Fins Joseph J
Weill Medical College of Cornell University, Division of Medical Ethics, New York, NY 10021, USA.
Am J Bioeth. 2008 Sep;8(9):46-52. doi: 10.1080/15265160802334490.
Without exaggeration, it could be said that we are entering a golden age of neuroscience. Informed by recent developments in neuroimaging that allow us to peer into the working brain at both a structural and functional level, neuroscientists are beginning to untangle mechanisms of recovery after brain injury and grapple with age-old questions about brain and mind and their correlates neural mechanisms and consciousness. Neuroimaging, coupled with new diagnostic categories and assessment scales are helping us develop a new diagnostic nosology about disorders of consciousness which will likely improve prognostication and suggest therapeutic advances. Historically such diagnostic refinement has yield therapeutic advances in medicine and there is no reason to doubt that this will be the case for disorders of consciousness, perhaps bringing relief to a marginalized population now on the periphery of the therapeutic agenda. In spite of this promise, the translation of research findings into the clinical context will be difficult. As we move from descriptive categories about disorders of consciousness, like the vegetative or minimally conscious states, to ones further specified by integrating behavioral and neuroimaging findings, humility not hubris should be the virtue that guides the ethical conduct of research and practice.
毫不夸张地说，我们正在进入神经科学的黄金时代。受神经成像最新进展的启发，这些进展使我们能够在结构和功能层面窥视大脑的运作，神经科学家们开始解开脑损伤后的恢复机制，并努力解决有关大脑与心智及其相关神经机制和意识的古老问题。神经成像，再加上新的诊断类别和评估量表，正在帮助我们开发一种关于意识障碍的新诊断分类法，这可能会改善预后并推动治疗进展。从历史上看，这种诊断的细化在医学上带来了治疗进展，毫无疑问，意识障碍也将如此，这或许能为目前处于治疗议程边缘的边缘化人群带来缓解。尽管有这样的前景，但将研究结果转化为临床应用将是困难的。当我们从关于意识障碍的描述性类别，如植物状态或最低意识状态，转向通过整合行为和神经成像结果进一步明确的类别时，谦逊而非傲慢才应该是指导研究和实践道德行为的美德。
