Theethicalissueswithdisorderofconsciousness(DOD)include:
A. The patients are unable to respond, therefore the assessment of their needs can only be approached by adopting a third person perspective.
B. DODs present a variety of ethical concerns. Most obvious is the lack of consent in any treatment decisions. Social issues arise from the enormous costs that are caused by people with DOD.
C. Defining death is an issue that comes with patients with severe traumatic brain injuries. The decision to withdraw life-sustaining care from these patients can be based on uncertain assessments about the individual's conscious awareness.
D. Case reports have shown that these patients in a persistent vegetative state can recover unexpectedly. This raises the ethical question about the premature termination of care by physicians.
Thebrain'sfunctionscanbeintentionallyintervenedforvariouspurposesusingdifferentapproaches,including:
A. physicalinterventions(e.g.electrostimulation & noninvasive transcranial stimulation methods)
B. pharmacologicalorpharmaceuticalinterventions(usingdrugsactingonthecentralnervoussystem)
C. surgicalinterventions
D. behavioralinterventions
Deep brain stimulation (DBS) is used to treat:
A. Parkinson's disease with severely impaired motor & cognitive function
B. obsessive compulsive disorder
C. treatment-resistant depression
D. Tourette's syndrome
Which of the following ethical arguments about pharmacological brain enhancement & cosmetic neuropharmacology are reasonable?
A. Cosmetic neuropharmacology, the use of drugs to improve cognition in normal healthy individuals, is highly controversial. Some case reports with the antidepressant Prozac indicated that patients seemed "better than well", & authors hypothesized that this effect might be observed in individuals not afflicted with psychiatric disorders. Following these case reports much controversy arose over the veracity & ethics of the cosmetic use of these antidepressants.
B. Opponents of cosmetic pharmacology believe that such drug usage is unethical & that the concept of cosmetic pharmacology is a manifestation of naive consumerism. Proponents, such as philosopher Arthur Caplan, state that it is an individual's (rather than government's, or physician's) right to determine whether to use a drug for cosmetic purposes.
C. Anjan Chatterjee, a neurologist at the University of Pennsylvania, has argued that Western medicine stands on the brink of a neuro-enhancement revolution in which people will be able to improve their memory & attention through pharmacological means.
D. Jacob Appel, a Brown University bioethicist, has raised concerns about the possibility of employers mandating such enhancement for their workers. The ethical concerns regarding pharmacological enhancement are not limited to Europe & North America, indeed, there is increasing attention given to cultural and regulatory contexts for this phenomenon, around the globe.
The ethical arguments about memory dampening may include:
A. While complete memory erasure is still an element of science-fiction, certain neurological drugs have been proven to dampen the strength & emotional association of a memory.
B. Propranolol, an FDA-approved drug, has been suggested to effectively dull the painful effects of traumatic memories if taken within 6 hours after the event occurs. This has begun the discussion of ethical implications, assuming the technology for memory erasure will only improve. Originally, propranolol was reserved for hypertension patients. However, doctors are permitted to use the drug for off-label purposes—leading to the question of whether they actually should.
C. There are numerous reasons for skepticism; for one, it may prevent us from coming to terms with traumatic experiences, it may tamper with our identities & lead us to an artificial sense of happiness, demean the genuineness of human life, and/or encourage some to forget memories they are morally obligated to keep.
D. Whether or not it is ethical to fully or partially erase the memory of a patient, it is certainly becoming a more relevant topic as this technology improves in our society.
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