Ethical Issues in Using Deception to Facilitate Rehabilitation for a Patient With Severe Traumatic Brain Injury

Objective: To explore ethical issues in using deception to improve participation in a patient with severe traumatic brain injury who had not responded to traditional behavioral and pharmacologic approaches. Design: Case study. Participant: A male in inpatient neurorehabilitation with history of severe traumatic brain injury and significant behavioral disruption that limited his therapy participation. Methods: Behavior modification program using principles of operant conditioning that required deception. Results: Participation in therapies significantly improved and disruptive behaviors decreased. Conclusion: When used cautiously and with careful consideration of the ethical implications, deception may be permissible as part of an intervention strategy with this population but only as a last resort.