Ethical Considerations

  • Dorothee HorstkötterEmail author
  • Guido de Wert


Since its first applications in humans, DBS has triggered a plethora of ethical questions and concerns and stimulated extensive ethical debates as to its significance and desirability. The main ethical goal is to guide and support responsible decision-making in clinical DBS treatment, as well as related medical research, and to raise awareness about salient ethical issues.

Traditional medical ethics consists of the three basic principles of respect for autonomy, beneficence/nonmaleficence and justice. In the context of DBS, these principles require specific attention as to what exactly it means to “respect autonomy,” to safeguard beneficence and nonmaleficence, and to live up to the requirements of justice. Taking the risks and side effects of DBS into account and comparing this treatment to possible alternative treatments is crucial. Given the increasing interest in applying DBS to psychiatric disorders, research ethical questions have been put on the agenda. The status of the brain also gave rise to the expression of profound ethical concerns, particularly regarding potential changes in patients’ personal identity. However, different understandings of this very concept lead to diverging evaluations of the ethical value of potentially identity-modifying techniques. Independent ethical substudies or integral add-on projects in DBS research can advance systematic ethical thought regarding ongoing research endeavors and upcoming new applications.


Deep brain stimulation Medical ethics Research ethics Autonomy Beneficence Neuroethics Personal identity Self-estrangement Experimental treatment Ethical add-on research 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Health, Ethics and Society, School of Mental Health and Neuroscience (MHeNS)Maastricht UniversityMaastrichtThe Netherlands
  2. 2.Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), School of Oncology and Developmental Biology (GROW)Maastricht UniversityMaastrichtThe Netherlands

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