Ethical and clinical considerations at the intersection of functional neuroimaging and disorders of consciousness

Authors

Adrian C. Byram, The University of British Columbia
Grace Lee, The University of British Columbia
Adrian M. Owen, Western University
Urs Ribary, Simon Fraser University
A. Jon Stoessl, The University of British Columbia
Andrea Townson, The University of British Columbia
Judy Illes, The University of British Columbia

Document Type

Article

Publication Date

10-1-2016

Journal

Cambridge Quarterly of Healthcare Ethics

First Page

613

Last Page

622

URL with Digital Object Identifier

10.1017/S0963180116000347

Abstract

© Cambridge University Press 2016. 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.