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  1. DBS and Autonomy: Clarifying the Role of Theoretical Neuroethics.Peter Zuk & Gabriel Lázaro-Muñoz - 2021 - 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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  • DBS and Autonomy: Clarifying the Role of Theoretical Neuroethics.Peter Zuk & Gabriel Lázaro-Muñoz - 2021 - 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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  • 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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  • Can Self-Validating Neuroenhancement Be Autonomous?Jukka Varelius - 2020 - Medicine, Health Care and Philosophy 23 (1):51-59.
    Consider that an individual improves her capacities by neuroscientific means. It turns out that, besides altering her in the way(s) she intended, the enhancement also changes her personality in significant way(s) she did not foresee. Yet the person endorses her new self because the neuroenhancement she underwent changed her. Can the person’s approval of her new personality be autonomous? While questions of autonomy have already gathered a significant amount of attention in philosophical literature on human enhancement, the problem just described—henceforth (...)
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  • The Ethics of Deep Brain Stimulation.Marcus Unterrainer & Fuat S. Oduncu - 2015 - Medicine, Health Care and Philosophy 18 (4):475-485.
    Deep brain stimulation is an invasive technique designed to stimulate certain deep brain regions for therapeutic purposes and is currently used mainly in patients with neurodegenerative disorders, such as Parkinson’s disease. However, DBS is also used increasingly for other experimental applications, such as the treatment of psychiatric disorders, weight reduction. Apart from its therapeutic potential, DBS can cause severe adverse effects, some that might also have a significant impact on the patient’s personality and autonomy by the external stimulation of DBS (...)
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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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  • 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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  • 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, Historicism, and Moral Responsibility.Daniel Sharp & David Wasserman - 2016 - Neuroethics 9 (2):173-185.
    Although philosophers have explored several connections between neuroscience and moral responsibility, the issue of how real-world neurological modifications, such as Deep Brain Stimulation, impact moral responsibility has received little attention. In this article, we draw on debates about the relevance of history and manipulation to moral responsibility to argue that certain kinds of neurological modification can diminish the responsibility of the agents so modified. We argue for a historicist position - a version of the history-sensitive reflection view - and defend (...)
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  • Neuroethics, Cognitive Technologies and the Extended Mind Perspective.Jan-Hendrik Heinrichs - 2021 - 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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  • Human Enhancement and Communication: On Meaning and Shared Understanding.Laura Cabrera & John Weckert - 2013 - Science and Engineering Ethics 19 (3):1039-1056.
    Our technologies have enabled us to change both the world and our perceptions of the world, as well as to change ourselves and to find new ways to fulfil the human desire for improvement and for having new capacities. The debate around using technology for human enhancement has already raised many ethical concerns, however little research has been done in how human enhancement can affect human communication. The purpose of this paper is to explore whether some human enhancements could change (...)
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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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  • Correcting the Brain? The Convergence of Neuroscience, Neurotechnology, Psychiatry, and Artificial Intelligence.Stephen Rainey & Yasemin J. Erden - 2020 - Science and Engineering Ethics 26 (5):2439-2454.
    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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  • Embodiment in Neuro-Engineering Endeavors: Phenomenological Considerations and Practical Implications.Sadaf Soloukey Tbalvandany, Biswadjiet Sanjay Harhangi, Awee W. Prins & Maartje H. N. Schermer - 2019 - 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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  • 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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  • 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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  • Personal Identity, Direction of Change, and Neuroethics.Kevin Tobia - 2016 - Neuroethics 9 (1):37-43.
    The personal identity relation is of great interest to philosophers, who often consider fictional scenarios to test what features seem to make persons persist through time. But often real examples of neuroscientific interest also provide important tests of personal identity. One such example is the case of Phineas Gage – or at least the story often told about Phineas Gage. Many cite Gage’s story as example of severed personal identity; Phineas underwent such a tremendous change that Gage “survived as a (...)
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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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  • The Spectrum of Responsibility Ascription for End Users of Neurotechnologies.Andreas Schönau - forthcoming - Neuroethics:1-13.
    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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  • Towards New Human Rights in the Age of Neuroscience and Neurotechnology.Marcello Ienca & Roberto Andorno - 2017 - Life Sciences, Society and Policy 13 (1):1-27.
    Rapid advancements in human neuroscience and neurotechnology open unprecedented possibilities for accessing, collecting, sharing and manipulating information from the human brain. Such applications raise important challenges to human rights principles that need to be addressed to prevent unintended consequences. This paper assesses the implications of emerging neurotechnology applications in the context of the human rights framework and suggests that existing human rights may not be sufficient to respond to these emerging issues. After analysing the relationship between neuroscience and human rights, (...)
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  • Criminal Responsibility and Neuroscience: No Revolution Yet.Ariane Bigenwald & Valerian Chambon - 2019 - Frontiers in Psychology 10.
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  • Enhancement, Ethics and Society: Towards an Empirical Research Agenda for the Medical Humanities and Social Sciences.Martyn Pickersgill & Linda Hogle - 2015 - Medical Humanities 41 (2):136-142.
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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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  • 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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  • 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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  • Personal Identity and Ethics.David Shoemaker - 2008 - Stanford Encyclopedia of Philosophy.
    What justifies our holding a person morally responsible for some past action? Why am I justified in having a special prudential concern for some future persons and not others? Why do many of us think that maximizing the good within a single life is perfectly acceptable, but maximizing the good across lives is wrong? In these and other normative questions, it looks like any answer we come up with will have to make an essential reference to personal identity. So, for (...)
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  • Restoring Responsibility: Promoting Justice, Therapy and Reform Through Direct Brain Interventions.Nicole A. Vincent - 2014 - Criminal Law and Philosophy 8 (1):21-42.
    Direct brain intervention based mental capacity restoration techniques-for instance, psycho-active drugs-are sometimes used in criminal cases to promote the aims of justice. For instance, they might be used to restore a person's competence to stand trial in order to assess the degree of their responsibility for what they did, or to restore their competence for punishment so that we can hold them responsible for it. Some also suggest that such interventions might be used for therapy or reform in criminal legal (...)
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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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  • The Asilomar Survey: Stakeholders' Opinions on Ethical Issues Related to Brain-Computer Interfacing. [REVIEW]Femke Nijboer, Jens Clausen, Brendan Z. Allison & Pim Haselager - 2013 - Neuroethics 6 (3):541-578.
    Brain-Computer Interface (BCI) research and (future) applications raise important ethical issues that need to be addressed to promote societal acceptance and adequate policies. Here we report on a survey we conducted among 145 BCI researchers at the 4th International BCI conference, which took place in May–June 2010 in Asilomar, California. We assessed respondents’ opinions about a number of topics. First, we investigated preferences for terminology and definitions relating to BCIs. Second, we assessed respondents’ expectations on the marketability of different BCI (...)
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  • A Young Scientists’ Perspective on DBS: A Plea for an International DBS Organization.Rowan P. Sommers, Roy Dings, Koen I. Neijenhuijs, Hannah Andringa, Sebastian Arts, Daphne van de Bult, Laura Klockenbusch, Emiel Wanningen, Leon C. de Bruin & Pim F. G. Haselager - 2015 - Neuroethics 8 (2):187-190.
    Our think tank tasked by the Dutch Health Council, consisting of Radboud University Nijmegen Honours Academy students with various backgrounds, investigated the implications of Deep Brain Stimulation for psychiatric patients. During this investigation, a number of methodological, ethical and societal difficulties were identified. We consider these difficulties to be a reflection of a still fragmented field of research that can be overcome with improved organization and communication. To this effect, we suggest that it would be useful to found a centralized (...)
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  • Implantable Smart Technologies : Defining the ‘Sting’ in Data and Device.Gill Haddow, Shawn H. E. Harmon & Leah Gilman - 2016 - Health Care Analysis 24 (3):210-227.
    In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry (...)
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  • Side Effects or Symptoms? The Feeling of Self-Estrangement in DBS Patients.Luigi Pastore, Giuseppe Saracino, Marco Innamorati & Sara Dellantonio - 2014 - American Journal of Bioethics Neuroscience 5 (4):58-60.
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  • Neuroethics Beyond Normal.John R. Shook & James Giordano - 2016 - Cambridge Quarterly of Healthcare Ethics 25 (1):121-140.
    :An integrated and principled neuroethics offers ethical guidelines able to transcend conventional and medical reliance on normality standards. Elsewhere we have proposed four principles for wise guidance on human transformations. Principles like these are already urgently needed, as bio- and cyberenhancements are rapidly emerging. Context matters. Neither “treatments” nor “enhancements” are objectively identifiable apart from performance expectations, social contexts, and civic orders. Lessons learned from disability studies about enablement and inclusion suggest a fresh way to categorize modifications to the body (...)
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  • Stimulating More Than the Patient's Brain: Deep Brain Stimulation From a Systems Perspective.Johannes Keyser & Saskia K. Nagel - 2014 - American Journal of Bioethics Neuroscience 5 (4):60-62.
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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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  • 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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  • Neuroethics.Adina Roskies - 2016 - Stanford Encyclopedia of Philosophy.
  • Moral Enhancement: Do Means Matter Morally?Farah Focquaert & Maartje Schermer - 2015 - Neuroethics 8 (2):139-151.
    One of the reasons why moral enhancement may be controversial, is because the advantages of moral enhancement may fall upon society rather than on those who are enhanced. If directed at individuals with certain counter-moral traits it may have direct societal benefits by lowering immoral behavior and increasing public safety, but it is not directly clear if this also benefits the individual in question. In this paper, we will discuss what we consider to be moral enhancement, how different means may (...)
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