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Self-Regulation and the Boundaries of the Self: A Proposal for Determining Which DBS Applications Affect Autonomy in TRD Patients

By Abel Wajnerman Paz  Relational autonomy and clDBS Image courtesy of Wikimedia Commons The adaptive BCI known as ‘closed-loop deep brain stimulation’ (clDBS) is a device that stimulates the brain in order to prevent or modulate pathological neural activity patterns. What makes this kind of DBS an adaptive neurotechnology is that it automatically adjusts stimulation levels based on computational algorithms that detect or predict those pathological processes. One of the prominent ethical concerns raised by clDBS is that it may take subjects “out of the decisional loop.” By inhibiting or modulating undesirable neural states ‘automatically,’ i.e., without any control or supervision by the subject, the device potentially undermines her autonomy.  Some argue that this problem can be solved or minimized simply by thinking through key ethical concepts, like ‘autonomy.’ For instance, it has been suggested that autonomy is not threatened by clDBS if we understand it in a relational way. Accord

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