Medical Ethics Education for Neurology Residents: Where Do We Go from Here?

Neurologists regularly confront complex clinical scenarios that require the application of ethical principles to achieve a respectful and fair resolution. In this article, we describe the types of ethically precarious scenarios neurologists encounter, the current status of standards for ethics and communication training for neurology residents, and the present practice of ethics training in neurology residency programs. We make recommendations for optimizing bioethics training for neurology residents and suggest methods for assessing the efficacy of these training initiatives. We emphasize the current need for strengthening the practical bioethics skills of neurologists.

Insights From Chronic ECoG by RNS.

SUMMARY: The NeuroPace responsive neurostimulation system (RNS) has revolutionized the care of patients suffering from focal epilepsy since its approval in 2014. One major advantage of this device is its innate ability to gather long-term electrocorticographic (ECoG) data that the device uses in its novel closed-loop treatment paradigm. Beyond the standard stimulation treatments, which have been demonstrated to be safe and well-tolerated, the data collected by the RNS provide valuable information, such as the long-term circadian and ultradian variations that affect seizure risk, obtained under naturalistic conditions. Additionally, these data inform future surgical procedures, supplementing clinically reported seizures by patients, assessing the response to newly added anti-seizure medications, helping to forecast the risk of future seizures, and understanding the mechanisms of certain long-term outcomes in patients with postsurgical epilepsy. By leveraging these data, the delivery of high-quality clinical care for patients with epilepsy can only be enhanced. Finally, these data open significant avenues of research, including machine learning and artificial intelligence algorithms, which may also translate to improved outcomes in patients who struggle with recurrent seizures.