“I Am Who I Am”: On the Perceived Threats to Personal Identity from Deep Brain Stimulation

This article explores the notion of the dislocated self following deep brain stimulation (DBS) and concludes that when personal identity is understood in dynamic, narrative, and relational terms, the claim that DBS is a threat to personal identity is deeply problematic. While DBS may result in profound changes in behaviour, mood and cognition (characteristics closely linked to personality), it is not helpful to characterize DBS as threatening to personal identity insofar as this claim is either false, misdirected or trivially true. The claim is false insofar as it misunderstands the dynamic nature of identity formation. The claim is misdirected at DBS insofar as the real threat to personal identity is the discriminatory attitudes of others towards persons with motor and other disabilities. The claim is trivially true insofar as any dramatic event or experience integrated into one’s identity-constituting narrative could then potentially be described as threatening. From the perspective of relational personal identity, when DBS dramatically disrupts the narrative flow, this disruption is best examined through the lens of agency. For illustrative purposes, the focus is on DBS for the treatment of Parkinson’s disease.

[1]  B. Nuttin,et al.  Ethical and Legal Aspects of Neuromodulation: on the Road to Guidelines , 2007, Neuromodulation : journal of the International Neuromodulation Society.

[2]  Cynthia Willett Theorizing multiculturalism : a guide to the current debate , 1998 .

[3]  E. Gisquet Cerebral implants and Parkinson's disease: a unique form of biographical disruption? , 2008, Social science & medicine.

[4]  Martin Garwicz,et al.  Authenticity, Depression, and Deep Brain Stimulation , 2011, Front. Integr. Neurosci..

[5]  M. Schechtman Philosophical Reflections on Narrative and Deep Brain Stimulation , 2010, The Journal of Clinical Ethics.

[6]  H. Longino,et al.  What Can She Know? Feminist Theory and the Construction of Knowledge , 1992 .

[7]  Y Agid,et al.  Neurosurgery in Parkinson disease , 2006, Neurology.

[8]  M. Schermer,et al.  Ethical Issues in Deep Brain Stimulation , 2011, Front. Integr. Neurosci..

[9]  K. Atkins,et al.  Practical identity and narrative agency , 2008 .

[10]  E. Foncke,et al.  Pathological gambling after bilateral subthalamic nucleus stimulation in Parkinson disease , 2006, Journal of Neurology, Neurosurgery & Psychiatry.

[11]  Markus Christen,et al.  Deep Brain Stimulation in Parkinsonian Patients—Ethical Evaluation of Cognitive, Affective, and Behavioral Sequelae , 2011 .

[12]  H. L. Nelson Damaged Identities, Narrative Repair , 2001 .

[13]  B. Bejjani,et al.  Neurosurgery in Parkinson disease: A distressed mind in a repaired body? , 2007, Neurology.

[14]  Catriona Mackenzie,et al.  Relational Autonomy: Feminist Perspectives on Automony, Agency, and the Social Self (review) , 2002 .

[15]  W. Glannon Stimulating brains, altering minds , 2009, Journal of Medical Ethics.

[16]  O. Suchowersky,et al.  Gambling and Parkinson disease. , 2006, Archives of neurology.

[17]  M. Walker,et al.  Moral Understandings: A Feminist Study in Ethics , 1997 .

[18]  Lorraine Code What Can She Know? Feminist Theory and the Construction of Knowledge , 1991 .

[19]  S. Sherwin The politics of women's health : exploring agency and autonomy , 1998 .

[20]  M. Staal,et al.  [Manipulation of mental competence: an ethical problem in case of electrical stimulation of the subthalamic nucleus for severe Parkinson's disease]. , 2004, Nederlands tijdschrift voor geneeskunde.

[21]  M Tagliati,et al.  Subthalamic deep brain stimulation and impulse control in Parkinson’s disease , 2009, European journal of neurology.

[22]  M. Schechtman The Constitution of Selves , 1996 .

[23]  V. Visser-Vandewalle,et al.  [Manipulation of mental competence: an ethical problem in case of electrical stimulation of the subthalamic nucleus for severe Parkinson's disease]. , 2004, Nederlands tijdschrift voor geneeskunde.

[24]  Catriona Mackenzie Introduction: Practical identity and narrative agency , 2008 .

[25]  Elizabeth V. Spelman Moral Understandings: A Feminist Study in Ethics , 1998 .

[26]  L. Alcoff Visible Identities: Race, Gender, and the Self , 2005 .