Matthis Synofzik1, Thomas E Schlaepfer. 1. Department for Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, University of Tübingen, Germany.
Abstract
BACKGROUND: Deep brain stimulation (DBS) has been used for neuropsychiatric disorders in clinical and research settings for almost 50 years now. Recent evidence demonstrates some efficacy in treating obsessive-compulsive disorder and major depression in patients refractory to other treatment modalities beyond single case reports. This has led to a considerable surge of clinical and commercial interest in DBS for psychiatric indications. Because of the high vulnerability of psychiatric patients, the lack of extensive short- and long-term data about effectiveness and the rapid spread of questionable indications this new field in psychiatry requires ethical criteria that can be applied to both research and clinical decision-making. OBJECTIVE AND METHODS: We here present an evidence-based systematic ethical analysis of psychiatric DBS using the criteria of beneficence, nonmaleficence, and autonomy. RESULTS AND CONCLUSIONS: The proposed criteria are helpful in analyzing empirical evidence, informing research investigations and guiding clinical decision-making. This will prepare the ground for ethically justified, empirically comprehensive DBS in this highly vulnerable population and allow stringent future societal discussions about its legitimation. Copyright Â
BACKGROUND: Deep brain stimulation (DBS) has been used for neuropsychiatric disorders in clinical and research settings for almost 50 years now. Recent evidence demonstrates some efficacy in treating obsessive-compulsive disorder and major depression in patients refractory to other treatment modalities beyond single case reports. This has led to a considerable surge of clinical and commercial interest in DBS for psychiatric indications. Because of the high vulnerability of psychiatricpatients, the lack of extensive short- and long-term data about effectiveness and the rapid spread of questionable indications this new field in psychiatry requires ethical criteria that can be applied to both research and clinical decision-making. OBJECTIVE AND METHODS: We here present an evidence-based systematic ethical analysis of psychiatric DBS using the criteria of beneficence, nonmaleficence, and autonomy. RESULTS AND CONCLUSIONS: The proposed criteria are helpful in analyzing empirical evidence, informing research investigations and guiding clinical decision-making. This will prepare the ground for ethically justified, empirically comprehensive DBS in this highly vulnerable population and allow stringent future societal discussions about its legitimation. Copyright Â
Authors: Thomas E Schläpfer; Andreas Meyer-Lindenberg; Matthis Synofzik; Veerle Visser-Vandewalle; Jürgen Voges; Volker A Coenen Journal: Dtsch Arztebl Int Date: 2021-01-22 Impact factor: 5.594
Authors: Bart Nuttin; Hemmings Wu; Helen Mayberg; Marwan Hariz; Loes Gabriëls; Thorsten Galert; Reinhard Merkel; Cynthia Kubu; Osvaldo Vilela-Filho; Keith Matthews; Takaomi Taira; Andres M Lozano; Gastón Schechtmann; Paresh Doshi; Giovanni Broggi; Jean Régis; Ahmed Alkhani; Bomin Sun; Sam Eljamel; Michael Schulder; Michael Kaplitt; Emad Eskandar; Ali Rezai; Joachim K Krauss; Paulien Hilven; Rick Schuurman; Pedro Ruiz; Jin Woo Chang; Paul Cosyns; Nir Lipsman; Juergen Voges; Rees Cosgrove; Yongjie Li; Thomas Schlaepfer Journal: J Neurol Neurosurg Psychiatry Date: 2014-01-20 Impact factor: 10.154