Deep brain stimulation and relational agency: Negotiating relationships

Timothy Brown (2019) invites us to think about the ways in which people who are being treated with deep brain stimulation (DBS) might come to interact with their devices. He suggests that a framework of relational agency can help us to understand both the benefits and the challenges of DBS because DBS systems are, while not full fellow agents, more than mere props; users must sometimes 'negotiate and collaborate with their stimulators' (148). We agree that it is important to develop conceptual frameworks that both do justice to the ways that individuals respond to using DBS and give them new ways to think about the device, their relationship to it, and its role in their lives. In this commentary, we consider three aspects of Brown's discussion of DBS and relational agency: (1) the importance of thinking critically about what it means to have a relationship with a DBS device; (2) how the development of 'closed loop' implants might change the kinds of relationships that are possible; and (3) the need to consider how an individual's relationship with their device is shaped by their relationship with others in their lives. We see ourselves as building on, or offering suggestions for further developing, Brown's important paper.