Advancing from Treatment to Enhancement in
Deep Brain Stimulation: A Question of Research Ethics

Paul J. Ford, PHD, The Cleveland Clinic Foundation

When considering the implications of medical enhancement, the process whereby an enhancement technology matures and develops plays a critical role in the end use, the knowledge gained, and the character of the technology. Since the influence of values appears in all aspects of a technology, the why and how of the development strongly dictates the technological implementation. In this way, ends and means both play important roles in the good development and application of enhancement technologies. Although current standard indications for deep brain stimulation (DBS) include debilitating movement disorders, such as end-stage Parkinson's, researchers continue to expand the range of applications. This expansion addresses less severe movement disorders as well as psychiatric disorders. Both types of application could lead to DBS being utilized to enhance "normal" function. These circumstances provide an important opportunity to reflect on challenges to social and individual understandings of obligations and good action along the spectrum of health and enhancement. In particular, the proper support and undertaking of DBS research should be carefully reflected upon.