On the Significance of the Identity Debate in DBS and the Need of an Inclusive Research Agenda. A Reply to Gilbert, Vian
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ORIGINAL PAPER
On the Significance of the Identity Debate in DBS and the Need of an Inclusive Research Agenda. A Reply to Gilbert, Viana and Ineichen Anke Snoek & Sanneke de Haan & Maartje Schermer & Dorothee Horstkötter
Received: 29 January 2019 / Accepted: 6 May 2019 # The Author(s) 2019
Abstract Gilbert et al. (Neuroethics, 2018) argue that the concerns about the influence of Deep Brain Stimulation (DBS) on – as they lump together – personality, identity, agency, autonomy, authenticity and the self (PIAAAS) are due to an ethics hype. They argue that there is only a small empirical base for an extended ethics debate. We will critically examine their claims and argue that Gilbert and colleagues do not show that the identity debate in DBS is a bubble, they in fact give very little evidence for that. Rather they show the challenges of doing research in a field that is stretched out over multiple disciplines. In that sense their paper is an important starting point for a discussion on methodology and offers valuable lessons for a future research agenda. A. Snoek (*) : D. Horstkötter Department of Health, Ethics and Society, School for Mental Health and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands e-mail: [email protected]
D. Horstkötter e-mail: [email protected] S. de Haan School of Humanities and Digital Sciences, Culture Studies, Tilburg University, Warandelaan 2, Tilburg, the Netherlands e-mail: [email protected] M. Schermer Department of Medical Ethics and Philosophy, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, the Netherlands e-mail: [email protected]
Keywords Autonomy . Agency . Deep brain stimulation . Identity . Neuroethics . Self . Multidisciplinary research . Interdisciplinary methodology
Introduction In their review study, Gilbert, Viaña, and Ineichen [1] argue that the ethical concerns about the influence of Deep Brain Stimulation (DBS) on (as they lump together) personality, identity, agency, autonomy, authenticity and the self (PIAAAS) are due to a bubble that need to be deflated. They point towards the comparatively low number of primary studies conducted to date, that are greatly outnumbered by ethical studies. The question is whether ethicists do not make too much out of these very few examples of personality changes following DBS: that one patient may have felt like an electric doll [2] should not entice us to jump to conclusions about the effects of DBS in general. Against that background, they make an urgent request for more primary studies to better substantiate current ethical debates and the serious concerns expressed about the implications of DBS. So far, we agree with their findings: there is a small empirical basis for a large neuroethical debate, and more empirical research will result in a better informed neuroethical debate, and better informed patients, family and clinicians. However, Gilbert et al. do not only point to the asymmetry between the small portion of empirical studies and the boomin
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