Indications and ethical considerations of deep brain stimulation

Electrical impulses through chronically implanted electrodes in the human brain are used today in the relief of chronic crippling pain, motor movement disorders and behavior disturbances. A great number of reports from animal studies and several descriptions of the results produced by human stimulation seem to suggest that pain can often be adequately controlled. However, the perspectives of such methods raise many ethical problems and ask for caution. Nervous tissue damage after long-term stimulation, biochemical modifications, electrode migration and long-term follow-up of its clinical value are still under study and are the factors which might limit for the time being the indications. A restrictive role for this procedure is advocated for: 1. cases of chronic facial pain, 2. cases of chronic pain in other locations where other neurosurgical operations have failed and where the patient is not too young and is not suffering from pain of benign origin.