So-called psychosurgery, in which psychiatric disorders are treated by neurosurgery, for example, by cutting connections in the brain, may have a somewhat tarnished reputation after the insensitive use of lobotomy in the 20th century to treat anxiety and depression. Nevertheless, neurosurgery for psychiatric disorders can help some patients and the area develops rapidly. The field probably needs an updated regulation, but what are the challenges?
The issue is examined from an international perspective in an article in Frontiers in Human Neuroscience. Neurosurgery for psychiatric disorders does not have to involve destroying brain tissue or cutting connections. In so-called deep brain stimulation, for example, electrical pulses are sent to certain areas of the brain. The method has been shown to relieve movement disorders in patients with Parkinson’s disease. This unexpected possibility illustrates one of the challenges. How do we delimit which treatments the regulation should cover in an area with rapid scientific and technical development?
The article charts legislation on neurosurgery for psychiatric disorders from around the world. The purpose is to find strengths and weaknesses in the various legislations. The survey hopes to justify reasonable ways of dealing with the challenges in the future, while achieving greater international harmonisation. The challenges are, as I said, several, but regarding the challenge of delimiting the treatments to be covered in the regulation, the legislation in Scotland is mentioned as an example. It does not provide an exhaustive list of treatments that are to be covered by the regulation, but states that treatments other than those listed may also be covered.
If you are interested in law and want a more detailed picture of the questions that need to be answered for a good regulation of the field, read the article: International Legal Approaches to Neurosurgery for Psychiatric Disorders.
Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.
Chandler JA, Cabrera LY, Doshi P, Fecteau S, Fins JJ, Guinjoan S, Hamani C, Herrera-Ferrá K, Honey CM, Illes J, Kopell BH, Lipsman N, McDonald PJ, Mayberg HS, Nadler R, Nuttin B, Oliveira-Maia AJ, Rangel C, Ribeiro R, Salles A and Wu H (2021) International Legal Approaches to Neurosurgery for Psychiatric Disorders. Front. Hum. Neurosci. 14:588458. doi: 10.3389/fnhum.2020.588458
Thinking about law