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Ethical and Clinical Considerations at the Intersection of Functional Neuroimaging and Disorders of Consciousness

The Experts Weigh In

Published online by Cambridge University Press:  16 September 2016

ADRIAN C. BYRAM ,
GRACE LEE ,
ADRIAN M. OWEN ,
URS RIBARY ,
A. JON STOESSL ,
ANDREA TOWNSON  and
JUDY ILLES
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Abstract:

Recent neuroimaging research on disorders of consciousness provides direct evidence of covert consciousness otherwise not detected clinically in a subset of severely brain-injured patients. These findings have motivated strategic development of binary communication paradigms, from which researchers interpret voluntary modulations in brain activity to glean information about patients’ residual cognitive functions and emotions. The discovery of such responsiveness raises ethical and legal issues concerning the exercise of autonomy and capacity for decisionmaking on matters such as healthcare, involvement in research, and end of life. These advances have generated demands for access to the technology against a complex background of continued scientific advancement, questions about just allocation of healthcare resources, and unresolved legal issues. Interviews with professionals whose work is relevant to patients with disorders of consciousness reveal priorities concerning further basic research, legal and policy issues, and clinical considerations.

Keywords

brain injurycovert consciousnessinformed consentlegal capacityneuroethicsneuroimaging
Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 25 , Special Issue 4: Clinical Neuroethics , October 2016 , pp. 613 - 622
Copyright
Copyright © Cambridge University Press 2016 

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