Disclosing Results of Tests for Covert Consciousness: A Framework for Ethical Translation.
Michael J YoungKarnig KazazianDavid FischerIndia A LissakYelena G BodienBrian L EdlowPublished in: Neurocritical care (2024)
The advent of neurotechnologies including advanced functional magnetic resonance imaging and electroencephalography to detect states of awareness not detectable by traditional bedside neurobehavioral techniques (i.e., covert consciousness) promises to transform neuroscience research and clinical practice for patients with brain injury. As these interventions progress from research tools into actionable, guideline-endorsed clinical tests, ethical guidance for clinicians on how to responsibly communicate the sensitive results they yield is crucial yet remains underdeveloped. Drawing on insights from empirical and theoretical neuroethics research and our clinical experience with advanced neurotechnologies to detect consciousness in behaviorally unresponsive patients, we critically evaluate ethical promises and perils associated with disclosing the results of clinical covert consciousness assessments and describe a semistructured approach to responsible data sharing to mitigate potential risks.
Keyphrases
- brain injury
- magnetic resonance imaging
- end stage renal disease
- subarachnoid hemorrhage
- clinical practice
- ejection fraction
- decision making
- chronic kidney disease
- newly diagnosed
- human health
- prognostic factors
- peritoneal dialysis
- healthcare
- risk assessment
- cerebral ischemia
- computed tomography
- magnetic resonance
- electronic health record
- palliative care
- social media
- big data
- health information
- artificial intelligence
- patient reported outcomes
- blood brain barrier
- climate change