title: Neuroethics and Disorders of Consciousness: Discerning Brain States in Clinical Practice and Research.
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.
authors.affiliation: E. William Davis, Jr. M.D. Professor of Medical Ethics and chief of the Division of Medical Ethics at Weill Cornell Medical College in New York City, where he also serves as professor of medicine, professor of medical ethics in neurology, and professor of medicine in psychiatry.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Fins
mesh_terms: D001921:Brain; D000066491:Clinical Decision-Making / Q000941:ethics; D003142:Communication; D003243:Consciousness; D046690:Deep Brain Stimulation; D003695:Delivery of Health Care / Q000941:ethics; D026690:Ethics, Clinical; D032984:Ethics, Research; D006296:Health Services / Q000941:ethics; D006806:Human Rights; D006801:Humans; D008297:Male; D028681:Moral Obligations; D009488:Neurosciences / Q000941:ethics*; D010146:Pain; D010166:Palliative Care; D010465:Perception; D018458:Persistent Vegetative State / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy; D012106:Research; D013727:Terminal Care