Electrodes in the brain--ethical criteria for research and treatment with deep brain stimulation for neuropsychiatric disorders

Brain Stimul. 2011 Jan;4(1):7-16. doi: 10.1016/j.brs.2010.03.002. Epub 2010 Mar 21.


Background: Deep brain stimulation (DBS) has been used for neuropsychiatric disorders in clinical and research settings for almost 50 years now. Recent evidence demonstrates some efficacy in treating obsessive-compulsive disorder and major depression in patients refractory to other treatment modalities beyond single case reports. This has led to a considerable surge of clinical and commercial interest in DBS for psychiatric indications. Because of the high vulnerability of psychiatric patients, the lack of extensive short- and long-term data about effectiveness and the rapid spread of questionable indications this new field in psychiatry requires ethical criteria that can be applied to both research and clinical decision-making.

Objective and methods: We here present an evidence-based systematic ethical analysis of psychiatric DBS using the criteria of beneficence, nonmaleficence, and autonomy.

Results and conclusions: The proposed criteria are helpful in analyzing empirical evidence, informing research investigations and guiding clinical decision-making. This will prepare the ground for ethically justified, empirically comprehensive DBS in this highly vulnerable population and allow stringent future societal discussions about its legitimation.

MeSH terms

  • Decision Making
  • Deep Brain Stimulation / adverse effects
  • Deep Brain Stimulation / ethics*
  • Guidelines as Topic
  • Humans
  • Mental Disorders / therapy*
  • Patient Preference