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The Burden of Normality: From 'chronically ill' to 'symptom free'. New ethical challenges for deep brain stimulation postoperative treatment
Citation
Gilbert, F, The Burden of Normality: From 'chronically ill' to 'symptom free'. New ethical challenges for deep brain stimulation postoperative treatment, Journal of Medical Ethics, 38, (7) pp. 408-412. ISSN 0306-6800 (2012) [Refereed Article]
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Copyright Statement
Copyright 2012 BMJ Publishing Group Ltd.
DOI: doi:10.1136/medethics-2011-100044
Abstract
Although an invasive medical intervention, Deep Brain
Stimulation (DBS) has been regarded as an efficient and
safe treatment of Parkinson’s disease for the last
20 years. In terms of clinical ethics, it is worth asking
whether the use of DBS may have unanticipated
negative effects similar to those associated with other
types of psychosurgery. Clinical studies of epileptic
patients who have undergone an anterior temporal
lobectomy have identified a range of side effects and
complications in a number of domains: psychological,
behavioural, affective and social. In many cases, patients
express difficulty adjusting from being chronically ill to
their new status as 'treated' or 'seizure free'. This
postoperative response adjustment has been described
in the literature on epilepsy as the 'Burden of Normality'
(BoN) syndrome. Most of the discussion about DBS
postoperative changes to self is focused on abnormal
side effects caused by the intervention (ie,
hypersexuality, hypomania, etc). By contrast, relatively
little attention is paid to the idea that successfully
'treated' individuals might experience difficulties in
adjusting to becoming 'normal'. The purpose of this
paper is (1) to articulate the postoperative DBS
psychosocial adjustment process in terms of the BoN
syndrome, (2) to address whether the BoN syndrome
illustrates that DBS treatment poses a threat to the
patient's identity, and (3) to examine whether the
current framework for rehabilitation after DBS
procedures should be updated and take into account the
BoN syndrome as a postoperative self-change response.
Item Details
Item Type: | Refereed Article |
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Keywords: | deep brain stimulation, DBS, psychosurgery, Parkinson's disease, Burden of Normaility, BoN, adjustment |
Research Division: | Philosophy and Religious Studies |
Research Group: | Applied ethics |
Research Field: | Bioethics |
Objective Division: | Expanding Knowledge |
Objective Group: | Expanding knowledge |
Objective Field: | Expanding knowledge in philosophy and religious studies |
UTAS Author: | Gilbert, F (Associate Professor Frederic Gilbert) |
ID Code: | 77936 |
Year Published: | 2012 |
Web of Science® Times Cited: | 84 |
Deposited By: | Philosophy |
Deposited On: | 2012-06-05 |
Last Modified: | 2015-06-22 |
Downloads: | 0 |
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