Ethics of neuroimaging after serious brain injury

ethics neuroimaging project

We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. Both the research team and research program are closely integrated with a CIHR funded project using functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to measure residual cognitive function in this patient population.


With 50,000 new cases occurring each year in Canada, serious brain injuries place an enormous burden on patients, families, and the healthcare system. Patient outcome after serious brain injury is highly variable. Following a period of coma (unconsciousness) lasting days or weeks, some patients make a good recovery, while others progress into a vegetative or minimally conscious state. As it is difficult to predict who will make a good recovery after serious brain injury, families and physicians are forced to make treatment decisions in the face of uncertainty. Further the diagnosis of vegetative and minimally conscious states is itself difficult, with error rates as high as 43%. Recent advances in neuroimaging allow for the detection of intact brain functions that cannot be found by routine bedside examination. Neuroimaging offers the prospect of improved prediction of patient outcome and increased diagnostic accuracy. Remarkably, in 3 cases, neuroimaging has been used to communicate with patients thought to be vegetative or minimally conscious. Neuroimaging after serious brain injury raises difficult ethical issues that must be addressed before it can be responsibly adopted in practice. Our research team brings together philosophers, neurologists, and neuroscientists to provide answers to these difficult problems.

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