In the 2015 David Kopf Lecture on Neuroethics of the Society for Neuroscience, Dr. Joseph Fins presents his work on neuroethics and disorders of consciousness through the experience of Maggie and Nancy Worthen, a young woman who sustained a severe brain injury and her mother who cared for her. The central protagonists in his book, Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness (Cambridge University Press, 2015), their experience is emblematic of the challenges faced by families touched by severe brain injury and the possibility for improved diagnosis and treatment offered by progress in neuroscience. By telling their story, and those of other families interviewed as part of the research for Rights Come to Mind, Fins calls for improved care for this population arguing that this is both an access to care issue and a civil and disability rights issue worthy of greater societal attention.

In Wallace’s short story “Luckily the Account Representative Knew CPR,” a vice president (VP) suffers cardiac arrest. As an account representative (AR) administers CPR, he discovers his own impersonality mirrored back to him by the VP—a disturbing vision of himself that the AR wishes to escape. Because modern moral theories would have the AR respond impersonally to the VP, those theories would only exacerbate his existential predicament. In contrast, by regarding the AR’s act as one that he, in particular, should perform, narrative ethics can discern a resolution for his predicament: because the AR still values his diminished capacities for care and spontaneity, this situation offers him an opportunity to revive those former traits. Doing so would give him greater authentic integrity, or narrative continuity with the most important aspects of his past. Authentic integrity can serve narrative ethics as a helpful starting point for understanding how the life stories of patients, clinicians, and others might appropriately unfold.