Why neurosurgeons should care about ethics and why ethicists should care about neurosurgery

At the most recent Neuroethics Canada Seminar Series, Dr. Nir Lipsman discussed why neurosurgeons should care about ethics and why ethicists should care about neurosurgery.

Bio:
Nir Lipsman, MD, PhD, FRCSC is a neurosurgeon and scientist at Sunnybrook Health Sciences Centre and an Assistant Professor of Surgery at the University of Toronto. He completed his undergraduate degree at the University of Toronto followed by a medical degree at Queen’s University, and a neurosurgical residency at the University of Toronto. During his residency, Dr. Lipsman completed his PhD investigating novel neuromodulation strategies in patients with treatment-resistant psychiatric and neurologic conditions. He is currently the Director of Sunnybrook’s Harquail Center for Neuromodulation, and the Clinical Director of Sunnybrook’s Focused Ultrasound Centre of Excellence.

Psychosurgery – data please

There is an interesting news article in today’s Science about regulating psychosurgery in China – and calls by some to ease regulations that were put in place a in 2008 by the health ministry limiting “psychosurgery to refractory OCD, depression, and anxiety disorders”. The contentious issue is, of course, schizophrenia, a condition that is notoriously difficult to describe in reductionist neuronal terms. Nonetheless, some neurosurgeons have been lesioning the brains of such patients, and providing anecdotal evidence for improvement.

The entire enterprise would be less worrisome if there were a strong scientific theory on which it were based, but I will grant that it is possible to use psychosurgery to treat diseases that appear refractory by other means.  Nonetheless, it seems a bit cavalier to irreversibly eliminate even a tiny piece someone’s brain on the basis of anecdotal evidence. What is required is a well-designed clinical trial which formally tests the hypothesis that the treatment is effective. Anything less is, well, let’s just say sub-par.

Link to news article in Science