Fins has argued against a nihilistic approach to patients with chronic disorders of consciousness, as if the loss of function is invariably permanent and there is nothing more to be gained from diagnostic testing and treatment. We agree that these patients deserve a more systematic approach to assessment, prognosis, and treatment. The evidence described in this review shows that these conditions include a wide range of pathologies, causes, prognoses, and proven treatments. Diagnostic testing can be used to determine the degree of injury and suggest residual capacity for cognitive function. Future work will allow the use of imaging modalities to predict recovery and development of tools to communicate with those who have lost all motor function.