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<p>Diagnosing patients with disorders of consciousness involves inductive risk: the risk of false negative and false positive results when gathering and interpreting evidence of consciousness. A recent proposal suggests mitigating that risk by incorporating patient values into methodological choices at the level of individual diagnostic techniques: when using machine-learning algorithms to detect neural evidence of responsiveness to commands, clinicians should consider the patient’s own preferences about whether avoiding false positives or false negatives takes priority (Birch, <CitationRef CitationID="CR3">2023</CitationRef>). In this paper, I argue that this proposal raises concerns about how to ensure that inevitable non-epistemic value judgments do not outweigh epistemic considerations. Additionally, it comes with challenges related to the predictive accuracy of surrogate decision-makers and the decisional burden imposed on them. Hence, I argue that patient values should not be incorporated at the level of gathering evidence of consciousness, but that they should play the leading role when considering how to respond to that evidence.</p>

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Patient values and inductive risk in disorders of consciousness

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月28日

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  • Mona-Marie Wandrey

摘要

Diagnosing patients with disorders of consciousness involves inductive risk: the risk of false negative and false positive results when gathering and interpreting evidence of consciousness. A recent proposal suggests mitigating that risk by incorporating patient values into methodological choices at the level of individual diagnostic techniques: when using machine-learning algorithms to detect neural evidence of responsiveness to commands, clinicians should consider the patient’s own preferences about whether avoiding false positives or false negatives takes priority (Birch, 2023). In this paper, I argue that this proposal raises concerns about how to ensure that inevitable non-epistemic value judgments do not outweigh epistemic considerations. Additionally, it comes with challenges related to the predictive accuracy of surrogate decision-makers and the decisional burden imposed on them. Hence, I argue that patient values should not be incorporated at the level of gathering evidence of consciousness, but that they should play the leading role when considering how to respond to that evidence.