Public perception of the vegetative state/unresponsive wakefulness syndrome: a crowdsourced study.

BACKGROUND

The vegetative state (VS)/unresponsive wakefulness syndrome (UWS) denotes brain-injured, awake patients who are seemingly without awareness. Still, up to 15% of these patients show signs of covert consciousness when examined by functional magnetic resonance imaging (fMRI) or EEG, which is known as cognitive motor dissociation (CMD). Experts often prefer the term to avoid the negative connotations associated with and to highlight the possibility for CMD. However, the perception of VS/UWS by the public has never been studied systematically.

METHODS

Using an online crowdsourcing platform, we recruited 1,297 lay people from 32 countries. We investigated if and might have a different influence on attitudes towards VS/UWS and the concept of CMD.

RESULTS

Participants randomized to be inquired about the believed that CMD was less plausible (mean estimated frequency in unresponsive patients 38.07% ± SD 25.15) than participants randomized to (42.29% ± SD 26.63; Cohen's d 0.164;  = 0.016). Attitudes towards treatment withdrawal were similar. Most participants preferred (60.05%), although a sizeable minority favored (24.21%; difference 35.84%, 95% CI 29.36 to 41.87;  < 0.0001). Searches on PubMed and Google Trends revealed that is increasingly used by academics but not lay people.

DISCUSSION

Simply replacing with may not be fully appropriate given that one of four prefer the first term. We suggest that physicians take advantage of the controversy around the terminology to explain relatives the concept of CMD and its ethical implications.