意识障碍的命名伦理问题

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY

NeuroRehabilitation Pub Date : 2024-01-23 DOI:10.3233/nre-230120

Nathaniel M. Robbins MD, James L. Bernat MD

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引用次数: 0

摘要

目前对严重意识障碍（DoC）的分类方案有几个缺陷。首先，在如何纳入隐蔽意识障碍患者方面尚未达成共识。其次，以意识为基础的严重意识障碍定义与以可观察到的运动反应为基础的严重意识障碍诊断之间存在不匹配。第三，目前的分类归纳为多种不同的综合征，这些综合征具有相同的表型，但并不包含潜在的病理生理学。在此，我们讨论了与当前严重 DoC 命名相关的几个伦理问题。最后，我们将针对这些缺陷提出一个修订后的命名法。

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Ethical issues of nosology in disorders of consciousness

The current classification scheme for severe disorders of consciousness (DoC) has several shortcomings. First, there is no consensus on how to incorporate patients with covert consciousness. Second, there is a mismatch between the definitions of severe DoC, based on consciousness, and the diagnosisof these same DoC, which is based on observable motoric responsiveness. Third, current categories are grouped into large heterogeneous syndromes which share phenotype, but do not incorporate underlying pathophysiology. Here we discuss several ethical issues pertaining to the current nosology of severe DoC. We conclude by proposing a revised nosology which addresses these shortcomings.

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来源期刊

NeuroRehabilitation CLINICAL NEUROLOGY-REHABILITATION

CiteScore

3.20

自引率

0.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： NeuroRehabilitation, an international, interdisciplinary, peer-reviewed journal, publishes manuscripts focused on scientifically based, practical information relevant to all aspects of neurologic rehabilitation. We publish unsolicited papers detailing original work/research that covers the full life span and range of neurological disabilities including stroke, spinal cord injury, traumatic brain injury, neuromuscular disease and other neurological disorders. We also publish thematically organized issues that focus on specific clinical disorders, types of therapy and age groups. Proposals for thematic issues and suggestions for issue editors are welcomed.