During the 20th Annual John Collins Harvey lecture, held Feb. 3 by the Georgetown University Medical Center, Dr. Joseph Fins described the case of a patient in a nonresponsive state, who underwent neurotechnological procedures to attempt to restore his consciousness. The technology, which is one example of recent developments in clinical neuroscience, allowed him to portray a limited level of consciousness. Amidst his previous nonresponsive state, he was able to regain a limited level of consciousness. 

“He told his mother that he loved her,” Fins said.

Fins explained how the health care field often neglects the quality of life of those that are usually in a nonresponsive state, an issue resulting from medical practitioners being unable to assess the consciousness of the patient. Fins suggested that emerging forms of neurotechnologies might improve the quality of life for many.

This year’s lecture, titled “Covert Consciousness and Clinical Ethics: Neuroscience and Normative Obligations,” featured a conversation between Dr. Joseph Fins, chief of the Division of Medical Ethics at Weill Cornell Medical College, and Dr. James Giordano, professor of neurology at Georgetown University Medical Center. 

Giordano is also Chief of the Neuroethics Studies Program at The Edmund D. Pellegrino Center for Clinical Bioethics (PCCB), which aims to develop an area for excellence and uniqueness in bioethics that can be applied to clinical medicine. Established in 1920, the PCCB promotes critical ethical reflection and discussion in the pursuit of health. 

Covert consciousness, the idea of awareness, is an abstract concept that plays a major role in clinical bioethics. It helps scientists assess where life begins and ends and has the capability to scope the practicality of medical treatments. 

Dr. Fins’ patient is an example of one patient who underwent neurotechnological treatment. The rise of neuroscientific development, biotechnological research and the progression of treatments and diagnostics in the medical field are developing alongside these evolving technologies, but these emerging technologies also raise ethical questions, according to Dr. Fins. 

“Many areas of neurotech are conducted internationally, and it is difficult to retract technology once they have a foothold,” Giordano said. “Consciousness is a correlation between the mind and body but very subjective.”

The consciousness of an individual plays into their human dignity, the value of one’s existence and may lead to more mistreatment in society if we started to assess each other based on this characteristic. Questions are then raised regarding how patients would be treated in the medical field. 

Giordano said that the fundamental role that consciousness plays in our daily lives is with actions as simple as interacting with one another.

“One has to communicate their consciousness to me for me to assess the interior state of the individual brain,” Giordano said. “The question is: is there actually something there, and how can we assess that?”

One of the main questions Dr. Fins and Dr. Giordano addressed during their talk was whether there is a fundamental difference between the mind and body and how those two are related. According to the pair, this is because the assessment of someone being conscious depends on their ability to practice what we consider to have consciousness in terms of awareness, memories and thoughts, but this ability is difficult to evaluate.

Dr. Fins said that he achieved certain answers to this question regarding covert consciousness with the ongoing progression of neurotechnologies that circulate in the medical field. Dr. Giordano said refraining from progress with technology is not an option. 

“It is actually problematic not to advance in technology,” Giordano told The Hoya. 

Many of these neurotechnologies are conducted around the world and have power in international markets. Therefore, realistically, the retraction of such neurotechnologies from advancing in today’s society is very difficult, especially once they have a foothold in the market. The progression of this industry is widespread amongst influential establishments in the world and cannot be stopped that easily. 

Giordano concluded by warning of the ways neurotechnology might change health care, even if these numerous concerns exist. 

“The question then becomes, are we prepared to use this technology and what it might illustrate. Are our institutions prepared to respond to these outcomes?”