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Tijdschrift voor Psychiatrie 59 (2017) 10, 662 - 666

Short report

Ethical issues relating to deep brain stimulation for psychiatric disorders

A.F.G. Leentjens, D. Horstkötter, G. de Wert

background Deep brain stimulation (dbs) can improve the quality of life of patients with therapy-resistant obsessive compulsive disorder (ocd). For other psychiatric indications, dbs should still be regarded as an experimental treatment.
aim To discuss potential ethical issues associated with the use of dbs in the treatment of psychiatric disorders.
method Ethical discourse.
results The ethical issues associated with the use of dbs to treat psychiatric disorders are no different from those that may arise during psychotherapeutic or pharmacological treatments. However, in view of the intensive and invasive nature of dbs, special attention should be given to establishing the indication for dbs treatment and discussions about the continuation or cessation of dbs in case of side-effects or lack of effect. Except in the case of ocd, dbs in psychiatry is provided mainly in a research context in which ethical questions, such as those relating to competence, need to be carefully considered.
conclusion The basic ethical principles in medicine generally provide an adequate basis for guiding clinical decisions relating to the use of dbs in the treatment of psychiatric disorders. However, as dbs treatment for psychiatric disorders continues to develop, proactive reflection on ethical issues is warranted.

keywords deep brain stimulation, ethics, obsessive compulsive disorder