Psychiatric neurosurgery and the Theory of Mind network: ethics in the suffering, refractory patient

Psychosurgery has evolved from imprecise lesional procedures to targeted stereotactic and neuromodulation interventions, with significant improvements in precision, safety, and ethical governance. Parallel advances in social neuroscience have mapped out the Theory of Mind (ToM) networks that support the attribution of mental states, empathy, and moral judgment. This article examines the historical progression of psychosurgery, links it to the neural correlates of ToM, and proposes a bioethical framework to mitigate risks to a patient's agency and personal identity.