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Ethics and the 2018 Practice Guideline on Disorders of Consciousness: A Framework for Responsible Implementation
Andrew Peterson1, Michael J Young1, Joseph J Fins1
1From the Institute for Philosophy and Public Policy (A.P.), George Mason University, Fairfax, VA; Penn Program on Precision Medicine for the Brain (A.P.), University of Pennsylvania, PA; Department of Neurology and Edmond J. Safra Center for Ethics (M.J.Y.), Harvard University, Boston, MA; Division of Medical Ethics (J.J.F.), Weill Cornell Medical College, Cornell University, New York, NY; and Solomon Center for Health Law & Policy (J.J.F.), Yale Law School, New Haven, CT.
Abstract:
The 2018 practice guideline on disorders of consciousness marks an important turning point in the care of patients with severe brain injury. As clinicians and health systems implement the guideline in practice, several ethical challenges will arise in assessing the benefits, harms, feasibility, and cost of recommended interventions. We provide guidance for clinicians when interpreting these recommendations and call on professional societies to develop an ethical framework to complement the guideline as it is implemented in clinical practice.
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