Late recovery from the minimally conscious state: ethical and policy implications
- PMID: 17242341
- DOI: 10.1212/01.wnl.0000252376.43779.96
Late recovery from the minimally conscious state: ethical and policy implications
Abstract
We consider the ethical and public policy implications of late recovery from the minimally conscious state in light of an Institute of Medicine exploratory meeting convened to discuss current knowledge about disorders of consciousness as well as a recently published study demonstrating axonal regrowth in a patient two decades after traumatic injury. Participants at the meeting (which included the authors) described a lack of research initiatives for basic investigations of patients in these states, the frequent warehousing of patients following a diagnosis of persistent vegetative state that limits their access to appropriate neurologic and diagnostic tests, and the breadth of public confusion about disorders of consciousness. Meeting participants encouraged the Institute to pursue a more formal study to outline both the need for research and the unique opportunities to study consciousness, now available through the use of neuroimaging and related technologies. Areas of initial focus would be to define the epidemiology of the minimally conscious state, elucidate mechanisms of recovery, and identify clinically useful diagnostic and prognostic markers that will aid decision making at the bedside.
Similar articles
-
Emergence from minimally conscious state: insights from evaluation of posttraumatic confusion.Neurology. 2010 Apr 6;74(14):1156; author reply 1156-7. doi: 10.1212/WNL.0b013e3181d5df0d. Neurology. 2010. PMID: 20368639 No abstract available.
-
How can we know if patients in coma, vegetative state or minimally conscious state are conscious?Prog Brain Res. 2009;177:11-9. doi: 10.1016/S0079-6123(09)17702-6. Prog Brain Res. 2009. PMID: 19818891
-
What is it like to be vegetative or minimally conscious?Curr Opin Neurol. 2007 Dec;20(6):609-13. doi: 10.1097/WCO.0b013e3282f1d6dd. Curr Opin Neurol. 2007. PMID: 17992077 Review.
-
Thirty years of the vegetative state: clinical, ethical and legal problems.Prog Brain Res. 2005;150:537-43. doi: 10.1016/S0079-6123(05)50037-2. Prog Brain Res. 2005. PMID: 16186047 Review.
-
The vegetative and minimally conscious states: consensus-based criteria for establishing diagnosis and prognosis.NeuroRehabilitation. 2004;19(4):293-8. NeuroRehabilitation. 2004. PMID: 15671583
Cited by
-
Ethics and the 2018 Practice Guideline on Disorders of Consciousness: A Framework for Responsible Implementation.Neurology. 2022 Apr 26;98(17):712-718. doi: 10.1212/WNL.0000000000200301. Epub 2022 Mar 11. Neurology. 2022. PMID: 35277446 Free PMC article.
-
The neuroethics of disorders of consciousness: a brief history of evolving ideas.Brain. 2021 Dec 16;144(11):3291-3310. doi: 10.1093/brain/awab290. Brain. 2021. PMID: 34347037 Free PMC article.
-
Reporting consciousness in coma: media framing of neuro-scientific research, hope, and the response of families with relatives in vegetative and minimally conscious states.JOMEC J. 2013 Jun 1;3:10244. doi: 10.18573/j.2013.10244. eCollection 2013. JOMEC J. 2013. PMID: 33604037 Free PMC article.
-
The Neglect of Persons with Severe Brain Injury in the United States: An International Human Rights Analysis.Health Hum Rights. 2020 Jun;22(1):265-278. Health Hum Rights. 2020. PMID: 32669806 Free PMC article.
-
Pharmacologically informed machine learning approach for identifying pathological states of unconsciousness via resting-state fMRI.Neuroimage. 2020 Feb 1;206:116316. doi: 10.1016/j.neuroimage.2019.116316. Epub 2019 Oct 29. Neuroimage. 2020. PMID: 31672663 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical