Brain-computer interface-based control of closed-loop brain stimulation: attitudes and ethical considerations. Issue 3 (2nd July 2016)

• Record Type: Journal Article
• Authors: Klein, Eran; Goering, Sara; Gagne, Josh; Shea, Conor V.; Franklin, Rachel; Zorowitz, Samuel; Dougherty, Darin D.; Widge, Alik S.
• Is Part Of: Brain-computer interfaces. Volume 3:Issue 3(2016)
• Page Start: 140
• Page End: 148
• Publication Date: 2016-07-02
• Subjects: deep brain stimulation -- ethics -- closed-loop -- patient-controlled -- end-user perspectives; Brain-computer interfaces -- Periodicals; Neurology -- Periodicals; 616.800285
• DOI: 10.1080/2326263X.2016.1207497
• Languages: English
• ISSNs: 2326-263X

Abstract

Abstract : Patients who have undergone deep brain stimulation (DBS) for emerging indications have unique perspectives on ethical challenges that may shape trial design and identify key design features for BCI-driven DBS systems. DBS research in cognitive and emotional disorders has generated significant ethical interest. Much of this work has focused on developing ethical guidelines and recommendations for open-loop DBS systems. While early trials of open-loop DBS for depression gave disappointing results, research is moving toward clinical trials with closed-loop or patient-controllable DBS systems that may modulate aspects of personality and emotion. Though user-centered design is an increasingly important principle in neurotechnology, the perspectives of implanted individuals on ethical issues raised by DBS are poorly understood. We solicited those perspectives through a focus group and set of qualitative interviews of participants in trials of DBS for depression and obsessive-compulsive disorder. We identified four major themes: control over device function, authentic self, relationship effects, and meaningful consent. Each has implications for the design of closed-loop systems for non-motor disorders.