Widening the use of deep brain stimulation: Ethical considerations in research on DBS to treat Anorexia Nervosa
Carolyn Plunkett is a Ph.D. Candidate in the Philosophy Department at The Graduate Center of City University of New York. She is also an Ethics Fellow in The Bioethics Program at the Icahn School of Medicine at Mount Sinai, and a Research Associate in the Division of Medical Ethics at NYU Langone Medical Center. Carolyn will defend her dissertation in spring 2016, and, beginning July 2016, will be a Rudin Post-Doctoral Fellow in the Divisions of Medical Ethics and Medical Humanities at NYU Langone Medical Center.
|Schematic of the deep brain stimulation setup
|A representation of anorexia nervosa from flickr user Benjamin Watson
This is where DBS comes in. Readers of this blog are familiar with DBS, but they may not know that it has been shown to be a promising treatment for AN, even chronic AN, and even AN in a small number of teens. An emerging neurobiological understanding of AN supports the notion that DBS will be effective. Plus, case studies and case series [1, 2, 3] on the use of DBS in 14 women with AN have shown that it has been effective in increasing body weight and decreasing AN-associated behaviors in 11 of them.
|Should DBS be performed on this “over-protected” population?
There remain obstacles to engaging this population in clinical research on DBS. Because I’m proposing trials for minors, we need to address not only barriers to establishing assent in teens with AN but also parental consent. Both are problematic with this population, but I think the problems are surmountable.
*Some researchers call for classifying stages of AN to better guide treatment and research. Morbidity and mortality worsens, and recovery becomes less likely, the longer the disease progresses. Treatment protocols typically do not distinguish between someone with a first diagnosis and someone who has been ill for 5 or 10 years, and research studies usually do not divide patients with AN into further subgroups based on length of illness, even though there is evidence that those who have had the illness longer require different care than those at earlier stages.
Want to cite this post?
Plunkett, C. (2015). Widening the use of deep brain stimulation: Ethical considerations in research on DBS to treat Anorexia Nervosa. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2015/11/widening-use-of-deep-brain-stimulation.html