Abstract Details

Title Ethically Translating Novel Neurotechnologies for Detecting Covert Consciousness: Clinician Perspectives from an Interim Analysis of the DECODE Study

Topic Practice, Policy, and Ethics

Presentation(s) S11 - Practice, Policy, and Ethics (12:03 PM-12:15 PM)

Poster/Presentation
Number 005

Objective To develop an ethical framework for responsible clinical translation of novel neurotechnologies to detect covert consciousness in patients following severe brain injury.

Background

Up to 20% of behaviorally unresponsive patients following severe brain injury may harbor covert awareness that evades detection via bedside examination, but which may be identified through advanced neurotechnologies including task-based or stimulus-based EEG and functional MRI. However, questions surrounding how to optimally deploy these neurotechnologies, communicate results, and translate findings into clinical practice are crucially underexplored.

Design/Methods Semi-structured interviews with 14 clinicians were conducted as part of DECODE (Data-driven neuroEthics for COnsciousness DEtection). Qualitative research methodology utilizing grounded theory and empirical neuroethics analysis were used to capture salient concerns and perspectives among clinicians surrounding the ethics of deploying and responsibly sharing results of advanced neurotechnologies to detect consciousness in patients with disorders of consciousness (DoC).

Results Clinicians with expertise caring for patients with DoC in diverse practice settings displayed varied ethical, clinical and philosophical perspectives surrounding the optimal use of neurotechnologies to detect consciousness in patients following brain injury. A general consensus was noted surrounding ethical obligations to ensure equitable access and communicate test results from novel neurotechnologies with families/surrogates, however, significant differences were observed in how clinicians perceived optimally contextualizing and conveying such information to surrogates/family members. Furthermore, divergent perspectives were highlighted surrounding optimum methods of clinical translation as well as which patients could benefit from the use of neurotechnologies for covert consciousness detection.

Conclusions Salient ethical themes emerging from interim analyses of interviews with clinicians revealed substantial variation in ethical perspectives on how to most effectively deploy these neurotechnologies in clinical practice. Further study is necessary and planned to capture perspectives of individuals from other stakeholder groups, including patients, surrogates and researchers, to inform the creation of a harmonized neuroethical framework for responsible clinical translation of these neurotechnologies.

Authors/Disclosures
Michael Young, MD (Massachusetts General Hospital, Brigham, Harvard) PRESENTER	Dr. Young has nothing to disclose.
	No disclosure on file
Yelena Bodien, PhD (Spaulding Rehabilitation Hospital)	Dr. Bodien has nothing to disclose.
Leigh R. Hochberg, MD, PhD, FAAN (Massachusetts General Hospital)	The institution of Dr. Hochberg has received research support from The MGH Translational Research Center has a clinical research support agreement (CRSA) with Axoft, Neuralink, Neurobionics, Precision Neuro, Synchron, and Reach Neuro, for which LRH provides consultative input. LRH is a non-compensated member of the Board of Directors of a nonprofit assistive communication device technology foundation (Speak Your Mind Foundation). Mass General Brigham (MGB) is convening the Implantable Brain-Computer Interface Collaborative Community (iBCI-CC); charitable gift agreements to MGB, including those received to date from Paradromics, Synchron, Precision Neuro, Neuralink, and Blackrock Neurotech, support the iBCI-CC, for which LRH provides effort.. The institution of Dr. Hochberg has received research support from Dr. Hochberg also receives research support from the US Department of Veterans Affairs and the National Institutes of Health.. Dr. Hochberg has received intellectual property interests from a discovery or technology relating to health care.
Brian Edlow, MD	Dr. Edlow has received research support from NIH.

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