NDLI: Threats to Neurosurgical Patients Posed by the Personal Identity Debate

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Review of Nada Gligorov: Neuroethics and the Scientific Revision of Common Sense : Dordrecht: Springer, 2016. 169 pp. USD $99.99 (hardcover), $79.99 (ebook)

Neuroethics : Volume 10, Issue 1, April 2017

Neuroethics : Volume 9

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Neuroethics : Volume 4

Neuroethics : Volume 3

Neuroethics : Volume 2

Neuroethics : Volume 1

Threats to Neurosurgical Patients Posed by the Personal Identity Debate

Content Provider	Springer Nature Link
Author	Müller, Sabine Bittlinger, Merlin Walter, Henrik
Copyright Year	2017
Abstract	Decisions about brain surgery pose existential challenges because they are often decisions about life or death, and sometimes about possible personality changes. Therefore they require rigorous neuroethical consideration. However, we doubt whether metaphysical interpretations of ambiguous statements of patients are useful for deriving ethical and legal conclusions. Particularly, we question the application of psychological theories of personal identity on neuroethical issues for several reasons. First, even the putative “standard view” on personal identity is contentious. Second, diverse accounts of personal identity have been introduced into the neuroethical debate, which are incompatible. Third, the criteria for “diagnosing” the supposed changes in “identity” are ambiguous and indeterminate. Fourth, the metaphysical theories of personal identity imply highly questionable ethical and legal revisions, namely the denial of advance directives, particularly of Ulysses contracts, and, for patients with brain cancer, even therapeutic nihilism.We discuss three examples in which ideas from the personal identity debate in metaphysics are straightforwardly applied to discuss ethical issues of neurosurgery. We discuss revisions of the current medico-legal practice that have been proposed on grounds of psychological theories of personal identity. We argue that the established status quo in law and clinical practice is beneficial to the patients concerned. Furthermore, it is metaphysically neutral, which is an important principle of liberal, democratic, pluralistic societies.We recommend a pragmatic approach: (1) empirical research on personality changes arising from brain disorders or interventions, (2) comprehensive information about risks of personality changes, and (3) advance directives, particularly Ulysses contracts.
Starting Page	299
Ending Page	310
Page Count	12
File Format	PDF
ISSN	18745490
Journal	Neuroethics
Volume Number	10
Issue Number	2
e-ISSN	18745504
Language	English
Publisher	Springer Netherlands
Publisher Date	2017-01-21
Publisher Place	Dordrecht
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Personal identity Narrative identity Personality change Deep brain stimulation Neuroethics Advance directives Ethics Neurology Neurobiology Neurosurgery Neuropsychology Neuroradiology
Content Type	Text
Resource Type	Article
Subject	Philosophy Neurology Health Policy Psychiatry and Mental Health

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