New taxonomy for prolonged disorders of consciousness may help with decisions on withdrawal of clinically assisted nutrition and hydration: A proposed decision-making pathway

• Autor(a) principal: Teixeira, Liliana da Conceição
• Data de Publicação: 2021
• Outros Autores: Rocha, Nuno, Nunes, Rui
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.8/7130
• topic: Clinically assisted nutrition and hydration; Consciousness; Covert cognition; Decision-making; Minimally conscious state; Prolonged disorders of consciousness; Vegetative state

The number of patients surviving severe brain injury is increasing; however, many are left in a prolonged disorder of consciousness. With appropriate treatment, these patients can survive for years. Unless a living will exists; the doctors can authorize withdrawal of artificial nutrition and hydration for these patients, based on best interests. There is an urge to revise the current terminology used in prolonged disorders of consciousness (vegetative state and minimally conscious state) to better reflect our understanding of these conditions, which will, in turn, ease the challenges faced when making a decision about withdrawal of artificial nutrition and hydration of these patients. A decision-making pathway based on a new taxonomy is proposed. The importance of reassessment is reinforced to clarify diagnosis and help with prognosis. Adopting a new classification for prolonged disorders of consciousness would clarify how we think about these patients