Using Patient Perspectives to Analyze the Ethical Implications of Identity during Deep Brain Stimulation for Treatment Resistant Depression Open Access
Fong, Kristina (Summer 2019)
Abstract
Deep brain stimulation (DBS) has emerged as a potential therapy for individuals with treatment resistant depression (TRD). However, its use has been ethically controversial, with concern about the potential harm that it may have over its potential benefits. One such concern at the forefront of debates is its impact to concepts of identity. Many scholars have responded to the ethical concerns surrounding DBS for depression, though there are few of these studies that are supported by empirical evidence, especially as they relate to identity. This project has the means to collect this empirical evidence that is scarcely found in ethics literature. As such, this thesis will investigate how patient experiences with DBS for depression affect notions of identity, and how these might influence decisions to become involved with this experimental therapy. Five themes emerged from the analysis of patient perspectives: well-unwell distinction, control, narrative, relationship to others, and perception. These themes provide insight into the relationship between identity, DBS, and depression and assist in promoting a framework of identity to adequately respond to current ethics discussions regarding DBS for depression research.
Table of Contents
Introduction 1
Aims, Objectives, and Research Questions 2
Section 1
Background 4
What is Major Depressive Disorder? 4
Treatment resistant depression and a new potential therapy 6
What is Deep Brain Stimulation? 7
Literature Review 9
What is identity? 9
Ethical Considerations in Deep Brain Stimulation 21
Ethical Considerations of DBS for Depression 33
Section 2
Research Design and Methods 39
Themes 46
Well-Unwell Distinction 46
Control 50
Development of Narrative 56
Relationship to Others 61
Perception 64
Discussion 69
Potential Themes 69
Informed Consent 69
Enhancement 71
Identifying with the Device 72
Limitations 73
Conclusion 76
References 78
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