consciousness and neurological diseases : an ethical challenge
Identifieur interne : 000106 ( Main/Exploration ); précédent : 000105; suivant : 000107consciousness and neurological diseases : an ethical challenge
Auteurs : Christian Tannier [France]Source :
Descripteurs français
- mix :
- Wicri :
- topic : Autonomie, Récusation, éthique, Neurologie, Autonomie, Neurologie.
English descriptors
Abstract
Neurological diseases affecting consciousness are the worst ordeal inflicted to the power of our mind (1), to our autonomy and independence. Even if medicine faces this drama with more and more precise diagnoses, therapy often remains helpless. Medical staff then confronts an ethical challenge when meeting this hurted human being, who experiences difficulties to be part of the world, as well as to claim his/her own identity and free will (2). How can we provide a fair and helpful medical care in these tragic situations? How can we preserve patient's autonomy without denying his/her extreme vulnerability? How should we consider the person when their consciousness is gone? (3) Finally, when close to the endpoint, how can we avoid "unreasonable" obstinacy as it is described by the law?In this work, we suggest balanced responses to these questions, considering the graduated levels of consciousness, in both its states and its contents. These responses contrast with those of the law or of oversimplified principles, that are inevitably binary. Yet, handling complexity does not preclude audacious challenges or wise limits. Betting on abilities rather than disabilities does not help the patient to recover; however, it represents a total shift in the caring relationship, by aiming to preserve autonomy, even if supported.These issues concern extreme vulnerability, as well as limits of human beings and medicine. They question both our responsibility and generosity, and invite us to avoid abandonment, violence as well as obstinacy. That is what ethics by essence: the search of a practical wisdom attenuating the tragic aspects of situations.
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Even if medicine faces this drama with more and more precise diagnoses, therapy often remains helpless. Medical staff then confronts an ethical challenge when meeting this hurted human being, who experiences difficulties to be part of the world, as well as to claim his/her own identity and free will (2). How can we provide a fair and helpful medical care in these tragic situations? How can we preserve patient's autonomy without denying his/her extreme vulnerability? How should we consider the person when their consciousness is gone? (3) Finally, when close to the endpoint, how can we avoid "unreasonable" obstinacy as it is described by the law?In this work, we suggest balanced responses to these questions, considering the graduated levels of consciousness, in both its states and its contents. These responses contrast with those of the law or of oversimplified principles, that are inevitably binary. Yet, handling complexity does not preclude audacious challenges or wise limits. Betting on abilities rather than disabilities does not help the patient to recover; however, it represents a total shift in the caring relationship, by aiming to preserve autonomy, even if supported.These issues concern extreme vulnerability, as well as limits of human beings and medicine. They question both our responsibility and generosity, and invite us to avoid abandonment, violence as well as obstinacy. That is what ethics by essence: the search of a practical wisdom attenuating the tragic aspects of situations.</div></front></TEI><affiliations><list><country><li>France</li></country></list><tree><country name="France"><noRegion><name sortKey="Tannier, Christian" sort="Tannier, Christian" uniqKey="Tannier C" first="Christian" last="Tannier">Christian Tannier</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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