@article{Sterling_2026_Neuromodulation_Ethical,
    abstract = {Objectives
Transcranial focused ultrasound stimulation (tFUS), also known as low-intensity focused ultrasound pulsation (LIFUP), may noninvasively modulate key brain networks subserving consciousness and carries promise as a novel interventional tool to stimulate recovery of consciousness in individuals with disorders of consciousness (DoC) following severe brain injury. However, the novelty of this approach and its attendant effects raise underexplored ethical considerations warranting explicit attention to ensure responsible development and deployment in clinical research and practice. Our objectives here are to develop an ethical framework for responsible translation of this emerging neurotechnology.
Materials and Methods
To identify and critically evaluate the responsible use of tFUS to promote recovery of consciousness in individuals with DoC, we examine ethical considerations through the lens of the principles of biomedical ethics, coupled with thematic, normative and philosophical analysis. We describe safeguards for innovation and clinical translation in this domain.
Results
Specific ethical domains examined include respect for autonomy, beneficence, nonmaleficence, justice, enrollment considerations and fair study access, which synergistically inform an ethical framework for stakeholders involved in pioneering and early use of tFUS.
Conclusions
To provide support for clinicians and investigators navigating complex decision-making at the nexus of neurotechnology and neuroethics, we propose a practical checklist for ethical implementation and evaluation of tFUS studies for patients with DoC.},
    author = {Sterling, Ally and Lew, Jason and Monti, Martin and Schnakers, Caroline and Fecchio, Matteo and Guerrin, Bastien and Schreier, David and Li, Jian and Edlow, Brian and Young, Michael},
    doi = {10.1016/j.neurom.2026.04.020},
    journal = {Neuromodulation},
    publisher = {Elsevier},
    title = {Ethical considerations in transcranial focused ultrasound neuromodulation for disorders of consciousness},
    year = {2026}
}