, Volume 10, Issue 2, pp 235–242 | Cite as

Emerging Ethical Issues Related to the Use of Brain-Computer Interfaces for Patients with Total Locked-in Syndrome

  • Michael N. Abbott
  • Steven L. Peck
Original Paper


New brain-computer interface and neuroimaging techniques are making differentiation less ambiguous and more accurate between unresponsive wakefulness syndrome patients and patients with higher cognitive function and awareness. As research into these areas continues to progress, new ethical issues will face physicians of patients suffering from total locked-in syndrome (total LIS), characterized by complete loss of voluntary muscle control, with retention of cognitive function and awareness detectable only with neuroimaging and brain-computer interfaces. Physicians, researchers, ethicists and hospital ethics committees should be aware of and prepared to handle ethical issues unique to these totally locked-in patients. Several thought experiments are discussed, to highlight potential ethical dilemmas surrounding surrogate decision-making, autonomy, end-of-life care, and pediatric care, which will be unique to total LIS patients. These, along with other ethical problems especially relevant to total LIS patients, merit further discussion among physicians, researchers, ethicists and hospital ethics committees, to facilitate consensus regarding these issues, and improve patient care.


Total locked-in syndrome Brain-computer interface Surrogate decision-making Autonomy Pediatric care End-of-life care 


Compliance with Ethical Standards


This study was funded by corresponding author’s internal departmental funds.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  1. 1.Biology DepartmentBrigham Young UniversityProvoUSA

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