Alive inside

Bioethics. 2020 Mar;34(3):295-305. doi: 10.1111/bioe.12678. Epub 2019 Oct 2.

Abstract

This article provides an ethical analysis of the U.S. practice guideline update on disorders of consciousness. Our analysis focuses on the guideline's recommendations regarding the use of investigational neuroimaging methods to assess brain-injured patients. Complex and multifaceted ethical issues have emerged because these methods alter the clinical understanding of consciousness. We address issues of false hope, patient suffering, and cost. We argue that, in spite of these concerns, there is significant benefit to using neuroimaging to assess brain-injured patients in most cases.

Keywords: consciousness; disorders of consciousness; minimally conscious state; neuroethics; neuroimaging; neurology; vegetative state.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Injury, Chronic / diagnostic imaging*
  • Consciousness / ethics
  • Consciousness Disorders / diagnostic imaging*
  • Cost-Benefit Analysis / ethics
  • Humans
  • Male
  • Moral Status
  • Neuroimaging / ethics*
  • Practice Guidelines as Topic*
  • Quality of Life
  • Therapies, Investigational / ethics*
  • United States