic Gilbert - 2018 - American Journal of Bioethics Neuroscience 9 (2):100-104.
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  • The Missing Empirical Studies of DBS Recipients' Views of Self.Daniel R. Morrison - 2017 - American Journal of Bioethics Neuroscience 8 (2):126-128.
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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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  • It’s Not Just Counting That Counts: A Reply to Gilbert, Viaña, and Ineichen.Robyn Bluhm & Laura Y. Cabrera - forthcoming - Neuroethics:1-4.
    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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  • The Need for Further Fine-Grained Distinctions in Discussions of Authenticity and Deep Brain Stimulation.Jonathan Pugh, Hannah Maslen & Julian Savulescu - 2017 - American Journal of Bioethics Neuroscience 8 (3):W1-W3.
  • A Place for Subjectivity in Psychiatry.Phoebe Friesen - 2017 - American Journal of Bioethics Neuroscience 8 (2):116-117.
  • 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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  • The Songs of the Sirens and the Wax in the Ears: An Autonomy-Based Tool for DBS Device Users.Oren Asman & Yechiel Michael Barilan - 2017 - American Journal of Bioethics Neuroscience 8 (2):120-122.
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  • Should We Be Concerned About Preserving Agency and Personal Identity in Patients With Adaptive Deep Brain Stimulation Systems?Gabriel Lázaro-Muñoz, Amy L. McGuire & Wayne K. Goodman - 2017 - American Journal of Bioethics Neuroscience 8 (2):73-75.
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  • The Patient's Voice in DBS Research: Advancing the Discussion Through Methodological Rigor.Merlin Bittlinger - 2017 - American Journal of Bioethics Neuroscience 8 (2):118-120.
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  • Two Concerns Regarding Subjectively Perceived Self-Estrangement.Karola Kreitmair - 2017 - American Journal of Bioethics Neuroscience 8 (2):124-125.
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  • What Neuroscience and Neurophilosophy Can Tell Us About the Effects of Deep Brain Stimulation on the Self.Georg Northoff - 2017 - American Journal of Bioethics Neuroscience 8 (2):55-58.
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  • The Multidimensionality and Context Dependency of Selves.Leon de Bruin, Roy Dings & Shaun Gallagher - 2017 - American Journal of Bioethics Neuroscience 8 (2):112-114.
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  • “I Miss You Too”: More Voices Needed to Examine the Phenomenological Effects of Deep Brain Stimulation.Cassandra Thomson & Rebecca Segrave - 2017 - American Journal of Bioethics Neuroscience 8 (2):122-123.
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  • The Effects of Closed-Loop Brain Implants on Autonomy and Deliberation: What Are the Risks of Being Kept in the Loop?Frederic Gilbert, Terence O’Brien & Mark Cook - 2018 - Cambridge Quarterly of Healthcare Ethics 27 (2):316-325.
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