Directors: Antonio M. Battro, Kurt W. Fischer and Fernando Vidal
Program officer: María Lourdes Majdalani
Neurotechnology-mediated communication: a new tool for personal rights of patients with disorders of consciousness?
The instrumental investigation of consciousness has witnessed an astonishing progress over the last years. Different neurotechnological tools and methods have been developed in order to assess residual consciousness in patients with Disorders of Consciousness (DOCs).
Notably, the identification of the activated areas and the real-time observation of the cerebral activity potentially allow a new form of technology-based communication without 1st person overt external behavior or speech, thus going beyond the behavioral manifestation of awareness.
As a result of these neuroscientific and neurotechnological developments, the ethically and legally relevant question arises: could a reliable and effective “cerebral” communication justify an assumption of a right to self-determination of these patients? Could it, for example, be justified to ask them for an informed consent to treatment? Do cerebrally communicating patients retain the same personal identity that they had before the disorder or are they reaching a new personal identity as consequence of the re-arrangement of their brain in connection with technology (i.e., BCI)? Is neurotechnology giving us new tools in order to respect the personal rights (i.e., informed consent and self-determination) of patients with DOCs?
To date the use of neurotechnology to communicate with patients with DOCs is still at the stage of proof of concepts, but the theoretical possibility and empirical results thus far achieved strongly urge a continued reflection about its possible clinical implementation. Particularly, the use of a cerebral communication with these patients to express an informed consent raises important theoretical and practical issues: the patient's effective ability to understand and process the provided information, her/his ability to integrate the provided information in order to make a coherent personal decision, her/his ability to emotionally feel the relevance of the possible clinical options.