The wonder evoked by the term “brain surgery” is well-deserved, but technological advances are expanding the scope and reach of neurosurgery, challenging the line between treatment and enhancement. The January issue of the AMA’s online ethics journal considers this issue from a variety of angles.
Neurosurgery is among the newest of surgical disciplines, and among the most fraught with ethical dilemma. Neurosurgical ethics involves the challenges of manipulating the anatomical center of human identity and the concerns of surgeons and patients who find themselves bound together in that venture.
Contributors to this month’s issue of Virtual Mentor explore current and possible neurosurgical interventions and offer guidance for decision-making under conditions of clinical and ethical uncertainty.
Articles in this issue include:
- “Risk perception, bias and the role of the patient-doctor relationship in decision-making about cerebral aneurysm surgery.” In this commentary, author Michael L. Kelly, MD, writes that treatment decisions in high-risk situations require a dynamic relationship between doctor and patient in which patient preferences and clinician recommendations contribute equally in shaping a final treatment decision.
- “A preparatory neuroethical approach to assessing developments in neurotechnology.” Author James Giordano, PhD, writes that the pace at which neurotechnological developments are being translated into clinical applications calls for a preparatory neuroethical model that can plot the benefits, burdens and risks of neurosurgery as a step toward minimizing risks and maximizing benefits.
- “Applying guidelines to individual patients: Deep brain stimulation for early-stage Parkinson’s disease.” A commentary by Bryn Esplin, JD, Andre G. Machado, MD, PhD, Paul J. Ford, PhD, and a separate commentary by Kara Beasley, DO, argue that deep brain stimulation surgery is appropriate when the needs and expected benefits outweigh the risks for a well-informed patient.