When information on a coma patient’s expected outcome is uncertain, a moral dilemma arises in clinical practice: if life-sustaining treatment is continued, the patient may survive with unacceptably poor neurological prospects, but if withdrawn a patient who could have recovered may die. Continuous electroencephalogram-monitoring (cEEG) is expected to substantially improve neuroprognostication for patients in coma after cardiac arrest. This raises expectations that decisions whether or not to withdraw will become easier. This paper investigates that expectation, exploring cEEG’s impacts when it becomes part of a socio-technical network in an Intensive Care Unit (ICU). Based on observations in two ICUs in the Netherlands and one in the USA that had cEEG implemented for research, we interviewed 25 family members, healthcare professionals, and surviving patients. The analysis focuses on (a) the way patient outcomes are constructed, (b) the kind of decision support these outcomes provide, and (c) how cEEG affects communication between professionals and relatives. We argue that cEEG can take away or decrease the intensity of the dilemma in some cases, while increasing uncertainty for others. It also raises new concerns. Since its actual impacts furthermore hinge on how cEEG is designed and implemented, we end with recommendations for ensuring responsible development and implementation.

当关于昏迷患者预期结果的信息不确定时，临床实践中会出现道德困境：如果继续维持生命治疗，患者可能存活，但神经系统前景不佳，但如果退出治疗，本可以康复的患者可能会死亡。连续脑电图监测 (cEEG) 有望显着改善心脏骤停后昏迷患者的神经预后。这引发了人们的期望，即决定是否退出将变得更加容易。本文调查了这种期望，探讨了当 cEEG 成为重症监护病房 (ICU) 中社会技术网络的一部分时的影响。根据在荷兰的两个 ICU 和美国的一个实施 cEEG 研究的 ICU 中的观察，我们采访了 25 名家庭成员、医疗保健专业人员、和幸存的病人。分析侧重于 (a) 构建患者结果的方式，(b) 这些结果提供的决策支持类型，以及 (c) cEEG 如何影响专业人员和亲属之间的沟通。我们认为 cEEG 在某些情况下可以消除或减少困境的强度，同时增加其他人的不确定性。这也引发了新的担忧。由于其实际影响还取决于 cEEG 的设计和实施方式，因此我们最后提出了确保负责任的开发和实施的建议。同时增加其他人的不确定性。这也引发了新的担忧。由于其实际影响还取决于 cEEG 的设计和实施方式，因此我们最后提出了确保负责任的开发和实施的建议。同时增加其他人的不确定性。这也引发了新的担忧。由于其实际影响还取决于 cEEG 的设计和实施方式，因此我们最后提出了确保负责任的开发和实施的建议。