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  1. Deep Brain Stimulation as a Probative Biology: Scientific Inquiry and the Mosaic Device.Joseph J. Fins - 2012 - American Journal of Bioethics Neuroscience 3 (1):4-8.
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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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  • The Role of Regret in Medical Decision-Making.Paddy McQueen - 2017 - Ethical Theory and Moral Practice 20 (5):1051-1065.
    In this paper, I explore the role that regret does and should play in medical decision-making. Specifically, I consider whether the possibility of a patient experiencing post-treatment regret is a good reason for a clinician to counsel against that treatment or to withhold it. Currently, the belief that a patient may experience post-treatment regret is sometimes taken as a sufficiently strong reason to withhold it, even when the patient makes an explicit, informed request. Relatedly, medical researchers and practitioners often understand (...)
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  • Learning From Deep Brain Stimulation: The Fallacy of Techno-Solutionism and the Need for ‘Regimes of Care’.John Gardner & Narelle Warren - 2019 - Medicine, Health Care and Philosophy 22 (3):363-374.
    Deep brain stimulation is an effective treatment for the debilitating motor symptoms of Parkinson’s disease and other neurological disorders. However, clinicians and commentators have noted that DBS recipients have not necessarily experienced the improvements in quality of life that would be expected, due in large part to what have been described as the ‘psychosocial’ impacts of DBS. The premise of this paper is that, in order to realise the full potential of DBS and similar interventions, clinical services need to be (...)
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  • Das Identitätsproblem der tiefen Hirnstimulation und einige seiner praktischen Implikationen.Dr Karsten Witt - 2013 - Ethik in der Medizin 25 (1):5-18.
    Ein Leitmotiv der medizinethischen Auseinandersetzung mit der tiefen Hirnstimulation (THS) ist die Beschäftigung mit Fragen personaler Identität. Da es sich bei personaler Identität auch um ein Problem der theoretischen Philosophie handelt, wird in diesem Aufsatz nicht nur die praktische Frage nach der ethischen Legitimation der THS durch informierte Einwilligung gestellt und ein modifiziertes Legitimationskriterium für wesensändernde THS erarbeitet. Vielmehr wird zunächst versucht, das Problem, um das es in der Debatte um THS und personaler Identität geht, besser zu verstehen.
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  • Deep Brain Stimulation and the Search for Identity.Karsten Witt, Jens Kuhn, Lars Timmermann, Mateusz Zurowski & Christiane Woopen - 2013 - Neuroethics 6 (3):499-511.
    Ethical evaluation of deep brain stimulation as a treatment for Parkinson’s disease is complicated by results that can be described as involving changes in the patient’s identity. The risk of becoming another person following surgery is alarming for patients, caregivers and clinicians alike. It is one of the most urgent conceptual and ethical problems facing deep brain stimulation in Parkinson’s disease at this time. In our paper we take issue with this problem on two accounts. First, we elucidate what is (...)
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  • Fostering the Trustworthiness of Researchers: SPECS and the Role of Ethical Reflexivity in Novel Neurotechnology Research.Paul Tubig & Darcy McCusker - 2020 - Research Ethics 17 (2):143-161.
    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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  • Narrative and Characterization.Karsten Witt - 2020 - Erkenntnis 85 (1):45-63.
    Many philosophers working on personal identity and ethics say that personal identity is constituted by stories: narratives people tell or would tell about their lives. Most of them also say that this is personal identity in the ‘characterization sense’, that it is the notion people in ordinary contexts are interested in, and that it raises the ‘characterization question’. I argue that these claims are inconsistent. Narrativists can avoid the incompatibility in one of two ways: They can concede that their view (...)
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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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  • 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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  • 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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  • The Mind and the Machine. On the Conceptual and Moral Implications of Brain-Machine Interaction.Maartje Schermer - 2009 - NanoEthics 3 (3):217-230.
    Brain-machine interfaces are a growing field of research and application. The increasing possibilities to connect the human brain to electronic devices and computer software can be put to use in medicine, the military, and entertainment. Concrete technologies include cochlear implants, Deep Brain Stimulation, neurofeedback and neuroprosthesis. The expectations for the near and further future are high, though it is difficult to separate hope from hype. The focus in this paper is on the effects that these new technologies may have on (...)
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  • Beyond Blind Optimism and Unfounded Fears: Deep Brain Stimulation for Treatment Resistant Depression.Veronica Johansson, Martin Garwicz, Martin Kanje, Helena Röcklinsberg, Jens Schouenborg, Anders Tingström & Ulf Görman - 2013 - Neuroethics 6 (3):457-471.
    The introduction of new medical treatments based on invasive technologies has often been surrounded by both hopes and fears. Hope, since a new intervention can create new opportunities either in terms of providing a cure for the disease or impairment at hand; or as alleviation of symptoms. Fear, since an invasive treatment involving implanting a medical device can result in unknown complications such as hardware failure and undesirable medical consequences. However, hopes and fears may also arise due to the cultural (...)
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  • The Gold-Plated Leucotomy Standard and Deep Brain Stimulation.Grant Gillett - 2011 - Journal of Bioethical Inquiry 8 (1):35-44.
    Walter Freeman, the self styled neurosurgeon, became famous (or infamous) for psychosurgery. The operation of frontal leucotomy swept through the world (with Freeman himself performing something like 18,000 cases) but it has tainted the whole idea of psychosurgery down to the present era. Modes of psychosurgery such as Deep Brain Stimulation and other highly selective neurosurgical procedures for neurological and psychiatric conditions are in ever-increasing use in current practice. The new, more exciting techniques are based in a widely held philosophical (...)
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  • Brain Machine Interface and Human Enhancement – An Ethical Review.Karim Jebari - 2013 - Neuroethics 6 (3):617-625.
    Brain machine interface (BMI) technology makes direct communication between the brain and a machine possible by means of electrodes. This paper reviews the existing and emerging technologies in this field and offers a systematic inquiry into the relevant ethical problems that are likely to emerge in the following decades.
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  • Mapping the Dimensions of Agency.Andreas Schönau, Ishan Dasgupta, Timothy Brown, Erika Versalovic, Eran Klein & Sara Goering - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):172-186.
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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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  • Identity Change and Informed Consent.Karsten Witt - 2017 - Journal of Medical Ethics 43 (6):384-390.
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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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  • Fostering Neuroethics Integration with Neuroscience in the BRAIN Initiative: Comments on the NIH Neuroethics Roadmap.Sara Goering & Eran Klein - 2020 - American Journal of Bioethics Neuroscience 11 (3):184-188.
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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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  • “I Am Who I Am”: On the Perceived Threats to Personal Identity From Deep Brain Stimulation. [REVIEW]Françoise Baylis - 2013 - Neuroethics 6 (3):513-526.
    This article explores the notion of the dislocated self following deep brain stimulation (DBS) and concludes that when personal identity is understood in dynamic, narrative, and relational terms, the claim that DBS is a threat to personal identity is deeply problematic. While DBS may result in profound changes in behaviour, mood and cognition (characteristics closely linked to personality), it is not helpful to characterize DBS as threatening to personal identity insofar as this claim is either false, misdirected or trivially true. (...)
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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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  • 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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  • Authenticity or Autonomy? When Deep Brain Stimulation Causes a Dilemma.Felicitas Kraemer - 2013 - Journal of Medical Ethics 39 (12):757-760.
    While deep brain stimulation (DBS) for patients with Parkinson's disease has typically raised ethical questions about autonomy, accountability and personal identity, recent research indicates that we need to begin taking into account issues surrounding the patients’ feelings of authenticity and alienation as well. In order to bring out the relevance of this dimension to ethical considerations of DBS, I analyse a recent case study of a Dutch patient who, as a result of DBS, faced a dilemma between autonomy and authenticity. (...)
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  • Health, Happiness and Human Enhancement—Dealing with Unexpected Effects of Deep Brain Stimulation.Maartje Schermer - 2013 - Neuroethics 6 (3):435-445.
    Deep Brain Stimulation (DBS) is a treatment involving the implantation of electrodes into the brain. Presently, it is used for neurological disorders like Parkinson’s disease, but indications are expanding to psychiatric disorders such as depression, addiction and Obsessive Compulsive Disorder (OCD). Theoretically, it may be possible to use DBS for the enhancement of various mental functions. This article discusses a case of an OCD patient who felt very happy with the DBS treatment, even though her symptoms were not reduced. First, (...)
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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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  • Did My Brain Implant Make Me Do It? Questions Raised by DBS Regarding Psychological Continuity, Responsibility for Action and Mental Competence.Laura Klaming & Pim Haselager - 2013 - Neuroethics 6 (3):527-539.
    Deep brain stimulation is a well-accepted treatment for movement disorders and is currently explored as a treatment option for various neurological and psychiatric disorders. Several case studies suggest that DBS may, in some patients, influence mental states critical to personality to such an extent that it affects an individual’s personal identity, i.e. the experience of psychological continuity, of persisting through time as the same person. Without questioning the usefulness of DBS as a treatment option for various serious and treatment refractory (...)
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  • European Public Deliberation on Brain Machine Interface Technology: Five Convergence Seminars. [REVIEW]Karim Jebari & Sven-Ove Hansson - 2013 - Science and Engineering Ethics 19 (3):1071-1086.
    We present a novel procedure to engage the public in ethical deliberations on the potential impacts of brain machine interface technology. We call this procedure a convergence seminar, a form of scenario-based group discussion that is founded on the idea of hypothetical retrospection. The theoretical background of this procedure and the results of five seminars are presented.
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  • Das Identitätsproblem der tiefen Hirnstimulation und einige seiner praktischen ImplikationenDeep brain stimulation, personal identity, and informed consent.Karsten Witt - 2013 - Ethik in der Medizin 25 (1):5-18.
    ZusammenfassungEin Leitmotiv der medizinethischen Auseinandersetzung mit der tiefen Hirnstimulation ist die Beschäftigung mit Fragen personaler Identität. Da es sich bei personaler Identität auch um ein Problem der theoretischen Philosophie handelt, wird in diesem Aufsatz nicht nur die praktische Frage nach der ethischen Legitimation der THS durch informierte Einwilligung gestellt und ein modifiziertes Legitimationskriterium für wesensändernde THS erarbeitet. Vielmehr wird zunächst versucht, das Problem, um das es in der Debatte um THS und personaler Identität geht, besser zu verstehen.
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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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  • DBS for Depression? Lessons From Patients’ Beliefs for Research, Treatment, and Noninvasive Brain Modulation.Dorothee Horstkötter & David E. J. Linden - 2018 - American Journal of Bioethics Neuroscience 9 (4):232-234.
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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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  • Is That the Same Person? Case Studies in Neurosurgery.Nancy S. Jecker & Andrew L. Ko - 2017 - American Journal of Bioethics Neuroscience 8 (3):160-170.
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  • Staying in the Loop: Relational Agency and Identity in Next-Generation DBS for Psychiatry.Sara Goering, Eran Klein, Darin D. Dougherty & Alik S. Widge - 2017 - American Journal of Bioethics Neuroscience 8 (2):59-70.
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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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  • Ethical Analyses of Predictive Brain Implants Should Be Consistent With Feminist Interpretations of Autonomy.G. K. D. Crozier & Timothy M. Krahn - 2015 - American Journal of Bioethics Neuroscience 6 (4):48-49.
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  • Ethical Considerations in Deep Brain Stimulation for the Treatment of Addiction and Overeating Associated With Obesity.Jared M. Pisapia, Casey H. Halpern, Ulf J. Muller, Piergiuseppe Vinai, John A. Wolf, Donald M. Whiting, Thomas A. Wadden, Gordon H. Baltuch & Arthur L. Caplan - 2013 - American Journal of Bioethics Neuroscience 4 (2):35-46.
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  • The Ethical Differences Between Psychiatric and Neurologic DBS: Smaller Than We Think?Matthis Synofzik & Jens Clausen - 2011 - American Journal of Bioethics Neuroscience 2 (1):37-39.
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