Parkinson’s disease and movement disorders: Historical and ethical perspectives

Abstract

Therapeutic interventions employed in the management of extrapyramidal movement disorders have the potential to modify behavior, mood, and personality by virtue of the fact that the basal ganglia and dopaminergic neural systems affected by these disorders are also intimately involved in cognitive, emotional, and behavioral processes. The ethical implications of this situation, however, have received widespread attention only in recent years. Despite the sometimes negative changes in behavior that may ensue, the indubitable liberating motor benefits of dopamine replacement therapy employed to treat Parkinson’s disease and the associated increase in personal freedom for the patient justify its employment. Neurotransplantation may in the future prove to be a useful approach that avoids such problems, but the current absence of a safe procedure militates against its use.