Deep Brain Stimulation and the Search for Identity |
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Authors: | Karsten Witt Jens Kuhn Lars Timmermann Mateusz Zurowski Christiane Woopen |
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Institution: | 1. Institute for the History of Medicine and Medical Ethics, Research Unit Ethics, University of Cologne, Herderstra?e 54, 50931, Cologne, Germany 2. Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany 3. Department of Neurology, University of Cologne, Joseph-Stelzmann-Str. 9, 50924, Cologne, Germany 4. Neuropsychiatric Clinic, Toronto Western Hospital, Department of Psychiatry, University Health Network, Toronto, ON, M5T 2S8, Canada
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Abstract: | Ethical evaluation of deep brain stimulation as a treatment for Parkinson’s disease is complicated by results that can be described as involving changes in the patient’s identity. The risk of becoming another person following surgery is alarming for patients, caregivers and clinicians alike. It is one of the most urgent conceptual and ethical problems facing deep brain stimulation in Parkinson’s disease at this time. In our paper we take issue with this problem on two accounts. First, we elucidate what is meant by “becoming another person” from a conceptual point of view. After critically discussing two broad approaches we concentrate on the notion of “individual identity” which centers on the idea of “core attitudes”. Subsequently we discuss several approaches to determine what distinguishes core attitudes from those that are more peripheral. We argue for a “foundational-function model” highlighting the importance of specific dependency relations between these attitudes. Our second aim is to comment on the possibility to empirically measure changes in individual identity and argue that many of the instruments now commonly used in selecting and monitoring DBS-patients are inappropriate for this purpose. Future research in this area is advised combining a conceptual and an empirical approach as a basis of sound ethical appraisal. |
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