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What we (Should) Talk about when we Talk about Deep Brain Stimulation and Personal Identity

Abstract

A number of reports have suggested that patients who undergo deep brain stimulation (DBS) may experience changes to their personality or sense of self. These reports have attracted great philosophical interest. This paper surveys the philosophical literature on personal identity and DBS and draws on an emerging empirical literature on the experiences of patients who have undergone this therapy to argue that the existing philosophical discussion of DBS and personal identity frames the problem too narrowly. Much of the discussion by neuroethicists centers on the nature of the threat posed by DBS, asking whether it is best understood as a threat to personal identity, autonomy, agency, or authenticity, or as putting patients at risk of self-estrangement. Our aim in this paper is to use the empirical literature on patients’ experiences post-DBS to open up a broader range of questions - both philosophical and practical, and to suggest that attention to these questions will help to provide better support to patients, both before and after treatment.

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Notes

  1. 1.

    We will discuss Baylis’s claim in greater detail later in the paper.

  2. 2.

    It is an open question whether changes to an individual’s authenticity, agency, and the like, should be understood as changes to aspects of personal identity or as affecting distinct, though related, aspects of the self. We will not pursue this question here, but will use the term “self-related characteristics” to encompass all of them.

  3. 3.

    Schechtman does note that Schüpbach and Agid “are at pains to point out that a direct role for …[brain stimulation] should not be ruled out”; however, as we noted above, they also emphasize that their patients experience a broad range of social and personal challenges that are not likely to be a direct result of the activity of the electrode.

  4. 4.

    It is also worth noting, as the empirical work done so far has been conducted in several different countries, that cultural beliefs and expectations may shape discourse about the self and thus the concerns that people have about self and identity.

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Correspondence to Robyn Bluhm.

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Bluhm, R., Cabrera, L. & McKenzie, R. What we (Should) Talk about when we Talk about Deep Brain Stimulation and Personal Identity. Neuroethics 13, 289–301 (2020). https://doi.org/10.1007/s12152-019-09396-6

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Keywords

  • Deep brain stimulation
  • Personal identity
  • Self
  • Neuroethics