Alive Inside

11 Pages Posted: 1 May 2020

See all articles by Andrew Peterson

Andrew Peterson

George Mason University

Adrian M. Owen

University of Western Ontario - Psychology

Jason Karlawish

University of Pennsylvania

Date Written: March 2020


This article provides an ethical analysis of the U.S. practice guideline update on disorders of consciousness. Our analysis focuses on the guideline’s recommendations regarding the use of investigational neuroimaging methods to assess brain‐injured patients. Complex and multifaceted ethical issues have emerged because these methods alter the clinical understanding of consciousness. We address issues of false hope, patient suffering, and cost. We argue that, in spite of these concerns, there is significant benefit to using neuroimaging to assess brain‐injured patients in most cases.

Keywords: consciousness, disorders of consciousness, minimally conscious state, neuroethics, neuroimaging, neurology, vegetative state

Suggested Citation

Peterson, Andrew and Owen, Adrian M. and Karlawish, Jason, Alive Inside (March 2020). Bioethics, Vol. 34, Issue 3, pp. 295-305, 2020, Available at SSRN: or

Andrew Peterson (Contact Author)

George Mason University ( email )

4400 University Drive
Fairfax, VA 22030
United States

Adrian M. Owen

University of Western Ontario - Psychology ( email )

London, Ontario

Jason Karlawish

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

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