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Science and Engineering Ethics

, Volume 24, Issue 4, pp 1119–1142 | Cite as

Should DBS for Psychiatric Disorders be Considered a Form of Psychosurgery? Ethical and Legal Considerations

  • Devan Stahl
  • Laura Cabrera
  • Tyler Gibb
Original Paper

Abstract

Deep brain stimulation (DBS), a surgical procedure involving the implantation of electrodes in the brain, has rekindled the medical community’s interest in psychosurgery. Whereas many researchers argue DBS is substantially different from psychosurgery, we argue psychiatric DBS—though a much more precise and refined treatment than its predecessors—is nevertheless a form of psychosurgery, which raises both old and new ethical and legal concerns that have not been given proper attention. Learning from the ethical and regulatory failures of older forms of psychosurgery can help shed light on how to address the regulatory gaps that exist currently in DBS research. To show why it is important to address the current regulatory gaps within psychiatric DBS, we draw on the motivations underlying the regulation of earlier forms of psychosurgery in the US. We begin by providing a brief history of psychosurgery and electrical brain stimulation in the US. Against this backdrop, we introduce psychiatric DBS, exploring current research and ongoing clinical trials. We then draw out the ethical and regulatory similarities between earlier forms of psychosurgery and psychiatric DBS. As we will show, the factors that motivated strict regulation of earlier psychosurgical procedures mirror concerns with psychiatric DBS today. We offer three recommendations for psychiatric DBS regulation, which echo earlier motivations for regulating psychosurgery, along with new considerations that reflect the novel technologies used in DBS.

Keywords

Deep brain stimulation Neuroethics Psychosurgery Psychiatric disorders Legal regulations 

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© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Michigan State Univeristy, College of Human MedicineEast LansingUSA
  2. 2.Michigan State University, College of Human MedicineEast LansingUSA
  3. 3.Western Michigan University Homer Stryker M.D. School of MedicineKalamazooUSA

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