[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-458758-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-458758-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","relational-personhood-the-missing-link-for-evaluating-clinical-impact-of-braincomputer-interfaces","Relational personhood: the missing link for evaluating clinical impact of brain–computer interfaces","","Brain–computer interfaces (BCIs) offer a promising neurotechnological pathway for people with severe motor and speech impairment to communicate and interact with the world. For clinical adoption, regulatory approval and reimbursement require clinical outcome assessment (COA) that quantifies real-world impact. The essay argues that existing COAs insufficiently capture a core, existential dimension of BCI contribution—relational personhood—because generic quality-of-life measures may miss social consequences and can show high baseline values despite meaningful subjective reconnection.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/relational-personhood-the-missing-link-for-evaluating-clinical-impact-of-braincomputer-interfaces/458758/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/relational-personhood-the-missing-link-for-evaluating-clinical-impact-of-braincomputer-interfaces/458758.png","ImageObject",300,407,{"name":42,"@type":43},"Mary Man","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":26},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"Why does the essay say current COAs for BCIs fall short?","Question",{"text":62,"@type":63},"Because commonly used quality-of-life and health-related quality-of-life tools may not reflect subjective, feels-based impact. They can be insensitive to severe motor impairment and may underrepresent social consequences that matter to patients and caregivers.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How can high baseline (HR-)QOL values affect evaluating BCI impact?",{"text":67,"@type":63},"The essay notes that some people already report high QOL or emotional domain values without BCI access. This can mask meaningful BCI-related subjective benefits, especially when chronic conditions lead to a response shift.",{"name":69,"@type":60,"acceptedAnswer":70},"What is relational personhood in the context of BCI outcomes?",{"text":71,"@type":63},"Relational personhood captures whether and to what extent people are perceived as full persons by each other. The essay proposes integrating this concept into BCI clinical outcome assessment to better represent existential reconnection experienced by users and caregivers.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},458758,1790754316,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":26,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":79,"read_time":110,"preview_page_count":4},7421720224475,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","[https://doi.org/10.1093/braincomms/fcaf470](https://doi.org/10.1093/braincomms/fcaf470) BRAIN COMMUNICATIONS 2026: fcaf470 | 1  \nBRAIN COMMUNICATIONS  \nESSAY  \nRelational personhood: the missing link for evaluating clinical impact of brain–computer interfaces  \nBrain–computer interfaces (BCIs) represent a promising novel neurotechnological solution for people with severe motorand speech impairment to communicate and interact with the world. For clinical adoption, regulatory approval and reimbursement, the clinical outcome assessment of this technology needs to be complemented by the concept of relational personhood.  \nBrain–computer interfaces (BCIs) use brain signals to control a computer and represent a highly promising assistive technology to enable people with severe motor and speech impairment to interact with the world. Successful demonstrations of fast and accurate BCI-generated expressions, of unsupervised at-home BCI use, as well as testimonials by BCI research participants, highlight the enormous impact BCI technology can have in their daily lives.1-3  \nWith the advent of companies seeking to bring BCIs to market, a key remaining challenge for regulatory approval, reimbursement and clinical implementation of BCIs is the definition of clinical outcome measures that accurately reflect, and can be used to quantify, this impact. Here, we argue that ‘relational personhood’ needs to be integrated in the clinical outcome assessment (COA) of BCIs. This concept captures a fundamental, existential dimension of what BCI technology can contribute to the lives of people with motor  \nand speech impairments and their caregivers, which isnot sufficiently covered by currently available clinical outcome measures.  \nWhy current clinical outcome assessments for BCI fall short  \nCOAs are standardizable assessments that describe or reflect how an individual feels, functions or survives in response to an intervention. Here, we address the subjective,‘feels’, aspect of the COA of BCIs that enable people to express themselves  \nand interact with the world. In a recent Food and Drug Administration/National Institutes of Health (FDA/NIH) joint workshop on developing COAs for implanted BCIs, a recurring question was how to make sense of the added subjective benefit for BCI users. What does re-enabling a former chess player to play chess again mean besides ‘improved entertainment’? What does it mean for a father and daughter to connect through a BCI besides ‘improved communication’?1,4  \nThe discussion on which clinical outcome measures capture the subjective impact experienced by BCI users has so far largely focused on quality of life (QOL), or health-related quality of life (HR-QOL) .5 Whereas QOL is a general term that expresses the overall wellbeing of an individual, HR-QOL assesses the impact of the individual’s health status (or treatment) on their QOL and is considered a more appropriate concept to evaluate the clinical impact of medical products than QOL. Yet, the clinical impact of a BCI may not be sufficiently captured by QOL or HR-QOL for two reasons. First, many currently available tools to assess HR-QOL are generic, include questions related to physical functioning that can be perceived as insensitive by people with severe motor impairment and focus insufficiently on the social consequences of the impairment, which matter more to patients than the physical disability per se.5 Second, it may prove difficult to demonstrate a meaningful improvement in (HR-)QOL as a result of BCI use, given that, at least a subportion of, people with severe motor and speech impairments already report a high QOL, or relatively high values in the emotional domains of HR-QOL scales, without having access to BCI technology.6 Indeed, it is well described that people with chronic conditions tend to adjust to their  \nReceived October 13, 2025. Revised October 17, 2025. Accepted November 27, 2025. Advance access publication January 8, 2026 © The Author(s) 2026","cbCaiiTXF9LGorPE","https://ap.wps.com/l/cbCaiiTXF9LGorPE","pdf",319387,"English","# Why current clinical outcome assessments for BCI fall short\n## Shortcomings of quality-of-life and health-related quality-of-life measures\n## The problem of high baseline (HR-)QOL and response shift\n# Relational personhood as the missing link\n## Defining relational personhood from philosophy\n## How enabling expression supports personhood recognition","[{\"question\":\"Why does the essay say current COAs for BCIs fall short?\",\"answer\":\"Because commonly used quality-of-life and health-related quality-of-life tools may not reflect subjective, feels-based impact. They can be insensitive to severe motor impairment and may underrepresent social consequences that matter to patients and caregivers.\"},{\"question\":\"How can high baseline (HR-)QOL values affect evaluating BCI impact?\",\"answer\":\"The essay notes that some people already report high QOL or emotional domain values without BCI access. This can mask meaningful BCI-related subjective benefits, especially when chronic conditions lead to a response shift.\"},{\"question\":\"What is relational personhood in the context of BCI outcomes?\",\"answer\":\"Relational personhood captures whether and to what extent people are perceived as full persons by each other. The essay proposes integrating this concept into BCI clinical outcome assessment to better represent existential reconnection experienced by users and caregivers.\"}]","Relational personhood: the missing link for evaluating clinical impact of brain–computer interfaces | PDF"]