scholarly journals They Affect the Person, but for Better or Worse? Perceptions of Electroceutical Interventions for Depression Among Psychiatrists, Patients, and the Public

2021 ◽  
pp. 104973232110376
Author(s):  
Robyn Bluhm ◽  
Emily Castillo ◽  
Eric D. Achtyes ◽  
Aaron M. McCright ◽  
Laura Y. Cabrera
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Treatment Effectiveness ◽  
Qualitative Content Analysis ◽  
Personality Change ◽  
The Self ◽  
The Public ◽  
Ethical Implications ◽  
Deep Brain

Responding to reports of cases of personality change following deep brain stimulation, neuroethicists have debated the nature and ethical implications of these changes. Recently, this literature has been challenged as being overblown and therefore potentially an impediment to patients accessing needed treatment. We interviewed 16 psychiatrists, 16 patients with depression, and 16 members of the public without depression, all from the Midwestern United States, about their views on how three electroceutical interventions (deep brain stimulation, electroconvulsive therapy, and transcranial magnetic stimulation) used to treat depression might affect the self. Participants were also asked to compare the electroceuticals’ effects on the self with the effects of commonly used depression treatments (psychotherapy and pharmaceuticals). Using qualitative content analysis, we found that participants’ views on electroceuticals’ potential effects on the self mainly focused on treatment effectiveness and side effects. Our results have implications for both theoretical discussions in neuroethics and clinical practice in psychiatry.

scholarly journals Beyond the Cuckoo’s Nest: Patient and Public Attitudes about Psychiatric Electroceutical Interventions

2021 ◽  
Author(s):  
Laura Y. Cabrera ◽  
Maryssa M. C. Gilbert ◽  
Aaron M. McCright ◽  
Eric D. Achtyes ◽  
Robyn Bluhm
Keyword(s):  
Deep Brain Stimulation ◽  
Transcranial Magnetic Stimulation ◽  
Electroconvulsive Therapy ◽  
Brain Stimulation ◽  
General Public ◽  
Magnetic Stimulation ◽  
Qualitative Content Analysis ◽  
Public Attitudes ◽  
Eligibility Criteria ◽  
Deep Brain

AbstractRecent research emphasizes the role of psychiatric electroceutical interventions (PEIs), bioelectronic treatments that employ electrical stimulation to affect and modify brain function, to effectively treat psychiatric disorders. We sought to examine attitudes about three PEIs—electroconvulsive therapy, transcranial magnetic stimulation, and deep brain stimulation—among patients with depression and members of the general public. As part of a larger study to assess different stakeholders’ attitudes about PEIs, we conducted semi-structured key informant interviews with 16 individuals living with depression and 16 non-depressive members of the general public. We used a purposive sampling approach to recruit potential participants based on eligibility criteria. We performed qualitative content analysis of interview transcripts. Participants from both groups expressed an overall cautionary attitude towards PEIs, yet there were mixed attitudes in both groups. Patients commonly described electroconvulsive therapy as scary, traumatic, or intense, while members of the general public often referenced the treatment’s negative portrayal in One Flew over the Cuckoo’s Nest. Patients and the general public saw transcranial magnetic stimulation as a potentially viable option, but in most cases only if medication was not effective. Deep brain stimulation attitudes were predominantly negative among patients and cautionary among public. The overall cautionary attitudes towards PEIs, together with the technological features and social aspects underlying those attitudes, highlight the need for unbiased education to fill the gaps in knowledge and inform perceptions of those who may benefit from these treatments.

scholarly journals Sex Disparities in the Self-Evaluation of Subthalamic Deep Brain Stimulation Effects on Mood and Personality in Parkinson's Disease Patients

2020 ◽  
Vol 11 ◽  
Author(s):  
Amelie D. Dietrich ◽  
Johannes A. Koeppen ◽  
Carsten Buhmann ◽  
Monika Pötter-Nerger ◽  
Hans O. Pinnschmidt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
The Self ◽  
Self Evaluation ◽  
Sex Disparities ◽  
Deep Brain

scholarly journals Pattern theory of self and situating moral aspects: the need to include authenticity, autonomy and responsibility in understanding the effects of deep brain stimulation

2020 ◽  
Author(s):  
Przemysław Zawadzki
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Full Range ◽  
The Self ◽  
The Other ◽  
Pattern Theory ◽  
Complex Relation ◽  
Induced Changes ◽  
Deep Brain

AbstractThe aims of this paper are to: (1) identify the best framework for comprehending multidimensional impact of deep brain stimulation (DBS) on the self; (2) identify weaknesses of this framework; (3) propose refinements to it; (4) in pursuing (3), show why and how this framework should be extended with additional moral aspects and demonstrate their interrelations; (5) define how moral aspects relate to the framework; (6) show the potential consequences of including moral aspects on evaluating DBS’s impact on patients’ selves. Regarding (1), I argue that the pattern theory of self (PTS) can be regarded as such a framework. In realizing (2) and (3), I indicate that most relevant issues concerning PTS that require resolutions are ontological issues, including the persistence question, the “specificity problem”, and finding lacking relevant aspects of the self. In realizing (4), I identify aspects of the self not included in PTS which are desperately needed to investigate the full range of potentially relevant DBS-induced changes—authenticity, autonomy, and responsibility, and conclude that how we define authenticity will have implications for our concept of autonomy, which in turn will determine how we think about responsibility. Concerning (5), I discuss a complex relation between moral aspects and PTS—on one hand, they serve as the lens through which a particular self-pattern can be evaluated; on the other, they are, themselves, products of dynamical interactions of various self-aspects. Finally, I discuss (6), demonstrating novel way of understanding the effects of DBS on patients’ selves.

scholarly journals Deep Brain Stimulation, Authenticity and Value

2017 ◽  
Vol 26 (4) ◽  
pp. 658-670 ◽  
Author(s):  
SVEN NYHOLM ◽  
ELIZABETH O’NEILL
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
The Self ◽  
Bad Faith ◽  
True Self ◽  
Her Family ◽  
Jean Paul ◽  
The Family ◽  
Existentialist Philosophy ◽  
Deep Brain

Abstract:In this article, we engage in dialogue with Jonathan Pugh, Hannah Maslen, and Julian Savulescu about how to best interpret the potential impacts of deep brain stimulation on the self. We consider whether ordinary peoples’ convictions about the true self should be interpreted in essentialist or existentialist ways. Like Pugh, Maslen, and Savulescu, we argue that it is useful to understand the notion of the true self as having both essentialist and existentialist components. We also consider two ideas from existentialist philosophy—Jean-Paul Sartre and Simone de Beauvoir’s ideas about “bad faith” and “ambiguity”—to argue that there can be value to patients in regarding themselves as having a certain amount of freedom to choose what aspects of themselves should be considered representative of their true selves. Lastly, we consider the case of an anorexia nervosa patient who shifts between conflicting mind-sets. We argue that mind-sets in which it is easier for the patient and his or her family to share values can plausibly be considered to be more representative of the patient’s true self, if this promotes a well-functioning relationship between the patient and the family. However, we also argue that families are well advised to give patients room to determine what such shared values mean to them, as it can be alienating for patients if they feel that others try to impose values on them from the outside.

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