Ethical Guidelines for Deep Brain Stimulation
- Deep Brain Stimulation (DBS) should only be used when there is a high change that the lives of patients will be improved by its use and when all other possible interventions have been tried
- Patients must be fully informed and informed consent must be obtained
- The whole procedure should be done by teams of appropriate specialists like neurosurgeons, neurologist, psychiatrist and other health professionals that can help the patient before during and after the operation and who will continuously monitor the patient
- The procedure should help restore (but not augment) normal function, should provide relief from pain and distress, and should never be used for law enforcement or for political or social purposes
- It is important to provide follow-up for every patient enrolled in a trial if at all possible and to report the outcomes in scientific journals
These ethical guidelines were recently published in the JAMA and I fully agree with these guidelines. The article starts with a brief description of DBS, it’s complications and a short history of the lessons from past errors of psychosurgery.
Important lessons from the abuses of psychosurgery in the last century make it imperative to have solid hypotheses with strong scientific support and appropriate safeguards (eg, interdisciplinary review boards) before proceeding to treat patients using DBS.
Using these guidelines with the recent technological advances DBS can perhaps help a lot of patients in the near future.
Kringelbach, M., & Aziz, T. (2009). Deep Brain Stimulation: Avoiding the Errors of Psychosurgery JAMA: The Journal of the American Medical Association, 301 (16), 1705-1707 DOI: 10.1001/jama.2009.551
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June 3, 2009 @ 5:56 pm
I agree there definately needs to be ethical guidelines (aren’t there always in any medical practice?). A few years ago, after many failed attempts at finding medication/s to help my depression my insurance company sent me a letter strongly suggesting that I go have the VNS procedure done.
I was very sick, and given my fears of authority and insurance scrutiny the letter felt extremely intimidating and demanding. Luckily I am informed about my treatments and at the time I recal there being both very few people in Canada who had undergone the procedure (I think maybe 7 or 8 people!) and I had read that the trials in Canada were not accepting people with atypical depression.
I still feel very angry that an insurance agency would even begin to believe they have the qualifications to ask a patient to participate in VNS. I worry for others like me who are less informed and feel pressured to go have VNS because the insurance agency told them to.
Glad to hear there are checks and ethics in place at the medical level to protect us.
…aqua
June 4, 2009 @ 9:02 am
Strange, very strange for an insurance company to suggest a treatment option especially VNS.
Kind regards dr Shock