An Instrument to Capture the Phenomenology of Implantable Brain Device Use
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An Instrument to Capture the Phenomenology of Implantable Brain Device Use Frederic Gilbert Klein & Goering
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Brown & Dasgupta & Martens &
Received: 4 July 2019 / Accepted: 13 September 2019 # Springer Nature B.V. 2019
Abstract One important concern regarding implantable Brain Computer Interfaces (BCI) is the fear that the intervention will negatively change a patient’s sense of identity or agency. In particular, there is concern that the user will be psychologically worse-off following treatment despite postoperative functional improvements. Clinical observations from similar implantable brain technologies, such as deep brain stimulation (DBS), show a small but significant proportion of patients report feelings of strangeness or difficulty adjusting to a new concept of themselves characterized by a maladaptive je ne sais quoi despite clear motor improvement. Despite the growing number of cases in the DBS literature, there is currently no accepted or standardized tool in neuroethics specifically designed to capture the phenomenological postoperative experience of patients implanted with DBS or BCI devices. Given potential risks of postoperative maladaptation, it is important for the field of neuroethics to develop a qualitative instrument that can serve as a shared method for capturing postoperative variations in patient experience of identity and agency. The goal of this article is to introduce an instrument we have developed for this purpose and call for F. Gilbert (*) Centre for Excellence for Electromaterials Science, College of Arts, Law and Education, School of Humanities, University of Tasmania, Hobart, Australia e-mail: [email protected] F. Gilbert : Brown : Dasgupta : Martens : Klein : Goering Center for Neurotechnology, University of Washington, Seattle, WA, USA
further neuroethical efforts to assess the phenomenology of implantable brain device use. Keywords Agency . Deep brain stimulation . Identity . Instrument . Implant . Personality . Phenomenology . Self . Side effects
Implantable neural devices, such as Deep Brain Stimulators (DBS) or Brain Computer Interfaces (BCI), offer the potential to greatly improve patients’ quality of life and wellness. Devices that treat a range of neurological and psychiatric symptoms and conditions have been approved or are currently being studied for clinical use [1–3]. Notwithstanding their positive functional impacts on patients, the psychosocial effects of implanted devices on patients’ postoperative experience remain poorly understood. An important ethical concern regarding DBS and implantable BCI is the fear that the intervention will negatively change a patient’s sense of identity or agency. There is currently a lively debate in the neuroethics literature addressing the putative effects of DBS on personality, identity, agency, autonomy, authenticity and self [4–12]. In particular, there is a possibility that the user will be worse-off psychologically or socially following treatment despite postoperative functional improvements.
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