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Patient’s lived experience with DBS between medical research and care: some legal implications

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Abstract

In the past 50 years, an ethical-legal boundary has been drawn between treatment and research. It is based on the reasoning that the two activities pursue different purposes. Treatment is aimed at achieving optimal therapeutic benefits for the individual patient, whereas the goal of scientific research is to increase knowledge, in the public interest. From this viewpoint, the patient’s experience should be clearly distinguished from that of a participant in a clinical trial. On this premise, two parallel and mutually exclusive regimes have been established. Yet in the case of deep brain stimulation (DBS), this presentation is a poor fit, for both the patient’s lived experience and medical practice and research. The frictions may be explained by the specificities of the treatment (including surgery and medical devices) and of the pathologies concerned (chronic and evolutive), and by the characteristics of the medical team implementing the treatment. These particularities challenge the dominant frame of reference in medical bioethics and cause difficulties for the current legal framework in fulfilling its dual role: to protect patients while supporting the development of innovative treatments. The dominant model is still the clinical trial for medication safety and legal requirements of drug market regulation. However, DBS forces us to reflect on a medical device that is permanently implanted in the brain by highly specialized multi-disciplinary neurosurgical teams, for the treatment of chronic evolutive diseases. These devices demand fine-tuning on a case-by-case basis and there is still a lot to discover about why DBS is effective (or not). As a result, the wall between treatment and research is osmotic: many discoveries are made incidentally, in the course of treatment. The following study begins with these observations, and suggests that we review legal provisions (especially in French and United States law) so that they are better adapted to the first-person needs and experience of the patient undergoing brain stimulation.

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References

  • Adèle, Paul-Anthelme, and Sonia Desmoulin-Canselier. 2016. Droit des dispositifs médicaux: Vers une réforme ou un simple réaménagement? Revue de Droit Sanitaire et Social 5: 930–942.

    Google Scholar 

  • Agid, Y., M. Schüpbach, M. Gargiulo, L. Mallet, I. L. Houeto, C. Behar, D. Maltete, V. Mesnage, and M.-L. Welter. 2006. Neurosurgery in Parkinson’s disease: The doctor is happy, the patient less so? Journal of Neural Transmission Supplementa 70: 409–414.

    Google Scholar 

  • Amadio, Jordan P., and Nicholas M. Boulis. 2011. Practical considerations in the ethics of parkinsonian deep brain stimulation. AJOB Neuroscience 2: 24–26.

    Article  Google Scholar 

  • APIDIM/SNITEM. 2016. Faire de la France un modèle pour l’accès à l’innovation des dispositifs médicaux. Recommandations issues d’une analyse comparée des stratégies spécifiques de l’accès au marché des dispositifs médicaux innovants. http://www.snitem.fr/sites/default/files/snitem-apidim_recommandations-2016.pdf. Accessed 22 Dec 2017.

  • Appelbaum, P. S., C. W. Lidz, and T. Grisso. 2004. Therapeutic misconception in clinical research: Frequency and risk factors. IRB 26 (2): 1–8.

    Article  Google Scholar 

  • Azulay, J. P. 2013. Neurostimulation des noyaux sous-thalamiques: Mieux vaut tôt que jamais! Revue Neurologique 169: 283–284.

    Article  Google Scholar 

  • Bell, Emily, Racine Mathieu and Eric Ghislaine. 2009. Preparing the ethical future of deep brain stimulation. Surgical Neurology 72: 577–586.

    Article  Google Scholar 

  • Bell, Emily, Bruce Maxwell, Mary Oat McAndrews, Abbas Sadikot, and Eric Racine 2011. Deep brain stimulation and ethics: Perspectives from a Multisite qualitative study of Canadian neurosurgical centers. World Neurosurgery: December 76 (6): 537–547.

    Article  Google Scholar 

  • Belmont Report. 1979. The Belmont Report: Ethical principles and guidelines for the protection of human subjects of research. http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.html. Accessed 22 Dec 2017.

  • Benabid, Alim-Louis. 2003. Deep brain stimulation for Parkinson’s Disease. Current Opinion in Neurobiology 13: 696–706.

    Article  Google Scholar 

  • Blank, Robert H. 2013. Intervention in the Brain. Politics, Policy, and Ethics. Cambridge: MIT Press.

    Book  Google Scholar 

  • Cabrera, Laura Y., Emily L. Evans, and Roy H. Hamilton. 2014. Ethics of the electrified mind: Defining issues and perspectives on the principled use of brain stimulation in medical research and clinical care. Brain Topography 27: 33–45.

    Article  Google Scholar 

  • Canselier (Desmoulin-Canselier), Sonia. 2015. Recherche et médecine “translationnelles”: Questions juridiques à propos d’un programme de politique scientifique. Cahiers Droit, Sciences et Technologies 5: 61–73.

    Article  Google Scholar 

  • Charles, D., P. E. Konrad, J. S. Neimat, A. L. Molinari, M. G. Tramontana, and S. G. Finder, et al. 2014. Subthalamic nucleus deep brain stimulation in early stage Parkinson’s disease. Parkinsonism and Related Disorders 20: 731–737.

    Article  Google Scholar 

  • Christopher, Paul P., and Laura B. Dunn. 2015. Risk and consent in neuropsychiatric deep brain stimulation: An exemplary analysis of treatment-resistant depression, obsessive-compulsive disorder, and dementia. In Handbook of Neuroethics, eds. J. Clausen, and N. Levy, 2, 589–605. Dordrecht: Springer.

    Google Scholar 

  • Clausen, Jens. 2010. Ethical brain stimulation: Neuroethics of deep brain stimulation in research and clinical practice. European Journal of Neuroscience 32: 1152–1162.

    Article  Google Scholar 

  • Comité Consultatif National d’Éthique pour les Sciences de la Vie et de la Santé. 2002. Avis n° 71: La neurochirurgie fonctionnelle d’affections psychiatriques sévères. Paris. http://www.ccne-ethique.fr/fr/publications/avis-sur-la-neurochirurgie-fonctionnelle-daffections-psychiatriques-severes#.WftPn2jWw2w. Accessed 22 Dec 2017.

  • Comité Consultatif National d’Éthique pour les Sciences de la Vie et de la Santé. 2013. Avis n° 122: Recours aux techniques biomédicales en vue de « neuro-amélioration » chez la personne non malade: Enjeux éthique. Paris. http://www.ccne-ethique.fr/sites/default/files/publications/ccne.avis_ndeg122.pdf. Accessed 22 Dec 2017.

  • Comité Consultatif National d’Éthique pour les Sciences de la Vie et de la Santé (CCNE). 2007. Avis n° 101:Santé, éthique et argent: Les enjeux éthiques de la contrainte budgétaire sur les dépenses de santé en milieu hospitalier. Paris. http://www.ccne-ethique.fr/sites/default/files/publications/avis101.pdf. Accessed 22 Dec 2017.

  • Copeland Samantha, M. 2013. Problems with seeing Deep Brain Stimulation recipients primarily as research subjects. AJOB Neuroscience 4 (2): 50–52.

    Article  Google Scholar 

  • Dekkers, W., and G. Boer. 2001. Sham neurosurgery in patients with Parkinson’s disease: Is it morally acceptable? Journal of Medical Ethics 27: 151–156.

    Article  Google Scholar 

  • Deuschl, Günter, Yves Agid. 2013. Subthalamic neurostimulation for Parkinson’s disease with early fluctuations: Balancing the risks and benefits. The Lancet Neurology 12: 1025–1034.

    Article  Google Scholar 

  • Deuschl, Günter, Michael Schüpbach, Karina Knudsen, O. Marcus Pinsker, Philippe Cornu, JörnRau, Yves Agid, and Carmen Schade-Brittinger. 2013. Stimulation of the subthalamic nucleus at an earlier disease stage of Parkinson’s disease: Concept and standards of the EARLYSTIM-study. Parkinsonism and Related Disorders 19: 53–61.

    Article  Google Scholar 

  • Doros, Gerald. 2010. FDA approval does not mean what you think it does! Journal of Invasive Cardiology 22 (8): 382–384.

    Google Scholar 

  • European Directive 90/385/EEC of 20 June 1990 on Active implantable medical devices. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A31990L0385. Accessed 31 July 2017.

  • European Regulation 2017/745 of 5 April 2017 on Medical devices. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A32017R0745. Accessed 31 July 2017.

  • Fins, Joseph J. 2012. Deep brain stimulation as a probative biology: Scientific inquiry & the mosaic device. American Journal of Bioethics-Neuro Science 3 (1): 4–8.

    Google Scholar 

  • Fins, Joseph J. 2015. Devices, drugs, and difference: Deep brain stimulation and the advent of personalized medicine. In Handbook of Neuroethics, eds. J. Clausen, and N. Levy, 2, 607–620. Dordrecht: Springer.

    Google Scholar 

  • Fins, Joseph J., and Zachary E. Shapiro. 2014. Deep brain stimulation, brain maps and personalized medicine: Lessons from the human genome project. Brain Topography 27: 55–62.

    Article  Google Scholar 

  • Fins, J. J., H. S. Mayberg, B. Nuttin, C. S. Kubu, T. Galert, V. Strum, K. Stoppenbrink, R. Merkel, and T. E. Schlaepfer. 2011. Neuropsychiatric deep brain stimulation research and the misuse of the humanitarian device exemption. Health Affairs 30 (2): 302–311.

    Article  Google Scholar 

  • Fins, J. J, C. S. Kubu, H. S. Mayberg, Reinhard Merkel, Bart, Nuttin, and T. E. Schlaepfer. 2017. Being open minded about neuromodulation trials: Finding success in our “failures”. Brain Stimulation 10 (2): 181–186.

    Article  Google Scholar 

  • Foley, Paul. 2015. Deep brain stimulation for Parkinson’s disease: Historical and neuroethical aspects. In Handbook of Neuroethics, eds. J. Clausen, and N. Levy, 2, 561–587. Dordrecht: Springer.

    Google Scholar 

  • French Cour de cassation. 2009. Chambre criminelle, 24 février 2009, pourvoi numéro 08-84.436. https://www.legifrance.gouv.fr/affichJuriJudi.do?idTexte=JURITEXT000020358473. Accessed 22 Dec 2017.

  • French Loi Huriet-Sérusclat. 1988. Loi n° 88-1138 du 20 décembre 1988 relative à la protection des personnes qui se prêtent à des recherches biomédicales. Journal officiel de la République Française. https://www.legifrance.gouv.fr/jo_pdf.do?id=JORFTEXT000000508831. Accessed 22 Dec 2017.

  • French Loi Jardé. 2012. Loi n° 2012-300 du 5 mars 2012 relative aux recherches impliquant la personne humaine. https://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000025441587&categorieLien=id. Accessed 22 Dec 2017.

  • French Loi Jardé modifiée. 2016. Ordonnance n° 2016-800 du 16 juin 2016 relative aux recherches impliquant la personne humaine et décret n° 2016-1537 du 16 novembre 2016. https://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000032719520&categorieLien=id. Accessed 22 Dec 2017.

  • Gardner, John. 2013. A history of deep brain stimulation: Technological innovation and the role of clinical assessment tools. Social Studies of Science 43 (5): 707–728.

    Article  Google Scholar 

  • Gardner, John, Clare Williams. 2015. Responsible research and innovation: A manifesto for empirical ethics? Clinical Ethics 10 (1–2): 5–12.

    Article  Google Scholar 

  • Guchet, Xavier. 2016. La Médecine personnalisée. Un essai philosophique. Paris: Les belles lettres/Médecine & sciences humaines.

    Google Scholar 

  • Gunduz, Aysegul, K.D. Foote, and S. Okun Michael. 2017. Reengineering deep brain stimulation for movement disorders: Emerging technologies. Current Opinion in Biomedical Engineering. https://doi.org/10.1016/j.cobme.2017.09.001.

    Google Scholar 

  • Hacker Mallory, L., James Tonascia, Maxim Turchan, Amanda Currie, Lauren Heusinkveld, Peter E. Konrad, Thomas L. Davis, Joseph S. Neimat, Fenna T. Phibbs, Peter Hedera, Lily Wang, Yaping Shi, David M. Shade, Alice L. Sternberg, Lea T. Drye, and David Charles. 2015. Deep brain stimulation may reduce the relative risk of clinically important worsening in early stage Parkinson’s disease. Parkinsonism and Related Disorders 21:1177–1183.

    Article  Google Scholar 

  • Hariz, Marwan. 2012. Twenty-five years of deep brain stimulation: Celebrations and apprehensions. Movement Disorders 27 (7):930–933.

    Article  Google Scholar 

  • Hariz, Marwan. 2013. Early surgery for Parkinson’s disease? Maybe, but not just yet. The Lancet Neurology 12:938–939.

    Article  Google Scholar 

  • Hariz, Marwan. 2014. Deep brain stimulation: New techniques. Parkinsonism and Related Disorders 20:S192–S196.

    Article  Google Scholar 

  • Hariz, Marwan. 2015. There is no credible rational for deep brain stimulation in very early Parkinson’s disease! Parkinsonism and Related Disorders 21: 345–346.

    Article  Google Scholar 

  • Hariz, G.-M., and K. Hamberg. 2013. Perceptions of living with a device-based treatment: An account of patients treated with deep brain stimulation for Parkinson’s disease. Neuromodulation. https://doi.org/10.1111/ner.12073.

    Google Scholar 

  • Hariz, Gun-Marie, Patricia Limousin, Katarina Hamberg. 2016. “DBS means everything – for some time”. Patients’ perspectives on daily life with deep brain stimulation for Parkinson’s disease. Journal of Parkinson’s Disease. https://doi.org/10.3233/JPD-160799.

    Google Scholar 

  • Horng, Sam, and Franklin G. Miller. 2015. Ethics of sham surgery in clinical trials for neurologic disease. In Handbook of Neuroethics, eds. J. Clausen, and N. Levy, 2, 1125–1138. Dordrecht: Springer.

    Google Scholar 

  • Kim Scott, Y.H. 2013. Competence for informed treatment and research. In Neuroethics in Practice. Medicine, Mind, and Society, eds. A. Chatterjee, and M. J. Farah, 83–95. New-York: Oxford University Press.

    Google Scholar 

  • Kimmelman, Jonathan, Spencer Philipps Hey. 2015. Clinical translation in central nervous system diseases: Ethical and social challenges. In Handbook of Neuroethics, eds. J. Clausen, and N. Levy, 2, 1107–1124. Dordrecht: Springer.

    Google Scholar 

  • Kringelbach, Morten L., and Tipu Z. Aziz. 2011. Neuroethical principles of deep brain stimulation. (commentary). World Neurosurgery 76 (6): 518–519.

    Article  Google Scholar 

  • Largent, Emily, Steven Joffe, and Franklin Miller. 2011. Can research and care be ethically integrated? The Hastings Center Report 41 (4): 37–46.

    Article  Google Scholar 

  • Lévêque, Marc. 2013. Psychochirurgie. Paris: Springer.

    Book  Google Scholar 

  • Leykin, Y., P. P. Christopher, P. E. Holtzheimer, P. S. Appelbaum, H. S. Mayberg, and S. H. Lisanby, and L. B. Dunn. 2011. Participants’ perceptions of deep brain stimulation research for treatment-resistant depression: Risks, benefits, and therapeutic misconception. AJOB Primary Research 2:33–41.

    Article  Google Scholar 

  • Mascret, Caroline. 2015. Les nouvelles règles juridiques de la prise en charge de l’innovation des technologies en santé par l’assurance maladie. Petites Affiches 77 (17 avril 2015): 4–7.

    Google Scholar 

  • Mathers, J., C. Rick, C. Jenkinson, R. Garside, H. Pall, R. Mitchell, S. Bayliss, and L. L. Jones. 2016. Patients’ experiences of deep brain stimulation for Parkinson’s disease: A qualitative systematic review and synthesis. BMJ Open. https://doi.org/10.1136/bmjopen-2016-011525.

    Google Scholar 

  • Mestre, Tiago A., Alberto J. Espay, Connie Marras, Mark H. Eckman, Pierre Pollak, and Anthony E. Lang. 2014. Subthalamic nucleus-deep brain stimulation for early motor complications in Parkinson’s Disease: The EARLYSTIM Trial: Early is not always better. Movement Disorders 29 (14):1751–1756.

    Article  Google Scholar 

  • Morishita, Takashi, Sarah M. Fayad, Masa-aki Higuchi, Kelsey A. Nestor, and Kelly D. Foote. 2014. Deep brain stimulation for treatment-resistant depression: Systematic review of clinical outcomes. Neurotherapeutics 11 (3): 475–484.

    Article  Google Scholar 

  • Moutaud, Baptiste. 2009. C’est un problème neurologique ou psychiatrique ? Ethnologie de la stimulation cérébrale profonde appliquée au trouble obsessionnel compulsif. Université Paris Descartes.

  • Moutaud, Baptiste. 2010. L’implantation de la recherche clinique à l’hôpital en France. Histoire de la création des centres d’investigation clinique ». Médecines/Sciences 26 (7): 768–771.

    Article  Google Scholar 

  • Moutaud, Baptiste. 2014. Pour le bien de tous et l’intérêt de chacun. Essai clinique et innovation organisationnelle en psychochirurgie. Sciences Sociales et Santé 3 (32): 43–68.

    Article  Google Scholar 

  • Moutaud, Baptiste. 2016. Neuromodulation technologies and the regulation of forms of life: Exploring, treating, enhancing. Medical Anthropology: 35: 1–17.

    Article  Google Scholar 

  • Mulroy, Eoin, Nigel Robertson, Lorraine MacDonald, Arnold Bok and Simpson Mark. 2017. Patients’ perioperative experience of awake deep-brain stimulation for Parkinson disease. World Neurosurgery 105: 526–528.

    Article  Google Scholar 

  • Mundale, Jennifer. 2016. Reversibility and deep brain stimulation. Journal of Cognition and Neuroethics 3 (4): 97–111.

    Google Scholar 

  • Nicolaidis, Stylianos. 2017. Neurosurgery of the future: Deep brain stimulations and manipulations. Metabolism Clinical and Experimental 69: 16–20.

    Article  Google Scholar 

  • Nuffield Council on Bioethics. 2013. Novel neurotechnologies: intervening in the brain. http://nuffieldbioethics.org/wp-content/uploads/2013/06/Novel_neurotechnologies_report_PDF_web_0.pdf. Accessed 22 Dec 2017.

  • Office parlementaire des choix scientifiques et techniques. 2014. Les progrès de la génétique: vers une médecine de précision ? Les enjeux scientifiques, technologiques, sociaux et éthiques de la médecine personnalisée. Paris. http://www.senat.fr/rap/r13-306/r13-306_mono.html. Accessed 22 Dec 2017.

  • Paubel, Pascal. 2015. Forfait innovation: Un dispositif de financement des dispositifs médicaux perfectible. Journal de Droit de la Santé et de l’Assurance Maladie 1: 62–65.

    Google Scholar 

  • Rosin, Boris, Maya Slovik, Mitelman Rea, Michal Rivlin-Etzion, Suzanne Haber, Zvi Israel, Eilon Vaadia, and Hagai Bergman. 2011. Closed-loop deep brain stimulation is superior in ameliorating Parkinsonism. Neuron 72 (2): 370–384.

    Article  Google Scholar 

  • Sacristan, José. 2015. Clinical research and medical care: Towards effective and complete integration. BMC Medical Research Methodology 15: 53–65.

    Article  Google Scholar 

  • Schlaepfer, Thomas E., and Joseph.J. Fins. 2010. Deep brain stimulation and the neuroethics of responsible publishing: When one is not enough. Journal of the American Medical Association 303 (8): 775–776.

    Article  Google Scholar 

  • Schüpbach, M., M. Gargiulo, M.-L. Welter, L. Mallet, C. Béhar, I.-L. Houeto, D. Maltête, V. Mesnage, and Y. Agid. 2006. Neurosurgery in Parkinson disease: A distressed mind in a repaired body? Neurology 66: 1811–1816.

    Article  Google Scholar 

  • Schüpbach, Michael W.M., Jörn Rau, Jean-Luc Houeto, Paul Krack, Alfons Schnitzler, Carmen Schade-Brittinger, Lars Timmerman, and Günter Deuschl. 2014. Myths and facts about the EARLYSTIM Study. Movement Disorders 29 (14): 1742–1750.

    Article  Google Scholar 

  • Sperens, Maria, Katarina Hamberg, and Gun-Marie Hariz. 2017. Are patients ready for “EARLYSTIM”? Attitudes towards deep brain stimulation among female and male patients with moderately advanced Parkinson’s disease. Parkinson’s Disease. https://doi.org/10.1155/2017/1939831.

    Google Scholar 

  • Strauss, Ido, Suneil Kalia, and Andres Lozano. 2014. Where are we with surgical therapies for Parkinson’s disease? Parkinsonism and Related Disorders 20S1: 187–191.

    Article  Google Scholar 

  • Synofzik, Matthis. 2013. Functional neurosurgery and deep brain stimulation. In Neuroethics in Practice. Medicine, Mind, and Society, eds. A. Chatterjee, and M. J. Farah, 189–208. New-York: Oxford University Press.

    Chapter  Google Scholar 

  • Synofzik, Matthis. 2015. Ethical implications of brain stimulation. In Handbook of Neuroethics, eds. J. Clausen, and N. Levy, 2. 553–560. Dordrecht: Springer.

    Google Scholar 

  • Synofzik, Matthis, Thomas E. Schlaepfer. 2011. Electrodes in the brain-ethical criteria for research and treatment with deep brain stimulation for neuropsychiatric disorders. Brain Stimulation 4 (1): 7–16.

    Article  Google Scholar 

  • Thouvenin Dominique. 2009. Commentaire de l’article L. 1121-1 du code de la santé publique. In Code de la santé publique commenté, ed. F. Dreifuss-Netter, 43–55. Paris: Litec.

    Google Scholar 

  • Thouvenin, Dominique. 2012. La loi n° 2012 – 300 du 5 mars 2012: Des recherches pratiquées sur la personne aux recherches avec la personne. Revue de Droit Sanitaire et Social 5: 787–799.

    Google Scholar 

  • Timmermans, Stefan, Marc Berg. 2003. The Gold Standard: The Challenge of Evidence-Based Medicine and Standardization in Health Care. Philadelphia: Temple University Press.

    Google Scholar 

  • Unterrainer, Marcus, Fuat S. Oduncu. 2015. The ethics of deep brain stimulation. Medicine Health Care and Philosophy 18: 475–485.

    Article  Google Scholar 

  • US Code of Federal regulations. 2009. Title 45: Public Welfare Department of Health and Human Services, Part 46: Protection of Human Subjects. Washington: US Department of Health and Human Subjects. Revised January 15, 2009 Effective July 14, 2009. https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html. Accessed 22 Dec 2017.

  • USA National Research Act. 1974. Public Law 93–348 (July 12, 1974) To amend the Public Health Service Act to establish a program of National Research Service Awards to assure the continued excellence of biomedical and behavioral research and to provide for the protection of human subjects involved in biomedical and behavioral research and for other purposes. https://history.nih.gov/research/downloads/PL93-348.pdf. Accessed 15 Nov 2017.

  • Vialla, François. 2013. De quelques questions posées par l’administration de la preuve de l’information due au patient. Petites Affiches 112: 16–22.

    Google Scholar 

  • Wolf, Marc E., Mahmoud Abdallat, Christian Blahak, and Joachim K. Krauss. 2017. Pathological crying induced by deep brain stimulation of the subthalamic nucleus in Parkinson’s disease. Journal of Clinical Neuroscience 45: 159–161.

    Article  Google Scholar 

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Funding

This research was funded by the NormaStim ANR 14-CE30-0016-01 program with the support of the French National Research Agency (Agence Nationale de la Recherche).

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  1. CNRS/Université de Nantes UMR 6297 Droit et Changement Social, Faculté de Droit et de sciences politiques, Université de Nantes, Chemin de la Censive du Tertre, Nantes, France

    Sonia Desmoulin-Canselier

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Desmoulin-Canselier, S. Patient’s lived experience with DBS between medical research and care: some legal implications. Med Health Care and Philos 22, 375–386 (2019). https://doi.org/10.1007/s11019-018-9859-5

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