The ethics of neuromodulation for anorexia nervosa: a focus on rTMS
Identifieur interne : 000070 ( Main/Exploration ); précédent : 000069; suivant : 000071The ethics of neuromodulation for anorexia nervosa: a focus on rTMS
Auteurs : Alina Coman [Norvège] ; Finn Sk Rderud [Norvège] ; Deborah L. Reas [Norvège] ; Bj Rn M. Hofmann [Norvège]Source :
- Journal of Eating Disorders [ 2050-2974 ] ; 2014.
Abstract
Recently there has been emerging clinical and research interest in the application of deep brain stimulation (DBS) and repetitive transcranial magnetic stimulation (rTMS) to the treatment of anorexia nervosa (AN). To our knowledge, few studies have discussed ethical aspects associated with the increased use of neuromodulation in AN, some of which are quite specific to AN, despite the rapid development and dissemination of these new technologies.
We provide a brief overview of three published rTMS studies for AN and discuss ethical issues involved in the use of neuromodulation for AN.
In contrast to neurosurgery or DBS, rTMS is a less invasive technique, with less associated risk, and thus has greater potential to become a more widespread augmentation or add-on therapy for AN. New therapeutic procedures are promising, yet they raise ethical questions regarding informed consent and patient selection. Illness-specific issues surrounding authenticity and autonomy are important to consider, ensuring an ethical approach to treatment for patients with AN.
We argue that ethical investigations for neuromodulation techniques are timely and important, and discussions should go beyond the immediate goals of patient safety, consent, and risk and benefit, to consider broader ethical concepts such as authenticity and autonomy.
Url:
DOI: 10.1186/2050-2974-2-10
PubMed: 24690315
PubMed Central: 3977899
Affiliations:
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Box 1130, Blindern, Oslo N-0318, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Centre for Medical Ethics, University of Oslo, P.O. Box 1130, Blindern, Oslo N-0318</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Sk Rderud, Finn" sort="Sk Rderud, Finn" uniqKey="Sk Rderud F" first="Finn" last="Sk Rderud">Finn Sk Rderud</name><affiliation wicri:level="1"><nlm:aff id="I1">Regional Eating Disorders Service (RASP), Division of Mental Health and Addiction, Oslo University Hospital-Ullevål, P.O. Box 4956 Nydalen, Oslo N-0424, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Regional Eating Disorders Service (RASP), Division of Mental Health and Addiction, Oslo University Hospital-Ullevål, P.O. 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Box 4956 Nydalen, Oslo N-0424, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Regional Eating Disorders Service (RASP), Division of Mental Health and Addiction, Oslo University Hospital-Ullevål, P.O. Box 4956 Nydalen, Oslo N-0424</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Hofmann, Bj Rn M" sort="Hofmann, Bj Rn M" uniqKey="Hofmann B" first="Bj Rn M" last="Hofmann">Bj Rn M. Hofmann</name><affiliation wicri:level="1"><nlm:aff id="I2">Centre for Medical Ethics, University of Oslo, P.O. Box 1130, Blindern, Oslo N-0318, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Centre for Medical Ethics, University of Oslo, P.O. 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Box 4956 Nydalen, Oslo N-0424, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Regional Eating Disorders Service (RASP), Division of Mental Health and Addiction, Oslo University Hospital-Ullevål, P.O. Box 4956 Nydalen, Oslo N-0424</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Centre for Medical Ethics, University of Oslo, P.O. Box 1130, Blindern, Oslo N-0318, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Centre for Medical Ethics, University of Oslo, P.O. Box 1130, Blindern, Oslo N-0318</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Sk Rderud, Finn" sort="Sk Rderud, Finn" uniqKey="Sk Rderud F" first="Finn" last="Sk Rderud">Finn Sk Rderud</name><affiliation wicri:level="1"><nlm:aff id="I1">Regional Eating Disorders Service (RASP), Division of Mental Health and Addiction, Oslo University Hospital-Ullevål, P.O. Box 4956 Nydalen, Oslo N-0424, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Regional Eating Disorders Service (RASP), Division of Mental Health and Addiction, Oslo University Hospital-Ullevål, P.O. Box 4956 Nydalen, Oslo N-0424</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Institute of Special Needs Education, University of Oslo, Sognsveien 250, Oslo N-0863, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Institute of Special Needs Education, University of Oslo, Sognsveien 250, Oslo N-0863</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Reas, Deborah L" sort="Reas, Deborah L" uniqKey="Reas D" first="Deborah L" last="Reas">Deborah L. Reas</name><affiliation wicri:level="1"><nlm:aff id="I1">Regional Eating Disorders Service (RASP), Division of Mental Health and Addiction, Oslo University Hospital-Ullevål, P.O. Box 4956 Nydalen, Oslo N-0424, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Regional Eating Disorders Service (RASP), Division of Mental Health and Addiction, Oslo University Hospital-Ullevål, P.O. Box 4956 Nydalen, Oslo N-0424</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Hofmann, Bj Rn M" sort="Hofmann, Bj Rn M" uniqKey="Hofmann B" first="Bj Rn M" last="Hofmann">Bj Rn M. Hofmann</name><affiliation wicri:level="1"><nlm:aff id="I2">Centre for Medical Ethics, University of Oslo, P.O. Box 1130, Blindern, Oslo N-0318, Norway</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Centre for Medical Ethics, University of Oslo, P.O. Box 1130, Blindern, Oslo N-0318</wicri:regionArea><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author></analytic><series><title level="j">Journal of Eating Disorders</title><idno type="eISSN">2050-2974</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>Recently there has been emerging clinical and research interest in the application of deep brain stimulation (DBS) and repetitive transcranial magnetic stimulation (rTMS) to the treatment of anorexia nervosa (AN). To our knowledge, few studies have discussed ethical aspects associated with the increased use of neuromodulation in AN, some of which are quite specific to AN, despite the rapid development and dissemination of these new technologies.</p></sec><sec><title>Method</title><p>We provide a brief overview of three published rTMS studies for AN and discuss ethical issues involved in the use of neuromodulation for AN.</p></sec><sec><title>Results</title><p>In contrast to neurosurgery or DBS, rTMS is a less invasive technique, with less associated risk, and thus has greater potential to become a more widespread augmentation or add-on therapy for AN. New therapeutic procedures are promising, yet they raise ethical questions regarding informed consent and patient selection. Illness-specific issues surrounding authenticity and autonomy are important to consider, ensuring an ethical approach to treatment for patients with AN.</p></sec><sec><title>Discussion</title><p>We argue that ethical investigations for neuromodulation techniques are timely and important, and discussions should go beyond the immediate goals of patient safety, consent, and risk and benefit, to consider broader ethical concepts such as authenticity and autonomy.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Insel, T" uniqKey="Insel T">T Insel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pietrini, F" uniqKey="Pietrini F">F Pietrini</name></author><author><name sortKey="Castellini, G" uniqKey="Castellini G">G Castellini</name></author><author><name sortKey="Ricca, V" uniqKey="Ricca V">V Ricca</name></author><author><name sortKey="Polito, C" uniqKey="Polito C">C 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Fonagy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Easter, Mm" uniqKey="Easter M">MM Easter</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Coman, A" uniqKey="Coman A">A Coman</name></author><author><name sortKey="Sk Rderud, F" uniqKey="Sk Rderud F">F Skårderud</name></author><author><name sortKey="Hofmann, Bm" uniqKey="Hofmann B">BM Hofmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schermer, M" uniqKey="Schermer M">M Schermer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="O Onnor, C" uniqKey="O Onnor C">C O’Connor</name></author><author><name sortKey="Rees, G" uniqKey="Rees G">G Rees</name></author><author><name sortKey="Joffe, H" uniqKey="Joffe H">H Joffe</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pickersgill, M" uniqKey="Pickersgill M">M Pickersgill</name></author><author><name sortKey="Cunningham Burley, S" uniqKey="Cunningham Burley S">S Cunningham-burley</name></author><author><name sortKey="Martin, P" uniqKey="Martin P">P Martin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Beauchamp, Tl" uniqKey="Beauchamp T">TL Beauchamp</name></author><author><name sortKey="Childress, Jf" uniqKey="Childress J">JF Childress</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Habermas, J" uniqKey="Habermas J">J Habermas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Daniels, N" uniqKey="Daniels N">N Daniels</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Daniels, N" uniqKey="Daniels N">N Daniels</name></author><author><name sortKey="Sabin, Je" uniqKey="Sabin J">JE Sabin</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Norvège</li></country><region><li>Østlandet</li></region><settlement><li>Oslo</li></settlement></list><tree><country name="Norvège"><region name="Østlandet"><name sortKey="Coman, Alina" sort="Coman, Alina" uniqKey="Coman A" first="Alina" last="Coman">Alina Coman</name></region><name sortKey="Coman, Alina" sort="Coman, Alina" uniqKey="Coman A" first="Alina" last="Coman">Alina Coman</name><name sortKey="Hofmann, Bj Rn M" sort="Hofmann, Bj Rn M" uniqKey="Hofmann B" first="Bj Rn M" last="Hofmann">Bj Rn M. Hofmann</name><name sortKey="Reas, Deborah L" sort="Reas, Deborah L" uniqKey="Reas D" first="Deborah L" last="Reas">Deborah L. Reas</name><name sortKey="Sk Rderud, Finn" sort="Sk Rderud, Finn" uniqKey="Sk Rderud F" first="Finn" last="Sk Rderud">Finn Sk Rderud</name><name sortKey="Sk Rderud, Finn" sort="Sk Rderud, Finn" uniqKey="Sk Rderud F" first="Finn" last="Sk Rderud">Finn Sk Rderud</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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