Coma Science: Clinical and Ethical Implications

This book brings together an outstanding group of clinical investigators and neuroscientists engaged in the study of disorders of consciousness. The challenges of coma science are surprisingly difficult with a degree of diagnostic uncertainty that may range at the bedside in some patients from unconscious to fully aware, even for patients with no evidence of behavioral responsiveness.

As measurements improve, behaviorally defined states ranging from vegetative state, minimally conscious state and up to patients in locked-in syndrome will reveal subcategories of patients whose level of consciousness we cannot at present with confidence identify. Many of these investigations are very much in the public eye in part because of their relationship to controversies about end-of-life decisions in permanently unconscious patients and the relationship to one of the major philosophical, sociological, political, and religious questions of humankind.

The chapters presented in this book are likely to help form the scientific foundations for frameworks to systematically organize information and approaches to future clinical assessments of disorders of consciousness. It is edited by Steven Laureys (Liège), Nicholas Schiff (New York) and Adrian Owen (Cambridge) and is an official title of the Coma and Consciousness Consortium funded by the James McDonnell Foundation. The books’ interest is threefold.

First, the exploration of brain function in disorders of consciousness represents a unique lesional approach to the scientific study of consciousness and adds to the worldwide effort to identify the 'neural correlate of consciousness'. Second, patients with coma and related disorders of consciousness continue to represent a major clinical problem in terms of diagnosis, prognosis, and treatment. Third, new scientific insights in this field have major ethical, societal and medico-legal implications, which are the topic of the last part of the book.

Edited by Laureys S, Schiff S Owen A, Elsevier, 
New York, November 2009, 496 pages, 28 chapters, color illustrations, hardback.
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