Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-vfjqv Total loading time: 0 Render date: 2024-04-28T15:11:00.781Z Has data issue: false hasContentIssue false

Chapter 16 - Cognitive Dissonance and the Care of Patients with Disorders of Consciousness

from Section 2 - Consultation

Published online by Cambridge University Press:  17 February 2022

D. Micah Hester
Affiliation:
University of Arkansas for Medical Sciences, College of Medicine
Toby L. Schonfeld
Affiliation:
National Center for Ethics in Health Care, US Department of Veterans Affairs
Get access

Summary

Although there is a substantial and growing scholarship on disorders of consciousness – conditions spanning coma, brain death, the vegetative state, and the minimally conscious state – when these cases occur in clinical practice, the degree of clinician ignorance can make it seem as if these scenarios were occurring for the very first time (Giacino et al., 2014). Care can be marked by improvisation and ignorance to the detriment of patients and families as well as to staff whose resilience can be tested by the challenges posed by severe brain injury.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, ZM, Fins, JJ (2017) The historical origins of the vegetative state: Received wisdom and the utility of the text. Journal of the History of the Neurosciences, 26(2): 140153.CrossRefGoogle ScholarPubMed
Classen, J, Doyle, K, Matory, A, et al. (2019). Detection of brain activation in unresponsive patients with acute brain injury. New England Journal of Medicine, 380(26): 24972505.CrossRefGoogle Scholar
Edlow, BL, Fins, JJ (2018). Assessment of covert consciousness in the intensive care unit: Clinical and ethical considerations. Journal of Head Trauma and Rehabilitation, 33(6): 424434.CrossRefGoogle ScholarPubMed
Fins, JJ (2015). Rights Come to Mind: Brain Injury, Ethics and the Struggle for Consciousness. New York: Cambridge University Press.CrossRefGoogle Scholar
Fins, JJ (2019a). Disorders of consciousness in clinical practice: Ethical, legal and policy considerations. In Posner, JP, Saper, CB, Claussen, J, Schiff, ND, eds., Plum and Posner’s Diagnosis of Stupor and Coma, 5th ed. New York: Oxford University Press, 449477.Google Scholar
Fins, JJ (2019b). Disorders of consciousness, Past, present, and future. Cambridge Quarterly of Healthcare Ethics, 28(4): 603615.CrossRefGoogle ScholarPubMed
Fins, JJ (2019c). When no one notices: Disorders of consciousness and the chronic vegetative state. The Hastings Center Report, 49(4): 1417.CrossRefGoogle ScholarPubMed
Fins, JJ (2020). Cruzan and the other evidentiary standard: A reconsideration of a landmark case given advances in the classification of disorders of consciousness and the evolution of disability law. Southern Methodist University Law Review, 73(1): 91118.Google Scholar
Fins, JJ, Bernat, JL (2018). Ethical, palliative, and policy considerations in disorders of consciousness. Neurology, 91(10): 471475.CrossRefGoogle ScholarPubMed
Fins, JJ, Pohl, BR (2015). Neuro-palliative care and disorders of consciousness. In Hanks, G, Cherny, NI, Christakis, NA, Fallon, M, Kassa, S, Portenoy, RK, eds., Oxford Textbook of Palliative Medicine, 5th ed. Oxford University Press, 285291.CrossRefGoogle Scholar
Giacino, JT, Ashwal, S, Childs, N, et al. (2002). The minimally conscious state: Definition and diagnostic criteria. Neurology, 58(3): 349353.Google Scholar
Giacino, JT, Fins, JJ, Laureys, S, Schiff, ND (2014). Disorders of consciousness after acquired brain injury: The state of the science. Nature Reviews Neurology, 10(2): 99114.CrossRefGoogle ScholarPubMed
Giacino, JT, Katz, DI, Schiff, ND, et al. (2018). Practice guideline: Disorders of consciousness. Neurology, 91(10): 450460.CrossRefGoogle ScholarPubMed
Jennett, B, Plum, F (1972). Persistent vegetative state after brain damage: A syndrome in search of a name. Lancet, 1(7753): 734737.CrossRefGoogle ScholarPubMed
Multi-Society Task Force on PVS. (1994). Medical aspects of the persistent vegetative state (Parts 1 and 2). New England Journal of Medicine, 330(21): 14991508 and 330(22): 1572–1579.CrossRefGoogle Scholar
Schiff, ND (2015). Cognitive motor dissociation following severe brain injury. JAMA Neurology, 72(12): 14131415.CrossRefGoogle Scholar
Schiff, ND, Fins, JJ (2016). Brain death and disorders of consciousness. Current Biology, 26(13): R572R576.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×