Modulating Agency: the Moral & Aesthetic Import of Closed-Loop Deep-Brain Stimulation

Thesis (Ph.D.)--University of Washington, 2019Deep-Brain Stimulation (DBS) is an FDA-approved treatment for symptoms of motor disorders—with experimental use for psychiatric disorders. DBS, however, causes a variety of side effects. The next generation of DBS systems—Closed-Loop DBS (CL-DBS)—will be able to record users’ neural activity in real time and adjust stimulation in order to meet users’ needs or demands. Moral philosophers question DBS’s influence on users’ experiences of authenticity, identity, and autonomous agency. Many of characterizations of (CL-)DBS, however, may not make sense of how DBS complicates, rather than simply impedes or bolsters, users’ abilities to exercise agency. This dissertation is a collection of three papers that propose frameworks for understanding how DBS users form relationships with their implants in order to express agency, how DBS has an impact on the aesthetic dimensions of the experience of agency, and how CL-DBS may prove trustworthy for users without a number of safeguards