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Ethical focal points in the international practice of deep brain stimulation


Christen, Markus; Ineichen, Christian; Bittlinger, Merlin; Bothe, Hans-Werner; Müller, Sabine (2014). Ethical focal points in the international practice of deep brain stimulation. AJOB Neuroscience, 5(4):65-80.

Abstract

Deep brain stimulation (DBS) is a standard therapy for several movement disorders, and the list of further indications that are investigated is growing rapidly. We performed two surveys among DBS experts (n1D 113) and centers (n2D 135) to identify ethical focal points in the current global practice of DBS. The data indicate a mismatch between the patients’ fears and the frequencies of the suspected side effects, a significant “satisfaction gap,” signs of improvements of outcome, habituation effects in terms of involved disciplines, a growing spectrum of novel indications that partly conflicts with the experts’ success probability ratings, and differences in the density of supply between countries that might affect the future development of DBS. We formulate ethical recommendations with regard both to patient-related practices (e.g., recruitment, assurance of alternatives) and to institutional development (e.g., measures for quality assurance and for the development of novel DBS indications).

Abstract

Deep brain stimulation (DBS) is a standard therapy for several movement disorders, and the list of further indications that are investigated is growing rapidly. We performed two surveys among DBS experts (n1D 113) and centers (n2D 135) to identify ethical focal points in the current global practice of DBS. The data indicate a mismatch between the patients’ fears and the frequencies of the suspected side effects, a significant “satisfaction gap,” signs of improvements of outcome, habituation effects in terms of involved disciplines, a growing spectrum of novel indications that partly conflicts with the experts’ success probability ratings, and differences in the density of supply between countries that might affect the future development of DBS. We formulate ethical recommendations with regard both to patient-related practices (e.g., recruitment, assurance of alternatives) and to institutional development (e.g., measures for quality assurance and for the development of novel DBS indications).

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Biomedical Ethics and History of Medicine
08 University Research Priority Programs > Ethics
Dewey Decimal Classification:170 Ethics
610 Medicine & health
Language:English
Date:2014
Deposited On:07 Jan 2015 16:05
Last Modified:14 Feb 2018 22:20
Publisher:Taylor & Francis Inc.
ISSN:2150-7759
Additional Information:This is an Author's Accepted Manuscript of an article published in AJOB Neuroscience, 02 Oct 2014 [copyright Taylor & Francis] Ethical Focal Points in the International Practice of Deep Brain Stimulation. Markus Christen, Christian Ineichen, Merlin Bittlinger, Hans-Werner Bothe, Sabine Müller, AJOB Neuroscience, Vol. 5, Iss. 4, 2014 [copyright Taylor & Francis], available online at: http://www.tandfonline.com/ 10.1080/21507740.2014.939380
OA Status:Green
Publisher DOI:https://doi.org/10.1080/21507740.2014.939380

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