The historical origins of the vegetative state: Received wisdom and the utility of the text

Adams, Zoe M.; Fins, Joseph J.

doi:10.1080/0964704x.2016.1184074

Cited by 15 publications

(9 citation statements)

References 15 publications

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“…16 Recently, Zoe Adams and I have recounted the etymology of the vegetative appellation drawing on Plum's scholarship. 17 Plum traces the origins of the vegetative state to the French physician Xavier Bichat (1771-1802), and the American neurologist and endocrinologist Walter Timme (1874-1956), who draws a line to Aristotle's De Anima [On the Soul]. 18,19 To characterize the awake but unresponsive state, Plum invoked a bifurcated nervous system as articulated by Bichat who wrote of a vie de relation (animalic) versus vie de nutrition (vegetative) nervous system.…”

Section: The Origins Of the Vegetative Statementioning

confidence: 99%

Disorders of Consciousness, Past, Present, and Future

Fins¹

2019

Camb Q Healthc Ethics

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Abstract:This paper, presented as the 2019 Cambridge Quarterly Neuroethics Network Charcot Lecture, traces the nosology of disorders of consciousness in light of 2018 practice guidelines promulgated by the American Academy of Neurology, the American College of Rehabilitation Medicine and the National Institute on Disability, Independent Living and Rehabilitation Research. By exploring the ancient origins of Jennett and Plum’s persistent vegetative state and subsequent refinements in the classification of disorders of consciousness—epitomized by the minimally conscious state, cognitive motor dissociation, and the recently described chronic vegetative state—the author argues that there is a counter-narrative to the one linking these conditions to the right to die. Instead, there is a more nuanced schema distinguishing futility from utility, informed by technical advances now able to identify covert consciousness contemplated by Jennett and Plum. Their prescience foreshadows recent developments in the disorders of consciousness literature yielding a layered legacy with implications for society’s normative and legal obligations to these patients.

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Section: The Origins Of the Vegetative Statementioning

confidence: 99%

Disorders of Consciousness, Past, Present, and Future

Fins¹

2019

Camb Q Healthc Ethics

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“…5 This new term represents a justified refinement in our thinking. Nonetheless, we comment upon how changes in the nomenclature of the VS may be received in the bioethics community and in society at large given the etymologic origins of the term vegetative state 6 and the place that the VS has played within American jurisprudence in the evolution of the right to refuse life-sustaining treatment. 7 Based on Dr.…”

Section: Diagnostic Nomenclature Ethics and Ideologymentioning

confidence: 99%

Ethical, palliative, and policy considerations in disorders of consciousness

Fins

Bernat

2018

Neurology

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This essay complements the scientific and practice scope of the American Academy of Neurology Guideline on Disorders of Consciousness by providing a discussion of the ethical, palliative, and policy aspects of the management of this group of patients. We endorse the renaming of "permanent" vegetative state to "chronic" vegetative state given the increased frequency of reports of late improvements but suggest that further refinement of this class of patients is necessary to distinguish late recoveries from patients who were misdiagnosed or in cognitive-motor dissociation. Additional nosologic clarity and prognostic refinement is necessary to preclude overestimation of low probability events. We argue that the new descriptor "unaware wakefulness syndrome" is no clearer than "vegetative state" in expressing the mismatch between apparent behavioral unawareness when patients have covert consciousness or cognitive motor dissociation. We advocate routine universal pain precautions as an important element of neuropalliative care for these patients given the risk of covert consciousness. In medical decision-making, we endorse the use of advance directives and the importance of clear and understandable communication with surrogates. We show the value of incorporating a learning health care system so as to promote therapeutic innovation. We support the Guideline's high standard for rehabilitation for these patients but note that those systems of care are neither widely available nor affordable. Finally, we applaud the Guideline authors for this outstanding exemplar of engaged scholarship in the service of a frequently neglected group of brain-injured patients.

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“…This statistic is higher in developing countries by 6.3% (4). The term of "vegetative" first mentioned by 3 Aristotle's treatise On the Soul, and it was invented as a diagnosis in 1972 by Jennett and Plum (5).…”

Section: Introductionmentioning

confidence: 99%

“…Vegetative state is a devastating condition, in which the patients may be awake but have no signs of awareness and recently is known as "unresponsive wakefulness syndrome" (6). In this state, the sleep-wake cycle and autonomic functions remain intact, but the awareness about self, others and environment would be lost (5). The criteria for diagnosis of PVS are usually subjective and recently, some imaging studies have been promoted (7).…”

Section: Introductionmentioning

confidence: 99%

The care-givers of patients with persistent vegetative state have a terrible life: the result of a qualitative study

Alimohammadi¹,

Arast²,

Abdi³

2020

Preprint

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Background persistent vegetative state (PVS) is one of the results of traumatic brain injury. These patients are hospitalized for a long time, and need more cares. The caregivers are first members who provide care and have some challenges accordingly. With regards to a lack of information in this issue, the current study was conducted to explore Iranian care-givers experiences of caring for PVS patients following traumatic brain injury.Methods this study was conducted as a descriptive phenomenological study in 2019. Semi-structured interviews were done on caregivers of PVS in a center of trauma in Iran. The interviews were recorded and wrote verbatim, then analyzed using seven steps of Collazi with management of MAXQUDA software. Guba and Lincoln`s criteria were used in favor of rigor, including credibility, dependability, transferability, and confirmability.Results twelve people participated in the study and five themes, and ten subthemes extracted from 428 codes. The themes were "falling into tensions", "seeking peace", "imposed therapeutic duties", "preserve connection" and 'unheard sounds ".Conclusion In this study, the caregivers of PVS experienced some injuries and familial crises. They wished peace by praying and drain their feelings, also did some imposed duties, and tried to address all the needs of patient. They assessed patients' signs daily and some information gap, therefore, wanted to obtain them by relationship with staff. The caregivers communicated with patients and hoped to recovery of patients. They were complained of accommodations and lack of staff visits.

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The historical origins of the vegetative state: Received wisdom and the utility of the text

Cited by 15 publications

References 15 publications

Disorders of Consciousness, Past, Present, and Future

Disorders of Consciousness, Past, Present, and Future

Ethical, palliative, and policy considerations in disorders of consciousness

The care-givers of patients with persistent vegetative state have a terrible life: the result of a qualitative study

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