Disorders of Consciousness Rehabilitation: Ethical Dimensions and Epistemic Dilemmas

Abstract

Patients with disorders of consciousness who survive to discharge following severe acute brain injury may face profoundly complex medical, ethical, and psychosocial challenges during their courses of recovery and rehabilitation. Although issues encountered in caring for such patients during acute hospitalization have received substantial attention, ethical challenges that may arise in subacute and chronic phases have been underexplored. Shedding light on these issues, this article explores the landscape of normative issues in the course of treating and facilitating access to care for persons with disorders of consciousness during rehabilitation and examines potential implications for patients, clinicians, family members, and society.

Keywords: Brain injury; Coma; Covert consciousness; Disorders of consciousness; Minimally conscious state; Neuroethics; Unresponsive wakefulness syndrome.