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Ethics in Disorders of Consciousness

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Annual Update in Intensive Care and Emergency Medicine 2011

Part of the book series: Annual Update in Intensive Care and Emergency Medicine 2011 ((AUICEM,volume 1))

Abstract

The introduction of the mechanical ventilator in the 1950s and the development of intensive care in the 1960s permitted many patients to sustain their vegetative functions and survive severe injuries. Despite such advances, in many cases patients were found to suffer from altered states of consciousness which had never been encountered before as these patients would normally have died from apnea [1]. The imminent ethical impact of these profound states of unconsciousness was reflected in the composition of the first bioethical committees discussing the redefinition of life and the concept of therapeutic obstinacy. In 1968, the Ad Hoc Committee of Harvard Medical School published a milestone paper for the redefinition of death as irreversible coma and brain failure [2]. The committee was comprised of ten physicians, a theologian, a lawyer and a historian of science, betokening the medical, legal and societal debates that were to follow. We will here give a brief overview of some ethical issues related to the concept of consciousness and the medical management of patients with disorders of consciousness, such as comatose, vegetative and minimally conscious states that may be encountered in the intensive care setting. We will emphasize the problem of pain management and end-of life decision-making.

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Authors and Affiliations

  1. Coma Science Group Cyclotron Research Center, University of Liège, Sart Tilman B-30, 4000, Liège, Belgium

    A. Demertzi, S. Laureys & M. -A. Bruno

Authors
  1. A. Demertzi
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  2. S. Laureys
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  3. M. -A. Bruno
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Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

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Demertzi, A., Laureys, S., Bruno, M.A. (2011). Ethics in Disorders of Consciousness. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2011. Annual Update in Intensive Care and Emergency Medicine 2011, vol 1. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18081-1_59

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  • DOI: https://doi.org/10.1007/978-3-642-18081-1_59

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-18080-4

  • Online ISBN: 978-3-642-18081-1

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