ABSTRACT
Only a fraction of patients in coma secondary to a primary acute brain injury develop a vegetative state (VS). At least 20% of patients show late transitions to a minimally conscious states (MCS). They are particularly common in young adults with traumatic brain injury. The main problems faced by clinicians are the diagnostic accuracy of VS and MCS as well as the usefulness of sophisticated paraclinical investigations. Specific therapies are of limited effectiveness. This population is vulnerable to misdiagnosis and limited access to medical care and rehabilitation, thus generating ethical problems.
Subject(s)
Humans , Brain Injuries/complications , Coma/etiology , Persistent Vegetative State/etiology , Palliative Care , Prognosis , Time Factors , Coma/diagnosis , Coma/therapy , Persistent Vegetative State/diagnosis , Persistent Vegetative State/therapy , Recovery of Function , Diagnosis, DifferentialABSTRACT
A discussion of four aspects of the legislation and of the medical ethics of the transplants is presented: the concept of death, the donation of organs, the selection of receivers and the future of the therapeutic transplants. The prominent paragraphs of the General Law of Health of the country about cerebral death, the two legal forms and organs donors' ethics, the criteria and more frequent problems for the selection of receivers, and the character of medical technology of transition of the therapeutic transplants are included.
Se presenta una discusión de cuatro aspectos de la legislación y de la ética médica de los transplantes: el concepto de muerte, la donación de órganos, la selección de receptores y el futuro de los trasplantes terapéuticos. Se incluyen los párrafos relevantes de la Ley General de Salud del país sobre muerte cerebral, las dos formas legales y éticas de donadores de órganos, los criterios y problemas más frecuentes para la selección de receptores, y el carácter de tecnología médica de transición de los trasplantes terapéuticos.