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Published in: Neurocritical Care 3/2009

01-06-2009 | Ethical Matters

Justified Use of Painful Stimuli in the Coma Examination: A Neurologic and Ethical Rationale

Authors: Michael A. Williams, Cynda H. Rushton

Published in: Neurocritical Care | Issue 3/2009

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Abstract

Much has been written about the neurologic basis and rationale for the coma examination, but little has been written about its ethical framework. In contrast to the neurologic framework, the ethical basis for the use of painful stimuli in the coma examination is context dependent and value driven, aimed at identifying the ethical justification for healthcare professionals to cause pain for patients in ways that would not be tolerated or justifiable in any other setting. Basic ethical principles can be used to justify the use of painful stimuli to examine patients, but they also impose limits on their use. To clarify the ethical issues that apply to the coma examination, we review its neurologic and ethical bases and propose a practical test by which to justify the use of painful stimuli.
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Metadata
Title
Justified Use of Painful Stimuli in the Coma Examination: A Neurologic and Ethical Rationale
Authors
Michael A. Williams
Cynda H. Rushton
Publication date
01-06-2009
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 3/2009
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-009-9196-x

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