Disorders of Consciousness, Agency, and Health Care Decision Making: Lessons from a Developmental Model

Author granted license

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International

Document Type

Article

Publication Date

2018

ISSN

2150-7740

Publisher

Taylor & Francis

Language

en-US

Abstract

The health care decision-making framework applied to adolescents, a process that gives minors an increasing role in decision making as they mature, should be applied to patients recovering from disorders of consciousness. The flexibility afforded by this framework allows for participation to change over time in accordance with the patient's evolution during the recovery process, unlike the rigid surrogate-focused model utilized for those with permanent incapacity. While the legal system may regard patients with disorders of consciousness and subsequent disability as incompetent to make decisions, respect for personhood and self-determination requires that the physician and surrogate involve the recovering patient in decision making to the maximal extent possible.

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