Egas Moniz (1874–1955) and the “invention” of modern psychosurgery: a historical and ethical reanalysis under special consideration of Portuguese original sources

Abstract

The Portuguese neurologist Egas Moniz (1874–1955) is often regarded as the founder of psychosurgery. He performed the first prefrontal leukotomy in 1935—about 75 years ago—with the help of neurosurgeon Almeida Lima (1903–1985). In contrast to the psychosurgical interventions performed by the Swiss psychiatrist Gottlieb Burckhardt (1836–1907), Moniz's interventions on the white brain substance caught great attention worldwide. As a matter of fact, it was this repercussion that led to the award of the Nobel Prize for Medicine in 1949, an award that is still highly controversial today.The goal of the present article is to reconstruct the historical background of the first leukotomies, the tangible expert debate since 1935 on the indication and legitimacy of these interventions, and their contemporary and recent (ethical) evaluation. Special focus will be set on the original Portuguese literature, which has been given too little attention thus far in the English-language literature.