Beyond Innovation: The Burdens and Harms of Maintenance in Deep Brain Stimulation

Abstract In this contribution, we explore iatrogenic harms associated with the maintenance of deep brain stimulation (DBS) systems. By conceptualizing patients with neural implants as infrastructures, we examine them as ongoing sites of maintenance that require continual care and adjustments. This analysis reveals the tradeoffs inherent in implantable neurotechnologies. Using first-hand accounts collected during a qualitative study of individuals with Parkinson’s disease treated with DBS, we subsequently develop a typology of harms associated with maintenance, highlighting the ethical issues arising from the integration of technology in the body. Importantly, by focusing on older DBS devices within a healthcare system constrained by financial resources, we address a gap in the literature, as current debates tend to prioritize innovation while neglecting the difficulties of maintaining older implanted systems. Our findings show how inadequate or faulty maintenance compromises the successful incorporation and integration of technological components within the body, underscoring the ethical significance of maintenance in the context of DBS. Finally, we emphasize the inherent limitations of implanted technologies in managing chronic illness and the enduring importance of caregivers. This study calls for a more comprehensive examination of the ethical implications of the maintenance in relation to neural implants.