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Detecting Levels of Consciousness

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Handbook of Neuroethics

Abstract

Patients with disordered consciousness due to brain injury pose medical and ethical challenges. Rates of clinical misdiagnosis of “vegetative”/unresponsive, minimally conscious and locked-in syndrome states remain challengingly high. Clinical misdiagnosis raises profound ethical concerns in terms of medical management, treatment of pain, and end-of-life decisions. Therefore, valid diagnosis is of utmost importance in clinical settings. A number of neuroimaging and electrophysiology studies now suggest that some behaviorally “vegetative state” patients may nevertheless show atypical cortical activation during resting state conditions; in some cases, they are able to follow commands or even communicate through willfully modified brain activity. Advances in investigating disorders of consciousness with neuroimaging techniques promise to lead to a more accurate understanding of individual patients’ cognitive abilities and to shed light on the gray zones of these clinical conditions. The formulation of an ethical framework which will strike a balance between the protection of these patients and further research on disorders of consciousness is an ethical, clinical, and scientific demand.

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Authors and Affiliations

  1. Coma Science Group, Cyclotron Research Center & Neurology Department, University of Liège, Sart Tilman-B30, 4000, Liège, Belgium

    Athena Demertzi & Steven Laureys

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  1. Athena Demertzi
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  2. Steven Laureys
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Correspondence to Athena Demertzi .

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Editors and Affiliations

  1. Institute for Ethics and History of Medicine, University of Tübingen, Tübingen, Germany

    Jens Clausen

  2. The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia

    Neil Levy

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Demertzi, A., Laureys, S. (2015). Detecting Levels of Consciousness. In: Clausen, J., Levy, N. (eds) Handbook of Neuroethics. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-4707-4_39

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  • DOI: https://doi.org/10.1007/978-94-007-4707-4_39

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