The Research Of The Problems Related To The Brain Ablative Surgery For Treating Addiction In The Hodegetics Field

Drug addiction, a chronic relapsing brain disorder which brings a serious problems to people health and society, is a progressing and fatal behavioral syndrome. It is characterized by compulsive drug-taking and drug-seeking behaviors despite negative consequences. Drug addiction is a very serious social problem, which will destroy their body and mind and consequently ruin their family and affect social stability. So it is very important to get an effective method to treat this disease. Currently, the treatments for drug addiction at home and abroad mostly consist of three related steps, known as detoxification, relapse prevention and social reintegration. Even if most of the therapies show satisfied efficacy for detoxification, the neuropsychological dependence as an important mechanism to prevent the relapse haven't been solved yet. The previous researches on the mechanisms of the addiction confirmed that activation of the mesocorticolimbic reward circuit is the fundamental neurobiological process to mediate drug addiction. Based on this theory, department of neurosurgery of Tangdu Hospital firstly treated the opiate addiction by ablating the nucleus accumbens which is the pivotal structure of the reward circuit, and succeeded to decrease the relapse rate to 40%. However, the stereotactic brain ablative neurosurgery is an irreversible and destructive surgery, which would also damage other normal brain tissue and function, and the therapeutic effect totally lies on the lesion during the operation. Therefore, it is a still widespread controversy practice from academia and public due to its potential risk. With lots of literature reviewed, the present study explore a serious of social and ethical problems triggered by brain ablative neurosurgery for treating addiction, such as:safety problems, whether the surgery can be used for clinical service, the independent rights of the patients, the surgery-related social and ethical problems about dignity of the individual patients, the relationship between the technique and ethics about the surgery, individual and social value, and conflict of benefits about the surgery. The article deeply analysis these problems and get several ethical principles needed to be followed during the surgery:the principle of knowing the truth, the principle of executive, the principle of following up, the principle of nocommercialization, the principle of priority of patients'profits and the principle of check up by ethic committee. According to analysis of the surgery related social and ethical problems and formulating of the related ethical principles, the study finally provided the key points for the standard development of brain ablative addiction treating surgery from the prospective of social ethics, i.e. strictly follow the medical ethical principle during the clinical trial, strengthen access rules for the brain ablative surgery for treating addiction, enforce the preclinical and clinical research on the addiction treatment in many ways and transit from the experience medicine to evidence based medicine. Aimed at constructing the related ethical principles for the drug addiction treatment by the brain ablative neurosurgery and ensuring the clients' rights and benefits, the present study means a lot for getting the ethical rules for the research on drug addiction treating surgery and building the harmonious society.