Abstract |
This paper investigates the question whether it is ethically justified to treat Parkinsonian patients with known or suspected pedophilia with deep brain stimulation - given increasing evidence that this treatment might cause impulse control disorders, disinhibition, and hypersexuality. This specific question is not as exotic as it looks at a first glance. First, the same issue is raised for all other types of sexual orientation or behavior which imply a high risk for harming other persons, e.g. sexual sadism. Second, there are also several ( psychotropic) drugs as well as legal and illegal leisure drugs which bear severe risks for other persons. We show that Beauchamp and Childress' biomedical ethics fails to derive a veto against medical interventions which produce risks for third persons by making the patients dangerous to others. Therefore, our case discussion reveals a blind spot of the ethics of principles. Although the first intuition might be to forbid the application of deep brain stimulation to pedophilic patients, we argue against such a simple way out, since in some patients the reduction of dopaminergic drugs allowed by deep brain stimulation of the nucleus subthalamicus improves impulsive control disorders, including hypersexuality. Therefore, we propose a strategy consisting of three steps: (1) risk assessment, (2) shared decision-making, and (3) risk management and safeguards.
|
Authors | Sabine Müller, Henrik Walter, Markus Christen |
Journal | International journal of law and psychiatry
(Int J Law Psychiatry)
2014 May-Jun
Vol. 37
Issue 3
Pg. 295-303
ISSN: 1873-6386 [Electronic] Netherlands |
PMID | 24289863
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
|
Copyright | Copyright © 2013 Elsevier Ltd. All rights reserved. |
Topics |
- Child Abuse, Sexual
- Child, Preschool
- Deep Brain Stimulation
(ethics, psychology)
- Humans
- Male
- Parkinson Disease
(psychology, therapy)
- Pedophilia
- Risk Assessment
- Sexual Behavior
|