Deep Brain Stimulation For Treatment-Resistant Neuropsychiatric Disorders

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.