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Neuroimaging for Disorders of Consciousness: Ethical Priorities in Research, Policy, and Translation

Published online by Cambridge University Press:  03 June 2015

AC Byram
Affiliation:
(Vancouver)
G Lee
Affiliation:
(Vancouver)
AM Owen
Affiliation:
(London)
U Ribrary
Affiliation:
(Burnaby)
J Stoessl
Affiliation:
(Vancouver)
A Towson
Affiliation:
(Vancouver)
J Illes
Affiliation:
(Vancouver)
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Abstract

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Background: Acquired brain injury is a critical health problem in Canada, placing greater demands on health resources as improvements in intensive care lead to more patients in long-term care. Clinical diagnosis of patients with disorders of consciousness remains difficult, but advances in neuroimaging research have the potential to reshape clinical management of such patients or provide unprecedented ways to communicate with them. Building on our earlier work, this study identifies ethically salient priorities for research and policy before translation of this promising technology. Methods: We interviewed 27 Canadian researchers, ethicists, lawyers, practitioners, allied health care professionals, and patient advocacy leaders, with expertise in neuroimaging or disorders of consciousness. Interviews were semi-structured and data were analyzed for emergent themes. Results: Participants were optimistic that neuroimaging could lead to improved clinical care. They discussed mitigating the risks of misinterpreting results and communication, creating guidelines for clinical use, and defining legal competence in this neuroimaging context as key ethical priorities for translation. Conclusions: The transition of neuroimaging techniques for disorders of consciousness from research to clinical care may yield substantial benefits to these patients, but first requires resolution of research, policy, and translational issues.

Type
CNS / CSCN Platform Presentations
Copyright
Copyright © The Canadian Journal of Neurological Sciences Inc. 2015