By Eric Racine
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Additional resources for Pragmatic Neuroethics: Improving Treatment and Understanding of the Mind-Brain (Basic Bioethics)
Food and Drug Administration (FDA) and the medical profession. Challenge 2. Informed Consent and Resource Allocation for Deep Brain Stimulation Deep brain stimulation (DBS) is a form of neurosurgery that is now widely used to treat PD and essential tremor (ET) and is emerging as a potential treatment for some neuropsychiatric disorders (Benabid 2007). DBS involves the implantation of at least one electrode, typically in thalamic, Salient Challenges in Modern Neuroethics 15 subthalamic, or globus pallidus regions (for PD or ET), which is connected by very small wires (leads) and electrically stimulated by an implanted pulse generator in the upper portion of the chest (the subclavicular region; other sites are generally targeted in neuropsychiatric conditions).
Farah and Wolpe have presented a similar argument: Reviewing Past and Current Neuroethics 37 The brain is the organ of the mind and consciousness, the locus of our sense of selfhood. Interventions in the brain therefore have different ethical implications than interventions in other organs. In addition, our growing knowledge of mindbrain relations is likely to affect our definitions of competence, mental health and illness, and death. Our moral and legal conceptions of responsibility are likewise susceptible to change as our understanding of the physical mechanisms of behavior evolves.
Are we in a position to obtain better insights into their chances of an eventual recovery? Could we even communicate with patients to learn about their end-of-life preferences if they have sufficient “residual cognitive capabilities,” and if so, would patients be able to convey more complex messages to their loved ones? These questions and several others related to the potential use of neuroimaging in DOC raise important issues, especially given the vulnerability of the patients, the limited understanding of DOC, and the sometimes desperate state of parents and friends of patients.