Related Experiment Video
Updated: May 6, 2026

Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
Ethical issues in states of impaired communication with intact consciousness and language
1ALS Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Abstract:
Acute and chronic peripheral and/or central disorders of the voluntary motor system can produce profound paresis or paralysis, at times with ophthalmoplegia, while preserving consciousness and language function. Although at times appearing to be unconscious, these patients are awake and alert but unable to communicate, manipulate their environment, or participate in medical decision-making. Clinicians caring for these patients are ethically tasked with recognizing this clinical reality, enacting measures to facilitate communication, and abiding by ethical and legal principles that support autonomous patient-centered decision-making. This chapter reviews the various disorders that may cause this state while using three exemplary disorders - locked-in syndrome, caused by an anterior pontine lesion; high cervical spinal cord lesion; and amyotrophic lateral sclerosis - to discuss the management of these patients.
Related Concept Videos
Language and Cognition
Barriers to Effective Communication I
Communication barriers include the following:
Physiological barriers: They are limitations caused by a person's health condition or disability, such as hearing loss, poor eyesight, illness, or unconsciousness. An example to overcome this...
Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Ethical Issues
Ethical Concerns in Healthcare:
Subconsciousness and No Awareness
An illustrative example of subconscious processing is its role in problem-solving. Often, individuals...
Therapeutic Communication
Verbal communication depends on language or a prescribed way of using words so that people can share information effectively. The critical aspects of verbal...

