Models of the patient-machine-clinician relationship in closed-loop machine neuromodulation

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Closed-loop neuromodulation represents an emerging area in clinical medicine. Neural devices capable of measuring brain function and using measurements to iteratively guide output, such as deep brain stimulation, will be a significant advance in neuromodulatory technology. The introduction of closed-loop devices, particularly “smart” machines, will require changes in clinical ethical practice. A model of the clinical relationship could be a useful tool for addressing ethical challenges arising in this new area. Traditional models of the clinical relationship, like Emanuel and Emanuel’s “four models,” are suited to current unidirectional forms of neuromodulation. An adequate model of the patientmachine- clinician relationship may need to move beyond traditional models. Thus, I explore three new models: the design model, the customer service model, and the quality monitoring model. The exploration of these models of the patientmachine- clinician relationship will benefit from keeping an Aristotelian ideal of friendship in mind.

Original languageEnglish (US)
Pages (from-to)273-290
Number of pages18
JournalIntelligent Systems, Control and Automation: Science and Engineering
Volume74
DOIs
StatePublished - 2015

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Closed-loop
Model
Brain
Relationships
Medicine
Customers
Monitoring
Output

ASJC Scopus subject areas

  • Computer Science Applications
  • Control and Systems Engineering
  • Mechanical Engineering
  • Control and Optimization

Cite this

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abstract = "Closed-loop neuromodulation represents an emerging area in clinical medicine. Neural devices capable of measuring brain function and using measurements to iteratively guide output, such as deep brain stimulation, will be a significant advance in neuromodulatory technology. The introduction of closed-loop devices, particularly “smart” machines, will require changes in clinical ethical practice. A model of the clinical relationship could be a useful tool for addressing ethical challenges arising in this new area. Traditional models of the clinical relationship, like Emanuel and Emanuel’s “four models,” are suited to current unidirectional forms of neuromodulation. An adequate model of the patientmachine- clinician relationship may need to move beyond traditional models. Thus, I explore three new models: the design model, the customer service model, and the quality monitoring model. The exploration of these models of the patientmachine- clinician relationship will benefit from keeping an Aristotelian ideal of friendship in mind.",
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