Deep Brain Stimulation (DBS) involves the surgical implantation of electrodes into the brain that, as the name indicates, stimulate the brain. The procedure is used to treat movement disorders and Tourette’s syndrome. It can also be used to treat neuropsychiatric disorders (such as PTSD).
From a moral standpoint, the use of DBS in treating such conditions is no more problematic than using surgery to repair a broken bone. If these were the only applications for DBS, then there would be no real moral concerns about the process. However, as is sometimes the case in medicine, there are potential applications that do raise moral concerns.
One matter for concern has been a philosophical problem for some time. To be specific, DBS can be used to stimulate the nucleus accumbens (a part of the brain associated with pleasure). While this can be used to treat depression, it can also (obviously) be used to create pleasure directly. Some might see it as a version of the infamous pleasure machine scenario of so many Ethics 101 classes. This is a technological upgrade to the classic pig objection most famously considered by J.S. Mill in his work on Utilitarianism. Thanks to these stock discussions, the ethical ground of pleasure implants is well covered (although, as always, there are no truly decisive arguments).
While the sci-fi/philosophy scenario of people in pleasure comas is interesting, what is more interesting is the ethics of DBS as a life-enhancer. That is, getting the implant not to use to excess or in place of “real” pleasure, but to make life a bit better. To use the obvious analogy, the excessive scenario is like drinking oneself into a stupor, while the life-upgrade would be like having a drink with dinner. On the face of it, it would be hard to object if the effect was simply to make a person feel a bit better about life—and it could even be argued that this would be preventative medicine. Just as person might be on medication to keep from developing high blood pressure or exercise to ward off diabetes, a person might get a brain boost to ward off potential depression. That said, there is a concern about abusing the technology (and the iron law of technology states that any technology that can be abused, will be abused).
Another area of concern is the use of DBS for enhancements. For example, if DBS can improve memory in Alzheimer’s patients, then perhaps it could do the same for healthy people. It is not difficult to imagine people seeking to boost their memory or other abilities through such technology. This, of course, is part of the broader topic of brain enhancements (which is part of the even more general topic of enhancements). As David Noonan has noted, DBS might become analogous to cosmetic or plastic surgery: what was once intended to treat serious injuries has also become an elective enhancement surgery. Just as people seek to enhance their appearance by surgery, it seems reasonable to believe that they might do so to enhance their mental abilities.
From a moral standpoint, there is the same concern that has long held about cosmetic surgery, namely the risk of harm when seeking enhancement. However, if enhancing one’s looks via surgery is morally acceptable, then enhancing one’s mood, memory and so on would be acceptable as well. In fact, it could be argued that such substantial improvements are more laudable than merely improving appearance.
There is also the stock moral concern with fairness: those who can afford such enhancements will have yet another advantage over those less well off, thus widening the chasm. This is a legitimate concern. But, aside from the nature of the specific advantage, nothing new morally. If it is acceptable for the wealthy to buy advantages in other ways, this should not be a special exception.
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