TY - JOUR
T1 - From psychosurgery to neuromodulation and palliation
T2 - History's lessons for the ethical conduct and regulation of neuropsychiatric research
AU - Fins, Joseph J.
N1 - Funding Information:
A physician and physiologist working in the Department of Psychiatry at Yale University, Delgado studied aggression in primates and then manipulated their response through the use of implantable electrodes, arguing that “a better understanding of the neurophysiological mechanisms responsible for aggressive and destructive reactions may provide man with greater capacity to educate and direct his own behavior” [59] . Delgado, some of whose work was funded by the United States Public Health Service, the Office of Naval Research, and the Department of the Air Force [60,61] , argued that society was on the cusp of a new era in which the human mind could influence its own evolution through the use of technology. Using notions of self-dominion, he envisioned an escape from the blind chance of normal evolution to one where man and technology would alter human history, ultimately leading to a “…future man with greater personal freedom and originality, a member of a psychocivilized society, happier, less destructive, and better balanced than present man” [54] .
PY - 2003/4/1
Y1 - 2003/4/1
N2 - As we contemplate the emerging era of neuromodulation and imagine the utility of deep brain stimulation for disease entities in neurology and psychiatry, our enthusiasm is immediately tempered by history. Just a generation ago, other confident investigators were heralding invasive somatic therapies like prefontal lobotomy to treat psychiatric illness. That era of psychosurgery ended with widespread condemnation, congressional calls for a ban, and a vow that history should never repeat itself. Now, just 30 years later, neurologists, neurosurgeons, and psychiatrists are implanting deep brain stimulators for the treatment of Parkinson's disease and contemplating their use for severe psychiatric illnesses, such as obsessive-compulsive disorder and the modulation of consciousness in traumatic brain injury.
AB - As we contemplate the emerging era of neuromodulation and imagine the utility of deep brain stimulation for disease entities in neurology and psychiatry, our enthusiasm is immediately tempered by history. Just a generation ago, other confident investigators were heralding invasive somatic therapies like prefontal lobotomy to treat psychiatric illness. That era of psychosurgery ended with widespread condemnation, congressional calls for a ban, and a vow that history should never repeat itself. Now, just 30 years later, neurologists, neurosurgeons, and psychiatrists are implanting deep brain stimulators for the treatment of Parkinson's disease and contemplating their use for severe psychiatric illnesses, such as obsessive-compulsive disorder and the modulation of consciousness in traumatic brain injury.
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U2 - 10.1016/S1042-3680(02)00118-3
DO - 10.1016/S1042-3680(02)00118-3
M3 - Review article
C2 - 12856496
AN - SCOPUS:0037399332
SN - 1042-3680
VL - 14
SP - 303
EP - 319
JO - Neurosurgery clinics of North America
JF - Neurosurgery clinics of North America
IS - 2
ER -