Table 3

Recommendations

Ethical issues	Recommendations
New form of disease and iatrogenic harms	Created better channels contributing to public understanding, in particular prospective patients, families or caregiver for informing them of risk of harms in late stages.
Informed consent	At the point of consenting, patient and family/caregiver should be made aware of their rights to stop treatment (for instance, not replacing battery). Given risks of impaired mental capacity in late PD stages, it should be required articulating advance directives prior to signing a DBS informed consent agreement.
End of life	With PD neurodegenerative trajectory still progresses to unexpected stages, palliative care should be supported and integrated into DBS practices
Caregiver burdens	Caregivers’ needs and experiences should be included in the treatment-related protocols