The Difficulty with Determining Whether Someone is Dead

Miller-Smith, Laura; Wagner, Ásdís Finnsdóttir; Lantos, John D.

doi:10.1007/978-3-030-00943-4_5

Cited by 2 publications

(1 citation statement)

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“…The assessment and management of pain in patients with a DOC remain a challenge. The perception of pain in these patients arises rehabilitative problems with ethical issues extending beyond the boundaries of end-of-life decisions ( Miller-Smith et al, 2019 ; Wolf-Meyer, 2020 ). To date, the correct assessment of DOC patients has a high rate of misdiagnosis ( Bosco et al, 2010 ; van Erp et al, 2015 ), and the misinterpretation of the behavioral signs may lead to a non-fully appropriate rehabilitative approach.…”

Section: Discussionmentioning

confidence: 99%

Addressing Pain for a Proper Rehabilitation Process in Patients With Severe Disorders of Consciousness

2021

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Consciousness constitutes a fundamental prerequisite in the individual appraisal and experience of pain. In the same way, a person needs to be able to report on pain perception. Patients who suffered a severe brain injury with disorders of consciousness (DOC) represent a spectrum of pathologies affecting patients' capacity to interact with the external world. In these patients, the most relevant aspects in response to pain are physiologic and behavioral. The treatments and management of pain are challenging issues in these patients, arising serious ethical concerns and bringing emotional load among medical staff, caregivers, and relatives. In this review, we report the importance of having a correct pain management in DOC patients, to individuate the best pharmacological treatment that can make the difference in detecting a behavioral response, indicative of a change in the level of consciousness, and in planning a more effective rehabilitative approach.

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