Fins Joseph J
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.
AMA J Ethics. 2016 Dec 1;18(12):1182-1191. doi: 10.1001/journalofethics.2016.18.12.ecas2-1612.
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.
对于意识障碍患者的临终关怀和参与临床研究的决策始于诊断辨别。准确区分脑状态可明确临床医生的伦理义务和责任。这项工作的核心是有义务为能感知疼痛的最低意识状态患者提供神经姑息治疗，并通过神经假体、药物和康复手段为神经网络完好但未充分激活的患者恢复功能性交流。本文综述了将科学进展应用于意识障碍患者的努力，包括在最低意识状态患者中进行深部脑刺激的研究性应用。这些努力有助于维护长期处于边缘地位人群的公民权利。
