Ethical and Legal Issues in Neurology: Chapter 19. Ethical issues in states of impaired communication with intact consciousness and language

Ethical and Legal Issues in Neurology: Chapter 19. Ethical issues in states of impaired communication with intact consciousness and language
ISBN-10
0128080817
ISBN-13
9780128080818
Series
Ethical and Legal Issues in Neurology
Category
Medical
Pages
472
Language
English
Published
2014-01-09
Publisher
Elsevier Inc. Chapters
Author
Leo Mccluskey

Description

Acute and chronic peripheral and/or central disorders of the voluntary motor system can produce profound paresis or paralysis, at times with ophthalmoplegia, while preserving consciousness and language function. Although at times appearing to be unconscious, these patients are awake and alert but unable to communicate, manipulate their environment, or participate in medical decision-making. Clinicians caring for these patients are ethically tasked with recognizing this clinical reality, enacting measures to facilitate communication, and abiding by ethical and legal principles that support autonomous patient-centered decision-making. This chapter reviews the various disorders that may cause this state while using three exemplary disorders – locked-in syndrome, caused by an anterior pontine lesion; high cervical spinal cord lesion; and amyotrophic lateral sclerosis – to discuss the management of these patients.

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