Neurobiology, Suffering and Unconscious Brain States

Commentary: neurobiology, suffering, and unconscious brain states

N.D. Schiff

Journal of Pain and Symptom Management 17, 303-304 (1999)


The case presented illustrates ambiguities concerning the state of consciousness and the management of patients with catastrophic brain injuries. The ethical problem presented centers on the administration of a morphine infusion in the hope of achieving an appearance of lessened "distress" in a comatose patient who exhibits an increased respiratory rate drive as the result of primary neurologic and metabolic causes. The house officer identifies difficulties in providing a mechanistic account of the possible level of awareness in the patient and the possiblity of pain and suffering

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