Abstract
The aim of the present paper was to investigate the fundamental ethical issues of Deep Brain Stimulation (DBS) on patients remaining in Persistent Vegetative State (PVS). First, the purpose of this analysis was to discuss the nature of this intervention in order to classify it such as an ordinary clinical practice, or otherwise as an extraordinary clinical practice or as experimental research. Second, ethical issues, criticisms, and methodological issues of this intervention, also in the future perspectives, are discussed, attempting to identify who could give informed consent for a patient in PVS.
Highlights
A Persistent Vegetative State (PVS) refers to a disorder of consciousness in which severely brain-injured patients remain in a state of wakefulness without detectable awareness
The aim of the present paper was to investigate the fundamental ethical issues of Deep Brain Stimulation (DBS) on patients remaining in Persistent Vegetative State (PVS)
Some may progress to a permanent Vegetative State (VS), generally 3 months after an anoxic brain event and 12 months after brain trauma, while others may progress to a Minimally Conscious State (MCS), in which integrated but under sustained cortical functions are retained [1, 2]
Summary
A Persistent Vegetative State (PVS) refers to a disorder of consciousness in which severely brain-injured patients remain in a state of wakefulness without detectable awareness. In this extended state of unconsciousness, accompanied by nearly normal cycles of sleeping and waking, the brainstem and thalamus are relatively spared, but cortical functional connectivity is limited or absent. Deep Brain Stimulation (DBS) has been proposed as an experimental therapeutic strategy that might produce consistent and sustained effects of maintaining excitatory activity within functionally disconnected forebrain neurons (2012). It is used in treating in several neurological and psychiatric diseases. The selection of potential recipients of DBS is limited by the current inability to estimate cerebral function based on bedside examination [4]
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