What are the implications of detecting consciousness in someone who looks and acts unconscious? Can and should this information be used to treat patients and manage expectations of caregivers? If so, how? The use of technology to detect consciousness raises a host of questions not only pertinent to medicine and science, but also to law, philosophy, ethics and beyond – questions at the heart of what it means to be conscious, and to recognize consciousness in others.
Can brain imaging be a “pain-o-meter” that tells courts when a person is in pain? Can fMRI help us discern whether intractable chronic pain is “all in your head” or all in the brain – or will it require us to reconsider that distinction?
Since alterations in the brain have the potential to alter cognition, personality, and even the sense of self, do surgical innovations require special ethical consideration? Should "invasiveness" matter ethically, or do we simply weigh risks against benefits? Should we have distinct policy or regulation regarding neurosurgical innovation? Do patients contemplating such innovations require special protections?
Edwin H. “Ned” Cassem, SJ, MD, a beloved member of our Massachusetts General Hospital family who served as chief of Psychiatry from 1989 to 2000 and was a true leader in clinical ethics, died July 4 at the age of 80.