National Core for Neuroethics, The University of British Columbia, Vancouver, BC, Canada.
Brain Topogr. 2014 Jan;27(1):33-45. doi: 10.1007/s10548-013-0296-8. Epub 2013 Jun 4.
In recent years, non-pharmacologic approaches to modifying human neural activity have gained increasing attention. One of these approaches is brain stimulation, which involves either the direct application of electrical current to structures in the nervous system or the indirect application of current by means of electromagnetic induction. Interventions that manipulate the brain have generally been regarded as having both the potential to alleviate devastating brain-related conditions and the capacity to create unforeseen and unwanted consequences. Hence, although brain stimulation techniques offer considerable benefits to society, they also raise a number of ethical concerns. In this paper we will address various dilemmas related to brain stimulation in the context of clinical practice and biomedical research. We will survey current work involving deep brain stimulation, transcranial magnetic stimulation and transcranial direct current stimulation. We will reflect upon relevant similarities and differences between them, and consider some potentially problematic issues that may arise within the framework of established principles of medical ethics: nonmaleficence and beneficence, autonomy, and justice.
近年来，人们越来越关注通过非药物手段来改变人类的神经活动。其中一种方法是脑刺激，它包括直接将电流应用于神经系统中的结构，或通过电磁感应间接应用电流。操纵大脑的干预措施通常被认为既有可能减轻毁灭性的大脑相关疾病，也有可能产生意想不到和不想要的后果。因此，尽管脑刺激技术为社会带来了巨大的好处，但也引发了许多伦理问题。在本文中，我们将在临床实践和生物医学研究的背景下讨论与脑刺激相关的各种困境。我们将调查涉及深部脑刺激、经颅磁刺激和经颅直流电刺激的当前工作。我们将反思它们之间的相关异同，并考虑在既定的医学伦理原则框架内可能出现的一些潜在问题：不伤害和有益、自主性和正义。
