Department of Neurology, University of Wisconsin, 1685 Highland Avenue, 7th Floor, Madison, WI 53705-2281, USA; Centro Anahuac de Desarrollo Estrategico en Bioetica (CADEBI), Universidad Anahuac Mexico, Edo. Mex. MEX; UNESCO Chair of Bioethics and Human Rights, Rome, ITA.
Department of Neurology, The University of Chicago, 5841 South Maryland Avenue, MC 2030, Chicago, IL 60637, USA.
Phys Med Rehabil Clin N Am. 2024 Feb;35(1):1-13. doi: 10.1016/j.pmr.2023.06.021. Epub 2023 Jul 27.
Providers of patients with disorders of consciousness (DoC) face clinical and ethical challenges that could be lessened by becoming acquainted with the subjective and objective aspects of consciousness. A first step to improving DoC taxonomies, management, and outcomes might be to recognize the shortcomings of the medical concept of consciousness and to improve the terminology used for the clinical parameters assessed. The authors critically review the medical perspective of consciousness represented by three sub-concepts that do not necessarily correlate with one another and discuss how none of them reflects fully the personal subjective nature of consciousness.
意识障碍(DoC)患者的提供者面临着临床和伦理方面的挑战,如果他们熟悉意识的主观和客观方面,这些挑战可能会减少。改善 DoC 分类、管理和结果的第一步可能是认识到意识的医学概念的局限性,并改进用于评估临床参数的术语。作者批判性地回顾了意识的医学观点,该观点由三个不一定相互关联的子概念来表示,并讨论了它们都没有完全反映意识的个人主观性。