Short abstract:

This multilevel study examines the construction of eligible patients in neuroscience, focusing on the example of Deep Brain Stimulation therapy in Italy and Germany. We assert that regional regulations and stakeholders profoundly shape the definition of an eligible patient.

Long abstract:

Deep Brain Stimulation (DBS) is widely considered as a promising neurotechnology for treating various neurodegenerative diseases. However, it is simultaneously surrounded by controversies regarding its clinical application, stemming from historical predecessors such as lobotomy and evoking both sci-fi aspirations and fears. Consequently, DBS is subject to high level of regulation, with only specific patients eligible for the treatment. This study aim is to analyse the construction of eligibility for DBS Italy and Germany through three levels: the regulatory framework; healthcare predictionaries in settings, and patients’ associations. While guidelines may appear uniform at the European level, our exploration underscores the significance of regional organizational environments in the decision-making processes, as well as the importance of non-formal criteria for offering patients DBS. This results in varying patient profiles and expectations, promoting reflection on disparities in health justice within clinical neuroscience. Our data basis includes interviews, ethnographic field notes, and other relevant documents. We assert that regional regulations and stakeholder scope significantly influence the DBS utilization, thereby profoundly shaping the definition of an eligible patient.