Disorders of consciousness, past, present, and future

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)603-615
Number of pages13
JournalCambridge Quarterly of Healthcare Ethics
Volume28
Issue number4
DOIs
StatePublished - Oct 1 2019

Keywords

  • Bryan Jennett
  • Chronic vegetative state
  • Disability rights
  • Disorders of consciousness
  • Disorders of consciousness
  • Fred Plum
  • Karen Ann Quinlan
  • Neuroethics
  • Permanent vegetative state
  • Persistent vegetative state
  • Practice guideline

ASJC Scopus subject areas

  • Issues, ethics and legal aspects
  • Health(social science)
  • Health Policy

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