Zuk Peter, Lázaro-Muñoz Gabriel
Baylor College of Medicine and Rice University, Center for Medical Ethics and Health Policy, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030.
Baylor College of Medicine, Center for Medical Ethics and Health Policy, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030.
Neuroethics. 2021 Oct;14(Suppl 1):83-93. doi: 10.1007/s12152-019-09417-4. Epub 2019 Jul 25.
Gilbert, Viaña, and Ineichen call for further empirical work on the effects of deep brain stimulation (DBS) on personality, identity, agency, authenticity, autonomy and self (PIAAAS) (Gilbert et al. 2018a). In particular, they emphasize the need for more sophisticated instruments measuring potential changes in PIAAAS. The development of such instruments, they argue, will provide a stronger empirical foundation for theoretical neuroethics work on DBS. We agree with this proposal. However, we believe that theoretical neuroethics has an important role to play in advancing empirical neuroethics that is not emphasized in Gilbert et al.'s remarks on the relationship between empirical and theoretical neuroethics. The development of instruments for more fully assessing changes in PIAAAS will require significant clarification of its component concepts. This task of clarification is the purview of theoretical neuroethics. In this article, we sketch how theoretical neuroethics can clarify the concept of autonomy. We hope that this can both serve as a model for the conceptual clarification of other components of PIAAAS and contribute to the development of the empirical measures that Gilbert and colleagues propose.
吉尔伯特、维亚尼亚和伊内申呼吁针对深部脑刺激（DBS）对人格、身份、能动性、真实性、自主性和自我（PIAAAS）的影响开展进一步的实证研究（吉尔伯特等人，2018a）。他们特别强调需要更精密的工具来测量PIAAAS的潜在变化。他们认为，开发此类工具将为关于DBS的理论神经伦理学研究提供更坚实的实证基础。我们赞同这一提议。然而，我们认为理论神经伦理学在推进实证神经伦理学方面可发挥重要作用，而吉尔伯特等人关于实证神经伦理学与理论神经伦理学关系的论述中并未强调这一点。要开发出能更全面评估PIAAAS变化的工具，就需要对其组成概念进行重大澄清。这项澄清任务属于理论神经伦理学的范畴。在本文中，我们概述了理论神经伦理学如何能够澄清自主性的概念。我们希望这既能为PIAAAS其他组成部分的概念澄清提供一个范例，又能有助于吉尔伯特及其同事所提议的实证测量方法的开发。
