Mertens, M., MA

Cross-cultural analysis of Responsible Innovation in prognosis of post-anoxic coma

Department of Philosophy, Faculty of Behavioural, Management and Social Sciences, Twente University,

Supervisors: Prof. Philip Brey


Mayli obtained a Bachelors Degree in Journalism from Artesis Plantijn University College in Antwerp, Belgium. Following a nearly decade-long professional career she acquired a Masters Degree in Applied Ethics from Linköping University in Sweden where she wrote a thesis on media-ethics: The War Within: Battling Polarization, Reductionism, and Superficiality – A critical analysis of truth-telling in war reporting. She then specialized in Bioethics at the Yale Interdisciplinary Center for Bioethics and became a member of the Sherwin B. Nuland Summer Institute in Bioethics. Her interests are in biomedical ethics and philosophy of technology; more particularly in neuro-ethics and responsible innovation.


Prognosis of neurological outcome of patients in coma after cardiac arrest is crucial for decision making on (continuation of) treatment. Recent research has shown that visual classification of continuous EEG may enable ultra-early, high quality prognosis of poor outcome within 24 hours. This technological innovation, in particular when translated in a quantitative index, may deepen existing controversies with regard to expected quality of life of surviving patients. It may also aggravate tensions between personal values (sanctity of life, quality of life, life of relatives,…) and societal concerns (cost reduction, performativity of practice,…). Finally, introduction of EEG-based technology enabling ultra-early prognostication may create new controversies regarding timing of the prognosis and subsequent decision making.

This PhD project focusses on the interests and experiences of specific stakeholders in this setting; namely the health-care professionals and family members of the patient, and in some cases, the patient themselves. The aim is -on the one hand- to explore how EEG-enabled prognosis might affect values in care for comatose patients in different contexts and cultures, comparing the Netherlands, the USA and possibly France or Brazil. On the other hand, the aim is to formulate how to develop the EEG-based prognostic technology in such a way that it takes into account these various concerns and thus can be considered a responsible innovation. Finally, a more general assessment will be made on whether -and if so- on how responsible innovation may vary depending on culture and context.