The ethical justifications for lobotomies in historical context and implications for clinical ethics practice
Thursday, October 12, 2023
8:15 AM – 9:30 AM ET
Location: Chasseur (Third Floor)
In the 1930’s, neuroscientist António Egas Moniz developed a revolutionary intervention, frontal leukotomy (lobotomy), to treat mental illness. While the intervention was met with skepticism by some, the lack of alternative treatments and overcrowding at mental institutions led many to welcome it. Lobotomies became widespread, and Moniz went on to win a Nobel Prize in 1949. But by the 1950’s, data emerged that lobotomies were not as successful as previously believed, and the concurrent development of psychotropic drugs led to the intervention’s demise. Today we look back at the lobotomy as a shameful part of medical history, but it was once supported by evidence and endorsed by prominent physicians. Considering this, if clinical ethicists (ethicists) were part of healthcare teams at the time, would they also have given their endorsement?
In this paper presentation, I apply two frameworks for ethical decision making ("Four-box method" and "The Ethics Workup") to explain the analysis and derived recommendations, from which I propose that an ethicist during that era would likely have made recommendations in favor of lobotomy. This case study highlights ethicists’ dependence on the expertise of other stakeholders. This dependence leaves ethical analysis vulnerable should expert opinion be incorrect. I conclude by arguing that ethicists and others who utilize their services should appreciate the scope and limitations of an ethicist’s recommendations; ethicists should therefore exercise caution in framing recommendations addressing controversial or innovative interventions.