Desmoulin-Canselier Sonia
NormaStim Program ANR14-CE30-0016, University of Nantes (UMR 6297 DCS), Nantes, France.
Laboratoire Droit et Changement Social, UMR CNRS 6297: Faculté de Droit de Nantes, Chemin de la Censive du Tertre, BP 8130744 313, Nantes Cedex 3, France.
Monash Bioeth Rev. 2020 May;38(1):15-34. doi: 10.1007/s40592-020-00111-3.
Deep brain stimulation (DBS) is an approved treatment for neurological diseases and a promising one for psychiatric conditions, which may produce spectacular results very quickly. It is also a powerful tool for brain research and exploration. Beyond an overview of the ethical and legal literature on this topic, this paper aims at showing that DBS is a compelling example for ethical-legal reflection, as it combines a highly technical surgical procedure, a complex active medical device and neuromodulation of the human brain to restore lost abilities caused by a chronic and evolving disease. Some of the ethical and legal issues raised by DBS are not specific, but shed new light on medical ethics and law. Others are more DBS-specific, as they are linked to the intricacies of research and treatment, to the need to tune the device, to the patients' control over the device and its effects and to the involvement of family caregivers.
深部脑刺激(DBS)是一种已获批准用于治疗神经疾病的方法,对于精神疾病而言也是一种前景广阔的治疗手段,它可能会非常迅速地产生显著效果。它还是大脑研究与探索的有力工具。除了对关于该主题的伦理和法律文献进行概述之外,本文旨在表明DBS是伦理-法律反思的一个引人注目的例子,因为它结合了一项高科技外科手术、一种复杂的有源医疗设备以及对人脑的神经调节,以恢复由慢性和不断发展的疾病导致的丧失能力。DBS引发的一些伦理和法律问题并非是该领域所特有的,而是为医学伦理和法律提供了新的视角。其他问题则更具DBS特异性,因为它们与研究和治疗的复杂性、调整设备的需求、患者对设备及其效果的控制以及家庭护理人员的参与有关。