Contemporary Ethical Considerations in Psychiatric Neurosurgery.

Background: Psychiatric neurosurgery has been shaped by an ethically complex history and rapid evolution in neurotechnology. In the modern era, there is a growing need to match the accelerating pace of scientific innovation with rigorous, contemporary ethical frameworks that prioritize patient autonomy, safety, and maintaining public trust.

Summary: In this article, we review 21st-century approaches to neurosurgery for psychiatric disorders that combine the precision of modern functional neurosurgery with advances in diagnostic and therapeutic neurotechnology. The ethical issues in contemporary psychiatric neurosurgery are multifaceted and evolving, reflecting the intersection of rapid scientific progress, changing societal values, and a controversial past.

Key messages: The four core principles of medical ethics-beneficence, nonmaleficence, autonomy, and justice-and their application to psychiatric neurosurgery are discussed in the context of existing and anticipated ethical issues (e.g., post-trial responsibilities in research, informed consent, disparities in access to care). Finally, we explore how technological breakthroughs, coupled with growing market investment and consumer interest in the field, establish a compelling need to develop robust, forward-looking regulatory frameworks that are aligned with these bioethical principles.