Physiopathology of coma and the vegetative state. Scientific aspects and bioethical choices

Journal title SALUTE E SOCIETÀ
Author/s Massimo Gandolfini
Publishing Year 2011 Issue 2011/1 Language Italian
Pages 8 P. 89-96 File size 271 KB
DOI 10.3280/SES2011-001006 IT
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Applying the technology of neuroimaging to patients in PVS we must to review radically our knowledge of the concept of "absence of consciousness" as the result of total damage to the function of the cerebral cortex. Neuroimaging has demonstred the existence of cortical areas able to manifest definite and definible fragments of cerebral activity in a severely damaged brain, which is said to be "unconscious". Today, it is not possible to talk more of the "absence of consciousness", but rather of the "submerged consciousness". This must lead to a very prudent attitude to avoid considering PVS as an irreversible and/or terminal state, for which it is useless investing scientific and social resources. The drift towards abandonment, or whorse, euthanasia - invoked by certain ideologies founded on the "quality of life" and on "a life not worth living" is more antiscientific than it has ever been. No pathology, including PVS, is defeated or resolved by abandoning or suppressing those who are their innocent victims.

Keywords: Coma, vegetative state, consciousness, wakefulness, neuroimaging, functional magnetic resonance

Massimo Gandolfini, Fisiopatologia del coma e dello stato vegetativo. Aspetti scientifici e scelte bioetiche in "SALUTE E SOCIETÀ" 1/2011, pp 89-96, DOI: 10.3280/SES2011-001006 IT