Gilbert Frédéricand, Viaña John Noel
Narrat Inq Bioeth. 2018;8(1):67-77. doi: 10.1353/nib.2018.0024.
Although deep brain stimulation (DBS) may result in dramatic motor improvement in people with Parkinson's disease (PD), it has been correlated with a number of postoperative psychiatric side effects. We report a case of a person with PD experiencing depression and hypomania following DBS surgery. We provide a detailed report of the patient's personal experiences dealing with and managing these psychiatric side effects for three years. Providing a personal narrative focusing on detailed patient subjective experiences complements reports that give insight into the short- and long-term effects of DBS on established psychiatric measures and neurologic activity. But, most importantly, such a qualitative approach provides prospective patients and clinicians with a broader ethical picture of real-life challenges faced and coping strategies employed by PD patients treated with DBS who are experiencing psychiatric adverse events. This case study reinforces the ethical need to disclose the potential risk of harm to prospective patients as well as the importance of establishing a multidisciplinary postoperative supportive group.
尽管深部脑刺激（DBS）可能会使帕金森病（PD）患者的运动能力得到显著改善，但它与一些术后精神副作用相关。我们报告了一例帕金森病患者在接受DBS手术后出现抑郁和轻躁狂的病例。我们详细报告了患者在三年来应对和管理这些精神副作用的个人经历。提供一份聚焦于患者详细主观体验的个人叙述，补充了那些深入探讨DBS对既定精神指标和神经活动的短期及长期影响的报告。但是，最重要的是，这种定性方法为未来的患者和临床医生提供了一幅更广阔的伦理图景，展现了接受DBS治疗且正经历精神不良事件的帕金森病患者所面临的现实生活挑战以及所采用的应对策略。本案例研究强化了向未来患者披露潜在伤害风险的伦理必要性，以及建立多学科术后支持小组的重要性。
