ABSTRACT
Disorders of consciousness (DOC) are a group of conditions characterized by impaired verbal and motor responsiveness to diverse stimuli, indicating disturbed consciousness. As neurotechnologies emerge and approach clinical application in DOC, ethical questions arise. This chapter discusses what they believe to be the most urgent issues at the heart of the ethical questions: informed consent, advance directives, personal identity, patient well-being, study designs and knowledge translation. Brain stimulation techniques are increasingly being studied with various objectives for patients with DOC. This includes both noninvasive technologies, like transcranial magnetic stimulation and transcranial direct current stimulation, and invasive neurostimulation like vagal nerve stimulation or deep brain stimulation, in which electrodes are surgically implanted in the thalamus, a deep inner region of the brain. The temporal continuity of personal identity can be relevant for moral reasoning among clinical decision makers and surrogates. Patients with DOC are chronically ill persons with a constant need for life support and have high mortality rates.
