Neuroethical evaluation of neuromodulation for stuttering: Implications for agency, identity, consent, and social...

Neuromodulation techniques are increasingly investigated as adjuncts to behavioral interventions for stuttering. While empirical studies have examined effects on speech fluency, little attention has been given to the ethical implications of directly modulating neural systems involved in communication. This review applied a neuroethical framework to evaluate how neuromodulation for stuttering may affect communicative agency, identity and authenticity, informed consent and vulnerability, and the social meaning of stuttering.

An integrative, conceptually guided review was conducted. Empirical studies of neuromodulation for developmental stuttering were identified through systematic database searches and analyzed alongside relevant neuroethics scholarship. Twenty neuromodulation studies were included. Ethical analysis was structured around four neuroethical domains.

Ethical analysis indicated that neuromodulation may both support and complicate communicative agency, introduce challenges related to attribution and authorship of speech, influence self-concept and authenticity, and create distinctive consent vulnerabilities shaped by stigma and expectation. At a broader level, brain-based framings of stuttering risk reinforcing normalization pressures and deficit-oriented narratives if not carefully contextualized.

The ethical significance of neuromodulation for stuttering extends beyond speech outcomes alone. Evaluation of these interventions should attend not only to efficacy, but also to their implications for agency, identity, informed consent under conditions of vulnerability, and social meaning.