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date: 24 January 2020

Abstract and Keywords

Severe psychiatric disorders may be resistant to conventional pharmacological and psychotherapeutic treatments. Invasive interventions such as deep-brain stimulation (DBS) and neurosurgical ablation (lesioning) can modulate dysfunctional neural circuits implicated in these disorders. Yet these two forms of psychiatric neurosurgery are still experimental and investigational and thus their safety and efficacy have yet to be established. This chapter is an examination and discussion of the main ethical issues surrounding the experimental use of DBS and lesioning for treatment-refractory psychiatric disorders. I address questions regarding research subjects’ exposure to risk and informed consent to be enrolled in clinical trials testing these techniques for major depression and obsessive-compulsive disorder. These questions include whether or to what extent the therapeutic misconception influences decisions to enroll in these trials. I then explore similar questions about the use of DBS for schizophrenia and anorexia nervosa. Finally, I discuss the obligations of researchers conducting these studies to research subjects.

Keywords: Consent, deep brain stimulation, lesioning, risk, psychiatric disorders, research, Therapeutic Misconception

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