World Neurosurgery
Volume 76, Issue 6 , Pages 537-547 , December 2011

Deep Brain Stimulation and Ethics: Perspectives from a Multisite Qualitative Study of Canadian Neurosurgical Centers

  • Emily Bell

      Affiliations

    • Neuroethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, Québec, Canada
    • ,
  • Bruce Maxwell

      Affiliations

    • Neuroethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, Québec, Canada
    • ,
  • Mary Pat McAndrews

      Affiliations

    • Division of Brain Imaging & Behaviour Systems–Neuroscience, Toronto Western Research Institute, Toronto, Ontario, Canada
    • ,
  • Abbas Sadikot

      Affiliations

    • Montreal Neurological Institute and Hospital, McGill University, Montréal, Québec, Canada
    • ,
  • Eric Racine

      Affiliations

    • Neuroethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, Québec, Canada
    • Department of Medicine and Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada
    • Department of Neurology and Neurosurgery, Medicine, and Biomedical Ethics Unit, McGill University, Montréal, Québec, Canada
    • Corresponding Author InformationTo whom correspondence should be addressed: Eric Racine, Ph.D.

Received 13 October 2010 ,Accepted 13 May 2011.

References 

  1. Agid Y, Schupbach M, Gargiulo M, Mallet L, Houeto JL, Behar C, et al. Neurosurgery in Parkinson's disease: the doctor is happy, the patient less so? . J Neural Transm Suppl . 2006;70:409–414
  2. Antonini A , Miro L , Castiglioni C , Pezzoli G . The rationale for improved integration between home care and neurology hospital services in patients with advanced Parkinson's disease . Neurol Sci . 2008;29(Suppl 5):S392–S396
  3. Bell E , Mathieu G , Racine E . Preparing the ethical future of deep brain stimulation . Surg Neurol . 2009;72:577–586 discussion 586
  4. Bell E , Maxwell B , McAndrews MP , Sadikot A , Racine E . Hope and expectation in deep brain stimulation: healthcare provider perspectives and approaches . J Clin Ethics . 2010;21:112–124
  5. Canada, Department of Justice . Canada Health Act . http://laws.justice.gc.ca/en/c-6/index.html Accessed on March 9, 2011
  6. Cohen DB, Oh MY, Baser SM, Angle C, Whiting A, Birk C, et al. Fast-track programming and rehabilitation model: a novel approach to postoperative deep brain stimulation patient care . Arch Phys Med Rehabil . 2007;88:1320–1324
  7. Farris SM , Gianola PA . Ethical issues surrounding deep brain stimulation in Parkinson's disease . J Am Acad Physician Assist . 2009;22:57–58
  8. Glannon W . Stimulating brains, altering minds . J Med Ethics . 2009;35:289–292
  9. Hsieh HF , Shannon SE . Three approaches to qualitative content analysis . Qualitative Health Research . 2005;15:1277–1288
  10. Lang AE, Houeto JL, Krack P, Kubu C, Lyons KE, Moro E, et al. Deep brain stimulation: preoperative issues . Mov Disord . 2006;21(Suppl 14):S171–S196
  11. Lopiano L, Rizzone M, Bergamasco B, Tavella A, Torre E, Perozzo P, et al. Deep brain stimulation of the subthalamic nucleus in PD: an analysis of the exclusion causes . J Neurol Sci . 2002;195:167–170
  12. MEDEC Canadian Heart Rhythm Task Force . Provincial variations in access to implantable cardioverter defibrillators (ICDs). Toronto, ON . http://www.medec.org/webfm_send/794 Accessed May 24, 2011
  13. Mortensen M , Burkholder J . Parkinson's care in Canada . EPNN J Summer . 2006;8–9
  14. Okun MS , Fernandez HH , Foote KD , Murphy TK , Goodman WK . Avoiding deep brain stimulation failures in Tourette syndrome . J Neurol Neurosurg Psychiatry . 2008;79:111–112
  15. Okun MS , Fernandez HH , Rodriguez RL , Foote KD . Identifying candidates for deep brain stimulation in Parkinson's disease: the role of the primary care physician . Geriatrics . 2007;62:18–24
  16. Pillon B . Neuropsychological assessment for management of patients with deep brain stimulation . Mov Disord . 2002;17(Suppl 3):S116–S122
  17. Rabins P, Appleby BS, Brandt J, DeLong MR, Dunn LB, Gabriels L, et al. Scientific and ethical issues related to deep brain stimulation for disorders of mood, behavior, and thought . Arch Gen Psychiatry . 2009;66:931–937
  18. Racine E , Waldman S , Palmour N , Risse D , Illes J . “Currents of hope”: neurostimulation techniques in U.S. and U.K. print media . Camb Q Healthc Ethics . 2007;16:312–316
  19. Resnick AS, Foote KD, Rodriguez RL, Malaty IA, Moll JL, Carden DL, et al. The number and nature of emergency department encounters in patients with deep brain stimulators . J Neurol . 2010;257:122–131
  20. Schechtman M . Philosophical reflections on narrative and deep brain stimulation . J Clin Ethics . 2010;21:133–139
  21. Schupbach WM , Agid Y . Psychosocial adjustment after deep brain stimulation in Parkinson's disease . Nat Clin Pract Neurol . 2008;4:58–59
  22. Siddiqui MS , Haq I , Okun MS . Deep brain stimulation in movement disorders . Continuum Lifelong Learning Neurol . 2010;16:110–130
  23. Silberstein P, Bittar RG, Boyle R, Cook R, Coyne T, O'Sullivan D, et al. Deep brain stimulation for Parkinson's disease: Australian referral guidelines . J Clin Neurosci . 2009;16:1001–1008
  24. Simpson CS, O'Neill BJ, Sholdice MM, Dorian P, Kerr CR, Ross DB, et al. Canadian Cardiovascular Society commentary on implantable cardioverter defibrillators in Canada: waiting times and access to care issues . Can J Cardiol . 2005;21:19A–24A
  25. Health human resources for neurosurgical services in Ontario Tepper J , Jaigobin C , Wang C . ICES investigative report . Toronto, ON: Institute for Evaluative Sciences; 2005;
  26. U.S. Department of Health E, and Welfare . Protection of human subjects (Use of psychosurgery in practice and research: report and recommendations of National Commission for the Protection of Human Subjects) . Fed Regist . 1977;42:26318–26332
  27. Woodrow SI , O'Kelly C , Hamstra SJ , Wallace MC . Unemployment in an underserviced specialty? (The need for co-ordinated workforce planning in Canadian neurosurgery) . Can J Neurol Sci . 2006;33:170–174

 Conflict of interest: This study was funded by the Canadian Institutes of Health Research, NNF 80045; States of Mind: Emerging Issues in Neuroethics (ER); New Investigator Award (ER); and Social Sciences and Humanities Research Council of Canada (EB).

PII: S1878-8750(11)00617-6

doi: 10.1016/j.wneu.2011.05.033

World Neurosurgery
Volume 76, Issue 6 , Pages 537-547 , December 2011

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