The review by Kobylarz and Schiff in this issue of ARCHIVES points toward a future of greater diagnostic precision for states of impaired consciousness with eventual implications for prognosis and treatment of severe brain injury.1
Bringing additional clarity to the diagnostic process would seem to be an unimpeachable good. Knowledge, at least in Baconian science, has always been empowering and value-neutral. Unfortunately, improving our understanding of disorders of consciousness is a contentious area. One need only recall the highly publicized case of Terry Schiavo in Florida in which diagnostic distinctions were intentionally conflated by ideology to promote a political agenda.
Fins JJ, Plum F. Neurological Diagnosis Is More Than a State of Mind: Diagnostic Clarity and Impaired Consciousness. Arch Neurol. 2004;61(9):1354–1355. doi:10.1001/archneur.61.9.1354
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