New Therapies, Old Problems, or, A Plea for Neuromodesty

Abstract

This article suggests that investigational deep brain stimulation (DBS) for mental disorders raises few new bioethical issues. Although the scientific basis of the procedure may be both complex and largely unknown, addressing informed consent in such situations is a familiar problem. After reviewing the legal and moral background for investigating DBS and the scientific difficulties DBS faces as a potential treatment for mental disorders, the article focuses on informed consent and makes two primary suggestions. The study of DBS may proceed, but “hyper-disclosure” of the complexities should be required for competent subjects or proper surrogates if the candidate is not competent, and the most rigorous standard for competence should be employed. Throughout, neuromodesty and caution are urged.

Keywords:

• bioethics
• deep brain stimulation
• informed consent
• neuroethics
• psychiatric disorders
• psychosurgery

Acknowledgments

I thank an anonymous referee for extremely helpful comments and references. I also thank Ed Greenlee for his invaluable assistance. As always, I thank my personal attorney, Jean Avnet Morse, for her sound, sober counsel and moral support.