Awareness Might Be Assessed By Quatitive Electric Tomoggraphy In Persistent Vegetative State And Minimally Conscious State

10.5580/e47 ◽  
2010 ◽  
Vol 13 (1) ◽  
Author(s):  
Andreas Bender ◽  
Ralf J. Jox ◽  
Eva Grill ◽  
Andreas Straube ◽  
Dorothée Lulé

2009 ◽  
Vol 58 (5) ◽  
Author(s):  
Massimo Gandolfini

L’articolo affronta il tema dello stato vegetativo persistente (SVP) e dello stato di minima coscienza (SMC), esponendone le basi neurofisiopatologiche, correlandole ai più recenti tentativi terapeutici. Si sottolinea, in particolare, l’importanza di una corretta diagnosi differenziale fra i due stati post-coma, considerata l’importanza del fattore tempo per un corretto giudizio prognostico. Infine si affronta il tema della distinzione fra “terapia” e “cura”, con le importanti conseguenze etiche. ---------- The article deals with the persistent vegetative state (SVP) and the minimally conscious state (SMC), explaining their neurophysiopathologic bases and correlating them to the most recent therapeutic attempts. In particular, the importance of a correct differential diagnosis between the two post-coma states is underlined, considering the importance of time as a factor for a correct prognosis. Finally, the the article focuses on the distinction between “therapy” and “care”, with the important ethical consequences.


2019 ◽  
Vol 28 (04) ◽  
pp. 603-615 ◽  
Author(s):  
JOSEPH J. FINS

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.


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