Disorders of Consciousness, Past, Present, and Future.

TitleDisorders of Consciousness, Past, Present, and Future.
Publication TypeJournal Article
Year of Publication2019
AuthorsFins, Joseph J.
JournalCamb Q Healthc Ethics
Date Published2019 10
KeywordsConsciousness Disorders, Disabled Persons, History, 20th Century, History, 21st Century, Humans, Independent Living, Neurology, Persistent Vegetative State, Practice Guidelines as Topic, Rehabilitation Research

This paper, presented as the 2019 Cambridge Quarterly Neuroethics Network Charcot Lecture, traces the nosology of disorders of consciousness in light of 2018 practice guidelines promulgated by the American Academy of Neurology, the American College of Rehabilitation Medicine and the National Institute on Disability, Independent Living and Rehabilitation Research. By exploring the ancient origins of Jennett and Plum's persistent vegetative state and subsequent refinements in the classification of disorders of consciousness-epitomized by the minimally conscious state, cognitive motor dissociation, and the recently described chronic vegetative state-the author argues that there is a counter-narrative to the one linking these conditions to the right to die. Instead, there is a more nuanced schema distinguishing futility from utility, informed by technical advances now able to identify covert consciousness contemplated by Jennett and Plum. Their prescience foreshadows recent developments in the disorders of consciousness literature yielding a layered legacy with implications for society's normative and legal obligations to these patients.

Alternate JournalCamb Q Healthc Ethics
PubMed ID31405394

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