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date: 19 April 2021

Abstract and Keywords

This article reviews some of the ethical issues raised by the emergence and use of deep brain stimulation (DBS) as a treatment for neuropsychiatric disorders. Issues include concerns about the capacity of persons with severe mental illness to give authentic informed consent, protecting vulnerable individuals from being exposed to unproven and potentially irreversible therapies, the use of DBS for psychiatric disorders in minors, the necessary organization of the interdisciplinary teams required to deliver these demanding treatments, and the degree and quality of oversight. DBS may be seen as the most recent on a continuum of surgical intervention for psychiatric disease and also represents an adaptation of the first implantable brain-interfacing device (IBID) in clinical use. Consideration of the ethical issues raised by such therapies will protect individuals with neurologic and psychiatric diseases from the abuses of the past.

Keywords: deep brain stimulation, neuropsychiatric disorders, ethical issues, first implantable brain-interfacing device, therapies

Debra J.H. Mathews

Debra J.H. Mathews is the Assistant Director for Science Programs at the Johns Hopkins Berman Institute of Bioethics, with a secondary appointment in the Institute of Genetic Medicine, and an Assistant Professor of Pediatrics in the School of Medicine. She has a Ph.D in genetics and a MA in bioethics from Case Western Reserve University.

Peter V. Rabins

Peter V. Rabins is Professor of Psychiatry and Behavioral Sciences in the Johns Hopkins Hospital and the Richman Family Professor for Alzheimer’s and Related Diseases. His interests include the effectiveness of current treatment for Alzheimer disease, the development of measures of quality of life in persons with Alzheimer disease and the care of patients with late stage dementia.

Benjamin D. Greenberg

Benjamin D. Greenberg is Chief of Adult OCD research at the National Institute of Mental Health (NIMH). He studied psychology at Amherst College, and received a Ph.D in neuroscience from UC San Diego, and an MD from the University of Miami. He was a neurology resident at Columbia University, and completed psychiatry residency at Johns Hopkins Hospital and a fellowship at the NIMH. His primary research for more than a decade has been in psychiatric neurosurgery.

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