Neuroethics and Disorders of Consciousness: Discerning Brain States in Clinical Practice and Research.

TitleNeuroethics and Disorders of Consciousness: Discerning Brain States in Clinical Practice and Research.
Publication TypeJournal Article
Year of Publication2016
AuthorsFins, Joseph J.
JournalAMA J Ethics
Volume18
Issue12
Pagination1182-1191
Date Published2016 Dec 01
ISSN2376-6980
KeywordsBrain, Clinical Decision-Making, Communication, Consciousness, Deep Brain Stimulation, Delivery of Health Care, Ethics, Clinical, Ethics, Research, Health Services, Human Rights, Humans, Male, Moral Obligations, Neurosciences, Pain, Palliative Care, Perception, Persistent Vegetative State, Research, Terminal Care
Abstract

Decisions about end-of-life care and participation in clinical research for patients with disorders of consciousness begin with diagnostic discernment. Accurately distinguishing between brain states clarifies clinicians' ethical obligations and responsibilities. Central to this effort is the obligation to provide neuropalliative care for patients in the minimally conscious state who can perceive pain and to restore functional communication through neuroprosthetics, drugs, and rehabilitation to patients with intact but underactivated neural networks. Efforts to bring scientific advances to patients with disorders of consciousness are reviewed, including the investigational use of deep brain stimulation in patients in the minimally conscious state. These efforts help to affirm the civil rights of a population long on the margins.

DOI10.1001/journalofethics.2016.18.12.ecas2-1612
Alternate JournalAMA J Ethics
PubMed ID28009244

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