Dimensions of the Threat to the Self Posed by Deep Brain Stimulation: Personal Identity, Authenticity, and Autonomy

Main Article Content

Przemysław Zawadzki
https://orcid.org/0000-0002-8319-4458

Abstract

Deep Brain Stimulation (DBS) is an invasive therapeutic method involving the implantation of electrodes and the electrical stimulation of specific areas of the brain to modulate their activity. DBS brings therapeutic benefits, but can also have adverse side effects. Recently, neuroethicists have recognized that DBS poses a threat to the very fabric of human existence, namely, to the selves of patients. This article provides a review of the neuroethical literature examining this issue, and identifies the crucial dimensions related to the self which DBS may endanger—personal identity, authenticity, and autonomy. The most influential theories accounting for these dimensions are analyzed herein, and it is argued that most of these theories require further refinement. This paper also demonstrates the interrelation between personal identity, authenticity, and autonomy, and concludes that one can only fully understand the impact of DBS on the self when all of these factors are taken into account.

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Zawadzki, Przemysław. 2021. “Dimensions of the Threat to the Self Posed by Deep Brain Stimulation: Personal Identity, Authenticity, and Autonomy”. Diametros 18 (69):1-28. https://doi.org/10.33392/diam.1592.
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References

Adamczyk A.K., Zawadzki P. (2020), “The Memory-Modifying Potential of Optogenetics and the Need for Neuroethics,” NanoEthics 14 (3): 207–225.
DOI: https://doi.org/10.1007/s11569-020-00377-1

Aggarwal S., Chugh N. (2020), “Ethical Implications of Closed Loop Brain Device: 10-Year Review,” Minds and Machines 30 (1): 145–170.
DOI: https://doi.org/10.1007/s11023-020-09518-7

Agid Y., Schüpbach M., Gargiulo M. et al. (2006), “Neurosurgery in Parkinson’s Disease: The Doctor Is Happy, the Patient Less So?,” Journal of Neural Transmission. Supplementum 70: 409–414.
DOI: https://doi.org/10.1007/978-3-211-45295-0_61

Ahlberg E., Laakso K., Hartelius L. (2011), “Perceived Changes in Communication as an Effect of STN Surgery in Parkinson’s Disease: A Qualitative Interview Study,” Parkinson’s Disease 2011: 1–9.
DOI: https://doi.org/10.4061/2011/540158

Atkins K. (2008), Narrative Identity and Moral Identity: A Practical Perspective, Routledge, New York.
DOI: https://doi.org/10.4324/9780203894903

Baertschi M., Favez N., Radomska M. et al. (2019), “An Empirical Study on the Application of the Burden of Normality to Patients Undergoing Deep Brain Stimulation for Parkinson’s Disease,” Journal of Psychosocial Rehabilitation and Mental Health 6 (2): 175–186.
DOI: https://doi.org/10.1007/s40737-019-00149-5

Baylis F. (2012), “The Self in Situ: A Relational Account of Personal Identity,” [in:] Being Relational:

Reflections on Relational Theory and Health Law, J. Downie, J.J. Llewelyn (eds.), BC: UBC Press, Vancouver: 109–131.

Baylis F. (2013), “‘I Am Who I Am’: On the Perceived Threats to Personal Identity from Deep Brain Stimulation,” Neuroethics 6 (3): 513–526.
DOI: https://doi.org/10.1007/s12152-011-9137-1

Beeker T., Schlaepfer T.E., Coenen V.A. (2017), “Autonomy in Depressive Patients Undergoing DBS-Treatment: Informed Consent, Freedom of Will and DBS’ Potential to Restore It,” Frontiers in Integrative Neuroscience 11: 1–11.
DOI: https://doi.org/10.3389/fnint.2017.00011

Beszłej J., Siwicki D., Fila-Witecka K. et al. (2019), “Deep Brain Stimulation in Obsessive-Compulsive Disorder – case report of two patients,” Psychiatria Polska 53 (4): 807–824.
DOI: https://doi.org/10.12740/PP/104643

Beszłej J., Wieczorek T., Kobyłko A. et al. (2019), “Deep Brain Stimulation: New Possibilities for the Treatment of Mental Disorders,” Psychiatria Polska 53 (4): 789–806.
DOI: https://doi.org/10.12740/PP/OnlineFirst/103090

Bewernick B.H., Kayser S., Sturm V. et al. (2012), “Long-Term Effects of Nucleus Accumbens Deep Brain Stimulation in Treatment-Resistant Depression: Evidence for Sustained Efficacy,” Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology 37 (9): 1975–1985.
DOI: https://doi.org/10.1038/npp.2012.44

Bhargava P., Doshi P. (2008), “Hypersexuality Following Subthalamic Nucleus Stimulation for Parkinson’s Disease,” Neurology India 56 (4): 474–476.
DOI: https://doi.org/10.4103/0028-3886.44830

Bluhm R., Cabrera L., McKenzie R. (2019), “What We (Should) Talk about When We Talk about Deep Brain Stimulation and Personal Identity,” Neuroethics 13 (3): 289–301.
DOI: https://doi.org/10.1007/s12152-019-09396-6

Brown T., Moore P., Herron J. et al. (2016), “Personal Responsibility in the Age of User-Controlled Neuroprosthetics,” [in:] 2016 IEEE International Symposium on Ethics in Engineering, Science and Technology (ETHICS), BC: IEEE, Vancouver: 1–12.
DOI: https://doi.org/10.1109/ETHICS.2016.7560039

Brown T., Thompson M.C., Herron J. et al. (2016), “Controlling Our Brains – a Case Study on the Implications of Brain-Computer Interface-Triggered Deep Brain Stimulation for Essential Tremor,” Brain-Computer Interfaces 3 (4): 165–170.
DOI: https://doi.org/10.1080/2326263X.2016.1207494

Chan D.T.M., Zhu X.L., Yeung J.H.M. et al. (2009), “Complications of Deep Brain Stimulation: A Collective Review,” Asian Journal of Surgery 32 (4): 258–263.
DOI: https://doi.org/10.1016/S1015-9584(09)60404-8

Chhatbar P.Y., Saha S. (2015), “Ethical Considerations of Neuroprostheses,” [in:] Implantable Neuroprostheses for Restoring Function, K. Kilgore (ed.), Woodhead Publishing Series in Biomaterials: 413–428.
DOI: https://doi.org/10.1016/B978-1-78242-101-6.00020-3

Chiken S., Nambu A. (2015), “Mechanism of Deep Brain Stimulation: Inhibition, Excitation, or Disruption?,” The Neuroscientist 22 (3): 313–322.
DOI: https://doi.org/10.1177/1073858415581986

Christman J. (2004), “Narrative Unity as a Condition of Personhood,” Metaphilosophy 35 (5): 695–713.
DOI: https://doi.org/10.1111/j.1467-9973.2004.00345.x

Christman J. (2009), The Politics of Persons: Individual Autonomy and Socio-Historical Selves, Cambridge University Press, Cambridge.
DOI: https://doi.org/10.1017/CBO9780511635571

Christman J. (2018), “Autonomy in Moral and Political Philosophy,” [in:] The Stanford Encyclopedia of Philosophy, E.N. Zalta (ed.), Spring 2018, Metaphysics Research Lab, Stanford University, URL = https://plato.stanford.edu/archives/spr2018/entries/autonomy-moral/ [Accessed 21.03.2020].

Clausen J. (2009), “Man, Machine and in Between,” Nature 457 (7233): 1080–1081.
DOI: https://doi.org/10.1038/4571080a

Clausen J. (2010), “Ethical Brain Stimulation – Neuroethics of Deep Brain Stimulation in Research and Clinical Practice,” European Journal of Neuroscience 32 (7): 1152–1162.
DOI: https://doi.org/10.1111/j.1460-9568.2010.07421.x

Cook M.J., O’Brien T.J., Berkovic S.F. et al. (2013), “Prediction of Seizure Likelihood with a Long-Term, Implanted Seizure Advisory System in Patients with Drug-Resistant Epilepsy: A First-in-Man Study,” The Lancet Neurology 12 (6): 563–571.
DOI: https://doi.org/10.1016/S1474-4422(13)70075-9

Corripio I., Roldán A., Sarró S. et al. (2020), “Deep Brain Stimulation in Treatment Resistant Schizophrenia: A Pilot Randomized Cross-over Clinical Trial,” EBioMedicine 51: 102568.
DOI: https://doi.org/10.1016/j.ebiom.2019.11.029

Craver C.F. (2012), “A Preliminary Case for Amnesic Selves: Toward a Clinical Moral Psychology,” Social Cognition 30 (4): 449–473.
DOI: https://doi.org/10.1521/soco.2012.30.4.449

Denning T., Matsuoka Y., Kohno T. (2009), “Neurosecurity: Security and Privacy for Neural Devices,” Neurosurgical Focus 27 (1): E7.
DOI: https://doi.org/10.3171/2009.4.FOCUS0985

Deuschl G., Herzog J., Kleiner-Fisman G. et al. (2006), “Deep Brain Stimulation: Postoperative Issues,” Movement Disorders: Official Journal of the Movement Disorder Society 21 (14): 219–237.
DOI: https://doi.org/10.1002/mds.20957

Dings R., de Bruin L. (2016), “Situating the Self: Understanding the Effects of Deep Brain Stimulation,” Phenomenology and the Cognitive Sciences 15 (2): 151–165.
DOI: https://doi.org/10.1007/s11097-015-9421-3

Douglas T. (2014), “Criminal Rehabilitation Through Medical Intervention: Moral Liability and the Right to Bodily Integrity,” The Journal of Ethics 18 (2): 101–122.
DOI: https://doi.org/10.1007/s10892-014-9161-6

Dworkin G. (1988), The Theory and Practice of Autonomy, Cambridge University Press, Cambridge.
DOI: https://doi.org/10.1017/CBO9780511625206

Eich S., Müller O., Schulze-Bonhage A. (2019), “Changes in Self-Perception in Patients Treated with Neurostimulating Devices,” Epilepsy & Behavior 90: 25–30.
DOI: https://doi.org/10.1016/j.yebeh.2018.10.012

Falowski S.M. (2015), “Deep Brain Stimulation for Chronic Pain,” Current Pain and Headache Reports 19 (7): 27.
DOI: https://doi.org/10.1007/s11916-015-0504-1

Fisher R., Salanova V., Witt T. et al., SANTE Study Group (2010), “Electrical Stimulation of the Anterior Nucleus of Thalamus for Treatment of Refractory Epilepsy,” Epilepsia 51 (5): 899–908.
DOI: https://doi.org/10.1111/j.1528-1167.2010.02536.x

Fitzgerald P.B., Segrave R.A. (2015), “Deep Brain Stimulation in Mental Health: Review of Evidence for Clinical Efficacy,” Australian & New Zealand Journal of Psychiatry 49 (11): 979–993.
DOI: https://doi.org/10.1177/0004867415598011

Focquaert F., DeRidder D. (2009), “Direct Intervention in the Brain: Ethical Issues Concerning Personal Identity,” Journal of Ethics in Mental Health 4 (2): 1–7.

Frankemolle A.M.M., Wu J., Noecker A.M. et al. (2010), “Reversing Cognitive–Motor Impairments in Parkinson’s Disease Patients Using a Computational Modelling Approach to Deep Brain Stimulation Programming,” Brain 133: 746–761.
DOI: https://doi.org/10.1093/brain/awp315

Frankfurt H.G. (1969), “Alternate Possibilities and Moral Responsibility,” Journal of Philosophy 66 (23): 829-839.
DOI: https://doi.org/10.2307/2023833

Frankfurt H.G. (1971), “Freedom of the Will and the Concept of a Person,” The Journal of Philosophy 68 (1): 5–20.
DOI: https://doi.org/10.2307/2024717

Franzini A., Broggi G., Cordella R. et al. (2013), “Deep-Brain Stimulation for Aggressive and Disruptive Behavior,” World Neurosurgery 80: S29.e11–14.
DOI: https://doi.org/10.1016/j.wneu.2012.06.038

Gallagher S. (2018), “Deep Brain Stimulation, Self and Relational Autonomy,” Neuroethics 18: 1–13.
DOI: https://doi.org/10.1007/s12152-018-9355-x

Gardner J. (2013), “A History of Deep Brain Stimulation: Technological Innovation and the Role of Clinical Assessment Tools,” Social Studies of Science 43 (5): 707–728.
DOI: https://doi.org/10.1177/0306312713483678

Gilbert F. (2012), “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): 408–412.
DOI: https://doi.org/10.1136/medethics-2011-100044

Gilbert F. (2013), “Deep Brain Stimulation and Postoperative Suicidality Among Treatment Resistant Depression Patients: Should Eligibility Protocols Exclude Patients with a History of Suicide Attempts and Anger/Impulsivity?,” AJOB Neuroscience 4 (1): 28–35.
DOI: https://doi.org/10.1080/21507740.2012.740143

Gilbert F. (2015), “A Threat to Autonomy? The Intrusion of Predictive Brain Implants,” AJOB Neuroscience 6 (4): 4–11.
DOI: https://doi.org/10.1080/21507740.2015.1076087

Gilbert F. (2018), “Deep Brain Stimulation: Inducing Self-Estrangement,” Neuroethics 11 (2): 157–165.
DOI: https://doi.org/10.1007/s12152-017-9334-7

Gilbert F., Goddard E., Viaña J.N.M. et al. (2017), “I Miss Being Me: Phenomenological Effects of Deep Brain Stimulation,” AJOB Neuroscience 8 (2): 96–109.
DOI: https://doi.org/10.1080/21507740.2017.1320319

Gilbert F., O’Brien T., Cook M. (2018), “The Effects of Closed-Loop Brain Implants on Autonomy and Deliberation: What Are the Risks of Being Kept in the Loop?,” Cambridge Quarterly of Healthcare Ethics 27 (2): 316–325.
DOI: https://doi.org/10.1017/S0963180117000640

Gilbert F., Viaña J.N.M. (2018), “A Personal Narrative on Living and Dealing with Psychiatric Symptoms after DBS Surgery,” Narrative Inquiry in Bioethics 8 (1): 67–77.
DOI: https://doi.org/10.1353/nib.2018.0024

Gilbert F., Viaña J.N.M., Ineichen C. (2018), “Deflating the ‘DBS Causes Personality Changes’ Bubble,” Neuroethics: 1–17.
DOI: https://doi.org/10.1007/s12152-018-9387-2

Gisquet E. (2008), “Cerebral Implants and Parkinson’s Disease: A Unique Form of Biographical Disruption?,” Social Science & Medicine 67 (11): 1847–1851.
DOI: https://doi.org/10.1016/j.socscimed.2008.09.026

Glannon W. (2010), “Consent to Deep Brain Stimulation for Neurological and Psychiatric Disorders,” The Journal of Clinical Ethics 21 (2): 104–111.

Glannon W. (2014a), “Neuromodulation, Agency and Autonomy,” Brain Topography 27 (1): 46–54.
DOI: https://doi.org/10.1007/s10548-012-0269-3

Glannon W. (2014b), “Philosophical Reflections on Therapeutic Brain Stimulation,” Frontiers in Computational Neuroscience 8 (54): 1–3.
DOI: https://doi.org/10.3389/fncom.2014.00054

Glannon W. (2016), “Ethical Issues in Neuroprosthetics,” Journal of Neural Engineering 13 (2): 021002.
DOI: https://doi.org/10.1088/1741-2560/13/2/021002

Goddard E. (2017), “Deep Brain Stimulation Through the ‘Lens of Agency’: Clarifying Threats to Personal Identity from Neurological Intervention,” Neuroethics 10 (3): 325–335.
DOI: https://doi.org/10.1007/s12152-016-9297-0

Goering S. (2015), “Stimulating Autonomy: DBS and the Prospect of Choosing to Control Ourselves Through Stimulation,” AJOB Neuroscience 6 (4): 1–3.
DOI: https://doi.org/10.1080/21507740.2015.1106274

Goering S., Klein E., Dougherty D.D. et al. (2017), “Staying in the Loop: Relational Agency and Identity in Next-Generation DBS for Psychiatry,” AJOB Neuroscience 8 (2): 59–70.
DOI: https://doi.org/10.1080/21507740.2017.1320320

Goethals I., Jacobs F., Van der Linden C. et al. (2008), “Brain Activation Associated with Deep Brain Stimulation Causing Dissociation in a Patient with Tourette’s Syndrome,” Journal of Trauma & Dissociation 9 (4): 543–549.
DOI: https://doi.org/10.1080/15299730802226126

Haahr A., Kirkevold M., Hall E.O.C. et al. (2013), “‘Being in It Together’: Living with a Partner Receiving Deep Brain Stimulation for Advanced Parkinson’s Disease – a Hermeneutic Phenomenological Study,” Journal of Advanced Nursing 69 (2): 338–347.
DOI: https://doi.org/10.1111/j.1365-2648.2012.06012.x

de Haan S., Rietveld E., Stokhof M. et al. (2013), “The Phenomenology of Deep Brain Stimulation-Induced Changes in OCD: An Enactive Affordance-Based Model,” Frontiers in Human Neuroscience 7 (653): 1–14.
DOI: https://doi.org/10.3389/fnhum.2013.00653

de Haan S., Rietveld E., Stokhof M. et al. (2015), “Effects of Deep Brain Stimulation on the Lived Experience of Obsessive-Compulsive Disorder Patients: In-Depth Interviews with 18 Patients,” PLOS ONE 10 (8): e0135524.
DOI: https://doi.org/10.1371/journal.pone.0135524

Hamani C., Pilitsis J., Rughani A.I. et al. (2014), “Deep Brain Stimulation for Obsessive-Compulsive Disorder Systematic Review and Evidence-Based Guideline Sponsored by the American Society for Stereotactic and Functional Neurosurgery and the Congress of Neurological Surgeons (CNS) and Endorsed by the CNS and American Association of Neurological Surgeons,” Neurosurgery 75 (4): 327–333.
DOI: https://doi.org/10.1227/NEU.0000000000000499

Hariz G.-M., Limousin P., Tisch S. et al. (2011), “Patients’ Perceptions of Life Shift after Deep Brain Stimulation for Primary Dystonia-A Qualitative Study,” Movement Disorders 26: 2101–2106.
DOI: https://doi.org/10.1002/mds.23796

Haslam C., Jetten J., Haslam S.A. et al. (2011), “‘I Remember Therefore I Am, and I Am Therefore I Remember’: Exploring the Contributions of Episodic and Semantic Self-Knowledge to Strength of Identity,” British Journal of Psychology 102 (2): 184–203.
DOI: https://doi.org/10.1348/000712610X508091

Hemm S., Wårdell K. (2010), “Stereotactic Implantation of Deep Brain Stimulation Electrodes: A Review of Technical Systems, Methods and Emerging Tools,” Medical & Biological Engineering & Computing 48 (7): 611–624.
DOI: https://doi.org/10.1007/s11517-010-0633-y

Herrington T.M., Cheng J.J., Eskandar E.N. (2016), “Mechanisms of Deep Brain Stimulation,” Journal of Neurophysiology 115 (1): 19–38.
DOI: https://doi.org/10.1152/jn.00281.2015

Hickey P., Stacy M. (2016), “Deep Brain Stimulation: A Paradigm Shifting Approach to Treat Parkinson’s Disease,” Frontiers in Neuroscience 10 (173): 1–11.
DOI: https://doi.org/10.3389/fnins.2016.00173

Hildt E. (2006), “Electrodes in the Brain: Some Anthropological and Ethical Aspects of Deep Brain Stimulation,” International Review of Information Ethics 5 (9): 33–39.
DOI: https://doi.org/10.29173/irie193

Houeto J.L. (2002), “Behavioural Disorders, Parkinson’s Disease and Subthalamic Stimulation,” Journal of Neurology, Neurosurgery & Psychiatry 72 (6): 701–707.
DOI: https://doi.org/10.1136/jnnp.72.6.701

Illman N.A., Rathbone C.J., Kemp S. (2011), “Autobiographical Memory and the Self in a Case of Transient Epileptic Amnesia,” Epilepsy & Behavior 21 (1): 36–41.
DOI: https://doi.org/10.1016/j.yebeh.2011.02.022

Johansson V., Garwicz M., Kanje M. et al. (2014), “Thinking Ahead on Deep Brain Stimulation: An Analysis of the Ethical Implications of a Developing Technology,” AJOB Neuroscience 5 (1): 24–33.
DOI: https://doi.org/10.1080/21507740.2013.863243

Johansson V., Garwicz M., Kanje M. et al. (2011), “Authenticity, Depression, and Deep Brain Stimulation,” Frontiers in Integrative Neuroscience 5 (21): 1–3.
DOI: https://doi.org/10.3389/fnint.2011.00021

Karas P.J., Mikell C.B., Christian E. et al. (2013), “Deep Brain Stimulation: A Mechanistic and Clinical Update,” Neurosurgical Focus 35 (5): E1.
DOI: https://doi.org/10.3171/2013.9.FOCUS13383

Kellmeyer P., Cochrane T., Müller O. et al. (2016), “The Effects of Closed-Loop Medical Devices on the Autonomy and Accountability of Persons and Systems,” Cambridge Quarterly of Healthcare Ethics 25 (4): 623–633.
DOI: https://doi.org/10.1017/S0963180116000359

Klein E. (2015), “Are Brain-Computer Interface (BCI) Devices a Form of Internal Coercion?,” AJOB Neuroscience 6 (4): 32–34.
DOI: https://doi.org/10.1080/21507740.2015.1094546

Klein E., Goering S., Gagne J. et al. (2016), “Brain-Computer Interface-Based Control of Closed-Loop Brain Stimulation: Attitudes and Ethical Considerations,” Brain-Computer Interfaces 3 (3): 140–148.
DOI: https://doi.org/10.1080/2326263X.2016.1207497

Klein S.B. (2012), “The Self and Its Brain,” Social Cognition 30 (4): 474–518.
DOI: https://doi.org/10.1521/soco.2012.30.4.474

Klein S.B. (2013), “The Sense of Diachronic Personal Identity,” Phenomenology and the Cognitive Sciences 12 (4): 791–811.
DOI: https://doi.org/10.1007/s11097-012-9285-8

Klein S.B. (2014), “Sameness and the Self: Philosophical and Psychological Considerations,”
DOI: https://doi.org/10.3389/fpsyg.2014.00029

Frontiers in Psychology 5 (29): 1–15.

Klein S.B., Cosmides L., Costabile K.A. et al. (2002), “Is There Something Special about the Self? A Neuropsychological Case Study,” Journal of Research in Personality 36 (5): 490–506.
DOI: https://doi.org/10.1016/S0092-6566(02)00001-6

Klein S.B., Gangi C.E. (2010), “The Multiplicity of Self: Neuropsychological Evidence and Its Implications for the Self as a Construct in Psychological Research,” Annals of the New York Academy of Sciences 1191: 1–15.
DOI: https://doi.org/10.1111/j.1749-6632.2010.05441.x

Klein S.B., Lax M.L. (2010), “The Unanticipated Resilience of Trait Self-Knowledge in the Face of Neural Damage,” Memory 18 (8): 918–948.
DOI: https://doi.org/10.1080/09658211.2010.524651

Klein S.B., Nichols S. (2012), “Memory and the Sense of Personal Identity,” Mind 121 (483): 677–702.
DOI: https://doi.org/10.1093/mind/fzs080

Kraemer F. (2013a), “Authenticity or Autonomy? When Deep Brain Stimulation Causes a Dilemma,” Journal of Medical Ethics 39 (12): 757–760.
DOI: https://doi.org/10.1136/medethics-2011-100427

Kraemer F. (2013b), “Me, Myself and My Brain Implant: Deep Brain Stimulation Raises Questions of Personal Authenticity and Alienation,” Neuroethics 6 (3): 483–497.
DOI: https://doi.org/10.1007/s12152-011-9115-7

Kuhn J., Bührle C.P., Lenartz D. et al. (2013), “Deep Brain Stimulation in Addiction Due to Psychoactive Substance Use,” Handbook of Clinical Neurology 116: 259–269.
DOI: https://doi.org/10.1016/B978-0-444-53497-2.00021-8

Kuncel A.M., Grill W.M. (2004), “Selection of Stimulus Parameters for Deep Brain Stimulation,” Clinical Neurophysiology 115 (11): 2431–2441.
DOI: https://doi.org/10.1016/j.clinph.2004.05.031

Laxton A.W., Lozano A.M. (2013), “Deep Brain Stimulation for the Treatment of Alzheimer Disease and Dementias,” World Neurosurgery 80 (3–4): S28.e1–8.
DOI: https://doi.org/10.1016/j.wneu.2012.06.028

Lewis C.J., Maier F., Horstkötter N. et al. (2015), “Subjectively Perceived Personality and Mood Changes Associated with Subthalamic Stimulation in Patients with Parkinson’s Disease,” Psychological Medicine 45 (1): 73–85.
DOI: https://doi.org/10.1017/S0033291714001081

Liddle J., Phillips J., Gustafsson L. et al. (2018), “Understanding the Lived Experiences of Parkinson’s Disease and Deep Brain Stimulation (DBS) through Occupational Changes,” Australian Occupational Therapy Journal 65 (1): 45–53.
DOI: https://doi.org/10.1111/1440-1630.12437

Lipsman N., Glannon W. (2013), “Brain, Mind and Machine: What Are the Implications of Deep Brain Stimulation for Perceptions of Personal Identity, Agency and Free Will?,” Bioethics 27 (9): 465–470.
DOI: https://doi.org/10.1111/j.1467-8519.2012.01978.x

Lipsman N., Woodside B., Lozano A.M. (2013), “Evaluating the Potential of Deep Brain Stimulation for Treatment-Resistant Anorexia Nervosa,” Handbook of Clinical Neurology 116: 271–276.
DOI: https://doi.org/10.1016/B978-0-444-53497-2.00022-X

Little S., Pogosyan A., Neal S. et al. (2013), “Adaptive Deep Brain Stimulation in Advanced Parkinson Disease: Adaptive DBS in PD,” Annals of Neurology 74 (3): 449–457.
DOI: https://doi.org/10.1002/ana.23951

Lozano A.M., Lipsman N., Bergman H. et al. (2019), “Deep Brain Stimulation: Current Challenges and Future Directions,” Nature Reviews Neurology 15 (3): 148–160.
DOI: https://doi.org/10.1038/s41582-018-0128-2

Mackenzie C., Poltera J. (2010), “Narrative Integration, Fragmented Selves, and Autonomy,” Hypatia 25 (1): 31–54.
DOI: https://doi.org/10.1111/j.1527-2001.2009.01083.x

Mackenzie C., Walker M. (2015), “Neurotechnologies, Personal Identity and the Ethics of Authenticity” [in:] Handbook of Neuroethics, J. Clausen, N. Levy (eds.), Springer, Dordrecht: 373–392.
DOI: https://doi.org/10.1007/978-94-007-4707-4_10

Mackenzie R. (2014), “Authenticity Versus Autonomy in Choosing the New Me: Beyond IEC and NIEC in DBS,” AJOB Neuroscience 5 (1): 51–53.
DOI: https://doi.org/10.1080/21507740.2014.873620

Mantione M., Figee M., Denys D. (2014), “A Case of Musical Preference for Johnny Cash Following Deep Brain Stimulation of the Nucleus Accumbens,” Frontiers in Behavioral Neuroscience 8 (152): 1–4.
DOI: https://doi.org/10.3389/fnbeh.2014.00152

Maslen H., Pugh J., Savulescu J. (2015), “The Ethics of Deep Brain Stimulation for the Treatment of Anorexia Nervosa,” Neuroethics 8 (3): 215–230.
DOI: https://doi.org/10.1007/s12152-015-9240-9

Mathers J., Rick C., Jenkinson C. et al. (2016), “Patients’ Experiences of Deep Brain Stimulation for Parkinson’s Disease: A Qualitative Systematic Review and Synthesis,” BMJ Open 6 (6): e011525.
DOI: https://doi.org/10.1136/bmjopen-2016-011525

Mathews D.J.H. (2011), “Deep Brain Stimulation, Personal Identity and Policy,” International Review of Psychiatry 23 (5): 486–492.
DOI: https://doi.org/10.3109/09540261.2011.632624

Matthews S., Kennett J. (2012), “Truth, Lies, and the Narrative Self,” American Philosophical Quarterly 49 (4): 301–315.

Medtronic (2021), “FDA Approves First-Of-Its-Kind Percept™ PC Neurostimulator with BrainSense™ Technology,” URL = https://newsroom.medtronic.com/news-releases/news-release-details/fda-approves-fi rst-its-kind-percepttm-pc-neurostimulator [Accessed 27.03.2020].

Merkel R., Boer G., Fegert J. et al. (2007), Intervening in the Brain: Changing Psyche and Society, Springer Science & Business Media, New York.

Miocinovic S., Somayajula S., Chitnis S. et al. (2013), “History, Applications, and Mechanisms of Deep Brain Stimulation,” JAMA Neurology 70 (2): 163–171.
DOI: https://doi.org/10.1001/2013.jamaneurol.45

Montel S.R., Bungener C. (2009), “Coping and Quality of Life of Patients with Parkinson Disease Who Have Undergone Deep Brain Stimulation of the Subthalamic Nucleus,” Surgical Neurology 72 (2): 105–111.
DOI: https://doi.org/10.1016/j.surneu.2008.05.026

Montgomery E.B., Gale J.T. (2008), “Mechanisms of Action of Deep Brain Stimulation (DBS),” Neuroscience & Biobehavioral Reviews 32 (3): 388–407.
DOI: https://doi.org/10.1016/j.neubiorev.2007.06.003

Morrell M.J. (2011), “Responsive Cortical Stimulation for the Treatment of Medically Intractable Partial Epilepsy,” Neurology 77 (13): 1295–1304.
DOI: https://doi.org/10.1212/WNL.0b013e3182302056

Mosley P.E., Hall W., Forlini C. et al. (2014), “Alienation and Authenticity in Parkinson’s Disease and Its Treatment,” AJOB Neuroscience 5 (4): 54–56.
DOI: https://doi.org/10.1080/21507740.2014.951783

Müller S., Riedmüller R., Walter H. et al. (2015), “An Ethical Evaluation of Stereotactic Neurosurgery for Anorexia Nervosa,” AJOB Neuroscience 6 (4): 50–65.
DOI: https://doi.org/10.1080/21507740.2015.1094536

Müller S., Walter H. (2010), “Reviewing Autonomy: Implications of the Neurosciences and the Free Will Debate for the Principle of Respect for the Patient’s Autonomy,” Cambridge Quarterly of Healthcare Ethics 19 (2): 205–217.
DOI: https://doi.org/10.1017/S0963180109990478

Nyholm S., Campbell S.M. (2016), “When Is Deep Brain Stimulation a Medical Benefit, and What Is Required for Consent?,” AJOB Neuroscience 7 (3): 150–152.
DOI: https://doi.org/10.1080/21507740.2016.1218384

Nyholm S., O’Neill E. (2016), “Deep Brain Stimulation, Continuity over Time, and the True Self,” Cambridge Quarterly of Healthcare Ethics 25 (4): 647–658.
DOI: https://doi.org/10.1017/S0963180116000372

Ondo W.G., Meilak C., Vuong K.D. (2007), “Predictors of Battery Life for the Activa Soletra 7426 Neurostimulator,” Parkinsonism & Related Disorders 13 (4): 240–242.
DOI: https://doi.org/10.1016/j.parkreldis.2006.11.002

Ostrem J.L., Racine C.A., Glass G. et al. (2011), “Subthalamic Nucleus Deep Brain Stimulation in Primary Cervical Dystonia,” Neurology 76 (10): 870–878.
DOI: https://doi.org/10.1212/WNL.0b013e31820f2e4f

Parastarfeizabadi M., Kouzani A.Z. (2017), “Advances in Closed-Loop Deep Brain Stimulation Devices,” Journal of Neuroengineering and Rehabilitation 14 (1): 79.
DOI: https://doi.org/10.1186/s12984-017-0295-1

Pham U., Solbakk A.-K., Skogseid I.-M. et al. (2015), “Personality Changes after Deep Brain Stimulation in Parkinson’s Disease,” Parkinson’s Disease 2015: 490507.
DOI: https://doi.org/10.1155/2015/490507

Pugh J. (2019), “No Going Back? Reversibility and Why It Matters for Deep Brain Stimulation,” Journal of Medical Ethics 45 (4): 225–230.
DOI: https://doi.org/10.1136/medethics-2018-105139

Pugh J., Maslen H., Savulescu J. (2017a), “The Need for Further Fine-Grained Distinctions in Discussions of Authenticity and Deep Brain Stimulation,” AJOB Neuroscience 8 (3): W1–W3.
DOI: https://doi.org/10.1080/21507740.2017.1380727

Pugh J., Maslen H., Savulescu J. (2017b), “Deep Brain Stimulation, Authenticity and Value,” Cambridge Quarterly of Healthcare Ethics 26 (4): 640–657.
DOI: https://doi.org/10.1017/S0963180117000147

Pugh J., Pycroft L., Sandberg A. et al. (2018), “Brainjacking in Deep Brain Stimulation and Autonomy,” Ethics and Information Technology 20 (3): 219–232.
DOI: https://doi.org/10.1007/s10676-018-9466-4

Rabins P., Appleby B.S., Brandt J. et al. (2009), “Scientific and Ethical Issues Related to Deep Brain Stimulation for Disorders of Mood, Behavior and Thought,” Archives of General Psychiatry 66 (9): 931–937.
DOI: https://doi.org/10.1001/archgenpsychiatry.2009.113

Ricoeur, P. (1991), “Narrative Identity,” Philosophy Today 35 (1): 73–81.
DOI: https://doi.org/10.5840/philtoday199135136

Ruge D., Cif L., Limousin P. et al. (2011), “Shaping Reversibility? Long-Term Deep Brain Stimulation in Dystonia: The Relationship between Effects on Electrophysiology and Clinical Symptoms,” Brain: A Journal of Neurology 134 (7): 2106–2115.
DOI: https://doi.org/10.1093/brain/awr122

Scaratti C., Zorzi G., Guastafierro E. et al. (2020), “Long Term Perceptions of Illness and Self after Deep Brain Stimulation in Pediatric Dystonia: A Narrative Research,” European Journal of Paediatric Neurology 26: 61–67.
DOI: https://doi.org/10.1016/j.ejpn.2020.02.010

Schechtman M. (1990), “Personhood and Personal Identity,” The Journal of Philosophy 87 (2): 71–92.
DOI: https://doi.org/10.2307/2026882

Schechtman M. (1996), The Constitution of Selves, Cornell University Press, Ithaca, NY.

Schechtman M. (2009), “Getting Our Stories Straight: Self-Narrative and Personal Identity,” [in:] Personal Identity and Fractured Selves: Perspectives from Philosophy, Ethics, and Neuroscience, D.J.H. Mathews, H. Bok, P.V. Rabins (eds.), Johns Hopkins University Press, Baltimore: 65–92.

Schechtman M. (2010), “Philosophical Reflections on Narrative and Deep Brain Stimulation,” The Journal of Clinical Ethics 21 (2): 133–139.

Schermer M. (2011), “Ethical Issues in Deep Brain Stimulation,” Frontiers in Integrative Neuroscience 5 (17): 1–5.
DOI: https://doi.org/10.3389/fnint.2011.00017

Schiff N.D., Giacino J.T., Kalmar K. et al. (2007), “Behavioural Improvements with Thalamic Stimulation after Severe Traumatic Brain Injury,” Nature 448 (7153): 600–603.
DOI: https://doi.org/10.1038/nature06041

Schrock L.E., Mink J.W., Woods D.W. et al., Tourette Syndrome Association International Deep Brain Stimulation (DBS) Database and Registry Study Group (2015), “Tourette Syndrome Deep Brain Stimulation: A Review and Updated Recommendations: Tourette Syndrome DBS Guidelines,” Movement Disorders 30 (4): 448–471.
DOI: https://doi.org/10.1002/mds.26094

Schüpbach M., Gargiulo M., Welter M.L. et al. (2006), “Neurosurgery in Parkinson Disease: A Distressed Mind in a Repaired Body?,” Neurology 66 (12): 1811–1816.
DOI: https://doi.org/10.1212/01.wnl.0000234880.51322.16

Sharp D., Wasserman D. (2016), “Deep Brain Stimulation, Historicism, and Moral Responsibility,” Neuroethics 9: 173–185.
DOI: https://doi.org/10.1007/s12152-016-9260-0

Smeding H.M.M. (2008), “Neuropsychological Effects of Subthalamic Nucleus Stimulation in Parkinson’s Disease,” URL = http://dare.uva.nl/document/106077 [Accessed 22.03.2020].

Smeets A.Y.J.M., Duits A.A., Horstkötter D. et al. (2018), “Ethics of Deep Brain Stimulation in Adolescent Patients with Refractory Tourette Syndrome: A Systematic Review and Two Case Discussions,” Neuroethics 11 (2): 143–155.
DOI: https://doi.org/10.1007/s12152-018-9359-6

Stahl D., Cabrera L., Gibb T. (2018), “Should DBS for Psychiatric Disorders Be Considered a Form of Psychosurgery? Ethical and Legal Considerations,” Science and Engineering Ethics 24 (4): 1119–1142.
DOI: https://doi.org/10.1007/s11948-017-9934-y

Starr P.A. (2013), “Deep Brain Stimulation for Other Tremors, Myoclonus, and Chorea,” Handbook of Clinical Neurology 116: 209–215.
DOI: https://doi.org/10.1016/B978-0-444-53497-2.00016-4

Strawson G. (2004), “Against Narrativity,” Ratio 17 (4): 428–452.
DOI: https://doi.org/10.1111/j.1467-9329.2004.00264.x

Synofzik M., Schlaepfer T.E. (2008), “Stimulating Personality: Ethical Criteria for Deep Brain Stimulation in Psychiatric Patients and for Enhancement Purposes,” Biotechnology Journal 3 (12): 1511–1520.
DOI: https://doi.org/10.1002/biot.200800187

Thomson C.J., Segrave R., Racine E. et al. (2020), “‘He’s Back so I’m Not Alone’: The Impact of Deep Brain Stimulation on Personality, Self, and Relationships in Parkinson’s Disease,” Qualitative Health Research 30 (14): 2217–2233.
DOI: https://doi.org/10.1177/1049732320951144

Thomson C.J., Segrave R.A., Carter A. (2019), “Changes in Personality Associated with Deep Brain Stimulation: A Qualitative Evaluation of Clinician Perspectives,” Neuroethics: 1–10.
DOI: https://doi.org/10.1007/s12152-019-09419-2

Trzópek J. (2013), Na tropach podmiotu: między filozoficznym a empirycznym ujęciem podmiotowości, Wydawnictwo Uniwersytetu Jagiellońskiego, Kraków.

Tulving E. (1985), Elements of Episodic Memory, Oxford University Press, Oxford, New York.

Tulving E. (1993), Self-Knowledge of an Amnesic Individual Is Represented Abstractly, [in:] “The Mental Representation of Trait and Autobiographical Knowledge about the Self,” T.K. Srull, R.S. Wyer, Jr. (eds.), Lawrence Erlbaum Associates, Inc, Hillsdale: 147–156.

Unterrainer M., Oduncu F.S. (2015), “The Ethics of Deep Brain Stimulation (DBS),” Medicine, Health Care and Philosophy 18 (4): 475–485.
DOI: https://doi.org/10.1007/s11019-015-9622-0

Vidailhet M., Jutras M.F., Grabli D. et al. (2013), “Deep Brain Stimulation for Dystonia,” Journal of Neurology, Neurosurgery, and Psychiatry 84 (9): 1029–1042.
DOI: https://doi.org/10.1136/jnnp-2011-301714

Vitek J.L. (2008), “Deep Brain Stimulation: How Does It Work?,” Cleveland Clinic Journal of Medicine 75 (2): 59–65.
DOI: https://doi.org/10.3949/ccjm.75.Suppl_2.S59

Wardrope A. (2014), “Authenticity and Autonomy in Deep-Brain Stimulation,” Journal of Medical Ethics 40 (8): 563–566.
DOI: https://doi.org/10.1136/medethics-2013-101419

Wheeler M.A., Stuss D.T., Tulving E. (1997), “Toward a Theory of Episodic Memory: The Frontal Lobes and Autonoetic Consciousness,” Psychological Bulletin 121 (3): 331–354.
DOI: https://doi.org/10.1037/0033-2909.121.3.331

Whiting D.M., Tomycz N.D., Bailes J. et al. (2013), “Lateral Hypothalamic Area Deep Brain Stimulation for Refractory Obesity: A Pilot Study with Preliminary Data on Safety, Body Weight, and Energy Metabolism,” Journal of Neurosurgery 119 (1): 56–63.
DOI: https://doi.org/10.3171/2013.2.JNS12903

Widge A.S., Dougherty D.D., Moritz C.T. (2014), “Affective Brain-Computer Interfaces As Enabling Technology for Responsive Psychiatric Stimulation,” Brain Computer Interfaces 1 (2): 126–136.
DOI: https://doi.org/10.1080/2326263X.2014.912885

Witt K., Daniels C., Reiff J. et al. (2008), “Neuropsychological and Psychiatric Changes after Deep Brain Stimulation for Parkinson’s Disease: A Randomised, Multicentre Study,” The Lancet Neurology 7 (7): 605–614.
DOI: https://doi.org/10.1016/S1474-4422(08)70114-5

Witt K., Kuhn J., Timmermann L. et al. (2013), “Deep Brain Stimulation and the Search for Identity,” Neuroethics 6 (3): 499–511.
DOI: https://doi.org/10.1007/s12152-011-9100-1

Zawadzki P. (2020), “Pattern Theory of Self and Situating Moral Aspects: The Need to Include Authenticity, Autonomy and Responsibility in Understanding the Effects of Deep Brain Stimulation,” Phenomenology and the Cognitive Sciences: 1–24.
DOI: https://doi.org/10.1007/s11097-020-09708-9

Zawadzki P. (2021), “Mapping the Dimensions of Agency: The Narrative as Unifying Mechanism,” AJOB Neuroscience 12 (2–3): 191–193.
DOI: https://doi.org/10.1080/21507740.2021.1904042

Zawadzki P., Adamczyk A.K. (2021), “Personality and Authenticity in Light of the Memory-Modifying Potential of Optogenetics,” AJOB Neuroscience 12 (1): 3–21.
DOI: https://doi.org/10.1080/21507740.2020.1866097