García O D
Rev Neurol. 1999;29(12):1202-12.
The concept of 'vegetative' state became popular in the medical literature, in the context of a 'neocorticalist' theory of consciousness. Its clear-cut simplicity and the prestige of its proponents contributed to this acceptance. However, this concept seems to be neurologically and philosophically inappropriate. In addition, in recent years a number of studies have shown that these states are frequently misdiagnosed, due mainly to their inherent complexity. Thus, the need for a new name for this syndrome has become increasingly evident. A conceptualization of the brain global functioning leads to a redefinition of these states. The 'syndrome of brain dismetafunction' is conceptually defined. This term does not have a pejorative connotation. It respects the inherent uncertainty associated to the subjective dimension of consciousness as well as to the prognosis of these states. It promotes an integrative approach to problems related to the diagnosis, treatment, and rehabilitation of these patients.
It seems pertinent to propose the abandonment of the term 'vegetative' both as conceptually equivocal and as a term that may become a self-fulfilling prophecy. Moreover, a no less important reason to abandon this qualifier is the possibility of a more coherent conceptualization of this syndrome. As a consequence, this approach leads to a new terminology.
在意识的“新皮质主义”理论背景下，“植物人”状态的概念在医学文献中流行起来。其清晰的简单性及其支持者的威望促成了这种接受。然而，这一概念在神经学和哲学上似乎并不恰当。此外，近年来一些研究表明，这些状态经常被误诊，主要是由于其内在的复杂性。因此，为该综合征取一个新名称的必要性日益明显。对大脑整体功能的概念化导致了对这些状态的重新定义。从概念上定义了“脑功能失调综合征”。这个术语没有贬义内涵。它尊重与意识主观维度以及这些状态的预后相关的内在不确定性。它促进了对与这些患者的诊断、治疗和康复相关问题的综合处理方法。
提出摒弃“植物人”这一术语似乎是恰当的，因为它在概念上模棱两可，而且可能会成为一种自我实现的预言。此外，摒弃这个限定词的一个同样重要的原因是有可能对该综合征进行更连贯的概念化。因此，这种方法产生了一个新的术语。
