Consciousness Unbound: the ethics of neuroimaging after serious brain injury
Severe brain injury is a major cause of disability and death. In the hours and days after brain injury, families may be faced with the decision whether to continue life-sustaining therapy. Patients who survive may emerge into a vegetative or minimally conscious state in which they are incapable of meaningful communication.
Recent advances in neuroimaging cast a new light on behaviorally non-responsive patients after brain injury. Functional MRI is now being used in the research setting to map residual cognitive function in brain-injured patients, including the ability to process speech, comprehend language, and follow commands. In a few cases, neuroimaging has allowed for communication with otherwise unresponsive patients.
This research raises difficult ethical issues: Should research results be shared with families? What does neuroimaging data tell us about our moral obligations to brain-injured patients? Can it provide clues as to the quality of their lives? And can neuroimaging communication be used to give patient a voice in medical decision-making?
An innovative collaboration between neuroscientists and philosophers at Western University provides some answers to these vexing questions.