Ethical and Clinical Considerations at the Intersection of Functional Neuroimaging and Disorders of Consciousness The Experts Weigh In

被引：10

作者：

Byram, Adrian C. ^{[1
]}

Lee, Grace ^{[2
]}

Owen, Adrian M. ^{[3
,4
]}

Ribary, Urs ^{[5
,6
]}

Stoessl, A. Jon ^{[7
,8
,9
,10
]}

Townson, Andrea ^{[11
,12
,13
]}

Illes, Judy ^{[7
,14
,15
,16
]}

机构：

[1] Univ British Columbia, Vancouver, BC, Canada

[2] Univ British Columbia, Dept Med, Div Neurobiol, Vancouver, BC, Canada

[3] Western Univ, Cognit Neurosci & Imaging, London, ON, Canada

[4] Western Univ, Dept Psychol, Brain & Mind Inst, London, ON, Canada

[5] Simon Fraser Univ, Cognit Neurosci, Burnaby, BC, Canada

[6] Simon Fraser Univ, Behav & Cognit Neurosci Inst, Burnaby, BC, Canada

[7] Univ British Columbia, Neurol, Vancouver, BC, Canada

[8] Univ British Columbia, Pacific Parkinsons Res Ctr, Vancouver, BC, Canada

[9] Univ British Columbia, Parkinsons, Vancouver, BC, Canada

[10] Univ British Columbia, Djavad Mowafaghian Ctr Brain Hlth, Vancouver, BC, Canada

[11] Univ British Columbia, Div Phys Med & Rehabil, Vancouver, BC, Canada

[12] GF Strong Rehabil Ctr, Vancouver, BC, Canada

[13] GF Strong Rehabil Ctr, Spinal Cord Injury Rehabil Evidence Project, Vancouver, BC, Canada

[14] Univ British Columbia, Neuroeth, Vancouver, BC, Canada

[15] Univ British Columbia, Natl Core Neuroeth, Vancouver, BC, Canada

[16] Int Neuroeth Soc, Bethesda, MD USA

来源：

CAMBRIDGE QUARTERLY OF HEALTHCARE ETHICS | 2016年 / 25卷 / 04期

基金：

加拿大创新基金会; 加拿大自然科学与工程研究理事会; 加拿大健康研究院;

关键词：

brain injury; covert consciousness; informed consent; legal capacity; neuroethics; neuroimaging; SEVERE BRAIN-INJURY; DETECTING AWARENESS; MORAL SIGNIFICANCE; CONSENT; ISSUES; STATE;

D O I：

10.1017/S0963180116000347

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

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.

引用

页码：613 / 622

页数：10

共 40 条

[1] Imagining a new era of neuroimaging, neuroethics, and neurolaw - Foreword [J].