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      What does it mean to call a medical device invasive?

      research-article
      1 , 2 ,
      Medicine, Health Care, and Philosophy
      Springer Netherlands
      Medical device, Invasiveness, Normative, Bioethics, Technology

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          Abstract

          Medical devices are often referred to as being invasive or non-invasive. Though invasiveness is relevant, and central, to how devices are understood and regarded in medicine and bioethics, a consensus concept or definition of invasiveness is lacking. To begin to address this problem, this essay explores four possible descriptive meanings of invasiveness: how devices are introduced to the body, where they are located in the body, whether they are foreign to the body, and how they change the body. An argument is offered that invasiveness is not purely descriptive, but implicates normative concepts of danger, intrusion, and disruption. In light of this, a proposal is offered for how to understand use of the concept of invasiveness in discussions of medical devices.

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          Most cited references53

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          Hold your horses: impulsivity, deep brain stimulation, and medication in parkinsonism.

          Deep brain stimulation (DBS) of the subthalamic nucleus markedly improves the motor symptoms of Parkinson's disease, but causes cognitive side effects such as impulsivity. We showed that DBS selectively interferes with the normal ability to slow down when faced with decision conflict. While on DBS, patients actually sped up their decisions under high-conflict conditions. This form of impulsivity was not affected by dopaminergic medication status. Instead, medication impaired patients' ability to learn from negative decision outcomes. These findings implicate independent mechanisms leading to impulsivity in treated Parkinson's patients and were predicted by a single neurocomputational model of the basal ganglia.
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            Chronic illness as biographical disruption.

            M Bury (1982)
            The paper is based on semi-structured interviews with a series of rheumatoid arthritis patients. Chronic illness is conceptualised as a particular type of disruptive event. This disruption highlights the resources (cognitive and material) available to individuals, modes of explanation for pain and suffering, continuities and discontinuities between professional and lay thought, and sources of variation in experience.
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              Neurosurgery in Parkinson disease: a distressed mind in a repaired body?

              To prospectively evaluate the impact of subthalamic nucleus (STN) stimulation on social adjustment in patients with Parkinson disease (PD). Before and 18 to 24 months after bilateral STN stimulation, the authors assessed 29 patients with PD for motor disability, cognition (Mattis dementia rating scale, frontal score), psychiatric morbidity (Mini-5.0.0, MADRS, BAS), quality of life (PDQ-39), social adjustment (Social Adjustment Scale), and psychological status using unstructured in-depth interviews. Despite marked improvement in parkinsonian motor disability, the absence of significant changes in cognitive status, and improvement of activities of daily living and quality of life by the end of the study, social adjustment did not improve. Several kinds of problems with social adjustment were observed, affecting the patients' perception of themselves and their body, marital situation, and professional life. Marital conflicts occurred in 17/24 couples. Only 9 out of 16 patients who had a professional activity before the operation went back to work after surgery. After STN stimulation, patients experienced difficulties in their relations with themselves, their spouses, their families, and their socio-professional environment. The authors suggest a multidisciplinary psychosocial preparation and follow-up to help patients and their entourage cope with the sudden changes in their existence following successful neurosurgery.
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                Author and article information

                Contributors
                kleine@ohsu.edu
                Journal
                Med Health Care Philos
                Med Health Care Philos
                Medicine, Health Care, and Philosophy
                Springer Netherlands (Dordrecht )
                1386-7423
                1572-8633
                3 May 2023
                3 May 2023
                2023
                : 26
                : 3
                : 325-334
                Affiliations
                [1 ]GRID grid.5288.7, ISNI 0000 0000 9758 5690, Department of Neurology, , Oregon Health & Science University, ; 3181 SW Sam Jackson Park Road, L226, Portland, OR 97239-3098 United States of America
                [2 ]GRID grid.34477.33, ISNI 0000000122986657, Department of Philosophy, , University of Washington, ; Washington, United States of America
                Author information
                http://orcid.org/0000-0002-0132-5777
                Article
                10147
                10.1007/s11019-023-10147-x
                10425495
                37131099
                6bee4108-c098-439a-8a23-a690b2cd5152
                © The Author(s) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 21 March 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000025, National Institute of Mental Health;
                Award ID: RF1MH117800-01
                Award Recipient :
                Categories
                Scientific Contribution
                Custom metadata
                © Springer Nature B.V. 2023

                Medicine
                medical device,invasiveness,normative,bioethics,technology
                Medicine
                medical device, invasiveness, normative, bioethics, technology

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