Division of Neurocritical Care, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Institute for Philosophy and Public Policy and Department of Philosophy, George Mason University, Fairfax, Virginia.
Semin Neurol. 2022 Jun;42(3):375-392. doi: 10.1055/a-1883-0701. Epub 2022 Jun 23.
This review provides an ethical analysis of disorders of consciousness (DoC) along the care continuum, from preinjury to injury, acute care to subacute care and early rehabilitation, and finally transitioning to chronic rehabilitation and societal reintegration. We provide an actionable, chronological assessment of ethical issues related to DoC care. This expands upon established ethics literature, which focuses almost exclusively on the clinical encounter for DoC. Our goal is to broaden the aperture of ethical analysis to address how social and environmental conditions predispose some persons to brain injury, and how such conditions might also pose barriers to meaningful societal reintegration after recovery.
这篇综述沿着护理连续体,从损伤前到损伤后、急性护理到亚急性护理和早期康复,最后过渡到慢性康复和社会重新融入,对意识障碍(DOC)进行了伦理分析。我们对与 DOC 护理相关的伦理问题进行了按时间顺序排列的、切实可行的评估。这扩展了几乎专门关注 DOC 临床情况的既定伦理文献。我们的目标是扩大伦理分析的视角,以解决社会和环境条件如何使某些人易患脑损伤,以及这些条件在康复后如何也可能成为有意义的社会重新融入的障碍。