The December 2022 issue of IEEE Spectrum is here!

Close bar

President-elect to the Bioethical Society highlights ethics of Deep Brain Stimulation

Joseph Fins has studied DBS and has much to say about using it in unconscious patients.

2 min read

The American Society for Bioethics has chosen Dr. Joseph Fins as its president for the 2011 term, a choice that will likely bring needed attention to the ethical issues surrounding the implementation of deep brain stimulators.

For much of his career at Weill Cornell Medical college, Fins has done what bio-ethecists do—fretted, advocated, encouraged, and debated about the proper treatment of patients. He's shown particular concern for people who recieve deep brain stimulation while in a state of vegetation and has written numerous papers about the potential benefits of this kind of therapy. 

Patients who have been unresponsive for over about a year have traditionally been viewed as hopeless cases and are not typically considered as candidates for DBS. A 2007 paper by Fins in Nature challenged this dogma when it revealed therapeutic benefits for a patient who recieved DBS after having been in a minimally concious state for over six years. The work not only broadens the therapeutic spectrum for this kind of patient, but also complicates our standard diagram of conciousness, which we tend to view as a discrete state. The mind of a vegetative patient begins to look more like a banked fire scattered with embers and the potential to at least partially reignite.

But then comes the ethical part. With a device as new and sucessful and complicated as the deep brain stimulator, great care needs to be taken to ensure that the individuals who go under the knife and allow surgeons to wire up their thought boxes are treated more as patients than as research subjects. Fins has used many panel discussions and opinion articles to discuss the on going care of DBS patients, and urge surgeons to make the long term commitment to patients who have already been mined for data.

One of the main problems that Fins talks about, beyond a lack of long-term initiative, is the need to spread basic neurosurgical information beyond specialists. When a patient goes home to a small community after recieving a deep brain stimulator, it is not acceptable for them to have to return to a specialized facility every time they need a minor tune up or a new battery. Fins likens the situation to the relative ease of maintaining a heart pacemaker, and says we can do better.

Lest people like Fins come across as downers, it's important to point out that his suggestions serve not only to caution people in the field of DBS. Doing things like developing long-term relationships with DBS patients will ultimately benefit the technology as we gather complete records of its perormance. Hopefully will is part of his agenda as presdent next year.

The Conversation (0)

Are You Ready for Workplace Brain Scanning?

Extracting and using brain data will make workers happier and more productive, backers say

11 min read
Vertical
A photo collage showing a man wearing a eeg headset while looking at a computer screen.
Nadia Radic
DarkGray

Get ready: Neurotechnology is coming to the workplace. Neural sensors are now reliable and affordable enough to support commercial pilot projects that extract productivity-enhancing data from workers’ brains. These projects aren’t confined to specialized workplaces; they’re also happening in offices, factories, farms, and airports. The companies and people behind these neurotech devices are certain that they will improve our lives. But there are serious questions about whether work should be organized around certain functions of the brain, rather than the person as a whole.

To be clear, the kind of neurotech that’s currently available is nowhere close to reading minds. Sensors detect electrical activity across different areas of the brain, and the patterns in that activity can be broadly correlated with different feelings or physiological responses, such as stress, focus, or a reaction to external stimuli. These data can be exploited to make workers more efficient—and, proponents of the technology say, to make them happier. Two of the most interesting innovators in this field are the Israel-based startup InnerEye, which aims to give workers superhuman abilities, and Emotiv, a Silicon Valley neurotech company that’s bringing a brain-tracking wearable to office workers, including those working remotely.

Keep Reading ↓Show less
{"imageShortcodeIds":[]}