When deciding whether to offer deep brain stimulation earlier than usual for Parkinson disease, it is important to consider not only the patient’s autonomy but also the validity of the evidence and concepts of harm that are being used to form practice policies.
A consensus has emerged that the paternalism behind use of the provocative saline infusion test for nonepileptic seizures cannot be justified because the harms to the patient, the physician, and their relationship exceed the benefits.