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Pragmatism and the Importance of Interdisciplinary Teams in Investigating Personality Changes Following DBS

  • Cynthia S. KubuEmail author
  • Paul J. Ford
  • Joshua A. Wilt
  • Amanda R. Merner
  • Michelle Montpetite
  • Jaclyn Zeigler
  • Eric Racine


Gilbert and colleagues (2018) point out the discrepancy between the limited empirical data illustrating changes in personality (and related concepts of identity, agency, authenticity, autonomy, and self, i.e., PIAAAS) following implantation of deep brain stimulating (DBS) electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities (representing the conceptual publications) and the sciences (representing the empirical work). This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences.


Deep brain stimulation Personality Parkinson’s disease Ethics Pragmatism 



CSK and PJF received funding by the National Institute of Neurological Disorders and Stroke, Award Number RC1NS068086 and the National Institute of Mental Health, Award Number R01MH114853. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke, National Institute of Mental Health, or the National Institutes of Health. ER acknowledges the support of a FRQ-S (Fonds de recheche du Québec – Santé) career award. CSK would also like to acknowledge and thank J. J. Fins, whose scholarship and advice over the years helped shape some of the ideas expressed in this paper.


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Center for Neurological Restoration, Cleveland ClinicClevelandUSA
  2. 2.Cleveland Clinic Lerner College of Medicine of Case Western Reserve UniversityClevelandUSA
  3. 3.Department of Psychological SciencesCase Western Reserve UniversityClevelandUSA
  4. 4.Institut de recherches cliniques de MontréalMontrealCanada

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