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Lobotomy History and Ethics

Sep 18, 2025

Overview

The lecture discusses the history, practice, and ethical implications of the lobotomy procedure in psychiatry, focusing on its development and use in mid-20th-century medicine.

Origins of Lobotomy

  • Lobotomy was developed in the 1930s as a surgical treatment for severe mental illness.
  • Dr. AntĂłnio Egas Moniz first performed the procedure in Portugal, earning a Nobel Prize.
  • Dr. Walter Freeman popularized lobotomy in the United States.

The Procedure

  • Lobotomy involved cutting connections in the brain’s prefrontal cortex to alter behavior.
  • The “ice pick” transorbital method was introduced by Dr. Freeman as a quicker, simpler approach.
  • Thousands of patients with schizophrenia, depression, or other disorders underwent lobotomies, often without consent.

Rationale and Popularity

  • Lobotomy was initially seen as a last resort for untreatable psychiatric conditions.
  • At the time, alternatives like antipsychotic medications were not available.
  • The procedure gained rapid popularity in overcrowded asylums and hospitals.

Outcomes and Decline

  • Lobotomies often caused severe side effects, such as personality changes, apathy, and cognitive impairment.
  • Some patients were left permanently disabled or died from the operation.
  • The introduction of psychiatric drugs and growing ethical concerns led to the decline of lobotomy in the 1950s and 1960s.

Ethical Considerations

  • Lobotomies were frequently performed on vulnerable populations without proper consent.
  • The procedure is now regarded as an example of medical ethics failures and patient rights violations.

Key Terms & Definitions

  • Lobotomy — a surgical procedure severing brain connections to treat mental illness.
  • Prefrontal Cortex — brain region involved in decision-making and personality.
  • Transorbital Lobotomy — a version of lobotomy using an instrument inserted through the eye socket.
  • Informed Consent — patients’ right to understand and agree to medical procedures.

Action Items / Next Steps

  • Review ethical standards for medical treatments.
  • Read about modern psychiatric treatments and compare them with lobotomy practices.