What do clinicians think about using deep brain stimulation to treat obsessive-compulsive disorder in pediatric patients?

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The 2022-2023 Bioethics Public Seminar Series continues next month with a webinar from Center Assistant Professor Michelle T. Pham, PhD, on “Clinician Perspectives on the Potential of DBS for Pediatric Patients with Treatment-Resistant OCD.” This virtual event is free to attend and open to all individuals.

Wednesday, February 15, 2023
1:30-2:30 PM EST (UTC−05:00)
Zoom webinar registration: bit.ly/bioethics-pham

The World Society for Stereotactic and Functional Neurosurgery has argued that at least two successful randomized controlled trials should be available before deep brain stimulation (DBS) treatment for a psychiatric disorder is considered “established.” DBS is currently offered to children ages 7 and older with refractory dystonia under an FDA-humanitarian device exemption. No randomized control trials were conducted – practitioners relied on evidence from DBS use in adults. In addition, accumulated research supports the safety and effectiveness of DBS for obsessive-compulsive disorder (OCD) in adults (Wu et al. 2021).

Approximately 10-20% of children with OCD have treatment-resistant presentations, so it is likely that there will be interest in offering DBS for some children (POTS 2004). Both ethical and empirical anticipatory work is needed to evaluate whether, and if so, under what conditions it might be appropriate to offer DBS in this context. This seminar will present qualitative data from semi-structured interviews with 24 clinicians with expertise in this area regarding: (a) acceptable levels of evidence to offer DBS in this patient population and (b) institutional policies or protocols needed to effectively provide care for them.

Michelle Pham with Spartan helmet graphic

Michelle T. Pham is an assistant professor in the Center for Bioethics and Social Justice and the Department of Medicine in the Michigan State University College of Human Medicine. She conducts research in the interdisciplinary field of Neuroethics and connected issues in the Philosophy of Science. Some recent topics include promoting post-trial care for patient-participants in experimental brain implant studies and decision-making in the context of pediatric deep brain stimulation. Pham also researches ways to promote engagement with patient-participants who contribute to neuroscience and neurotechnology research; and she has raised the concern that patient-participants in these brain implant studies may be exploited.

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Neuroethicist Michelle Pham joining Center faculty this fall

Michelle Pham photo

The Center for Bioethics and Social Justice at Michigan State University is excited to welcome new faculty member Michelle T. Pham, PhD, who starts in August. Pham specializes in philosophy of science, neuroethics, and social epistemology.

Most recently Pham was a postdoctoral research fellow in the Center for Bioethics at Harvard Medical School, where she collaborated on multiple NIH-funded neuroethics projects. One of her projects on post-trial care looks at the ways in which patient-participants with treatment-resistant conditions enrolled in experimental brain implant studies may not have continued access to these effective therapies or maintenance once these studies end. Another project looks at the ethical dimensions of deep brain stimulation for pediatric patients with dystonia, and potentially obsessive-compulsive disorder (OCD) in the near future.

Pham received her PhD in philosophy from University of Washington in 2020. Her research broadly seeks to examine and understand neurotechnology development and its relation to non-expert stakeholders, such as patients who participate in clinical trials.

Related: Welcoming two new faculty to the Center for Bioethics and Social Justice