Neuroimaging and Disorders of Consciousness: Envisioning an Ethical Research Agenda

Abstract

The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame to move these investigative techniques into mature clinical tools. This paper presents the recommendations and analysis of a Working Meeting on Ethics, Neuroimaging and Limited States of Consciousness held at Stanford University during June 2007. It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness.

Acknowledgment

The authors acknowledge the support of the Greenwall Foundation for sponsorship of the conference on which this paper is based. Dr. Fins is a recipient of a Robert Wood Johnson Foundation Investigator Award in Health Policy Research and also gratefully acknowledges support from the Charles A. Dana and Buster Foundations. Dr. Illes acknowledges the additional support of NIH/NINDS RO1 NS#045831. The meeting was hosted by the Stanford Center for Biomedical Ethics and Program in Neuroethics, Stanford University. Many thanks to Vivian Chin, Stanford University; Stephen Jones, Stanford University; Eugenie Marek, Stanford University; Navah Statman, National Alliance for Mental Illness, for attending; and Patricia Lau at the National Core for Neuroethics, University of British Columbia, for editorial assistance.

Cosigning Workshop Participants Martha J. Farah, University of Pennsylvania; Joseph T. Giacino, JFK Medical Center; Oleg Jardetsky, Stanford University; Albert R. Jonsen, California Pacific Medical Center; Maarten Lansberg, Stanford University; Sofia Lombera, Stanford University; David Magnus, Stanford University; Jennifer McCormick, Stanford University; Stephen J. Morse, University of Pennsylvania; Adrian M. Owen, Medical Research Council, UK; Eric Racine, Institut de Recherches Cliniques de Montréal, Montreal, Canada; Christine Wijman, Stanford University; Nicholas D. Schiff, Weill Cornell Medical College; William Winslade, University of Texas, Galveston.

Notes

∗Co-lead authors.

∗∗Equal authors in alphabetical order.