This piece was contributed by Dr. Syd Johnson. Learn more about her here and here.

Disorders of consciousness (DOC), including the vegetative state/unresponsive wakefulness syndrome, and the minimally conscious state, have long fueled legal and ethical debate, and are also a source of considerable anguish for families forced to make life and death decisions on behalf of their loved ones. Particularly contentious are decisions concerning the withdrawal of life-sustaining treatment for patients who have a poor prognosis for further recovery. Implicit assumptions about the value of life in a state of impaired consciousness often inform decisions, but persistently unanswered questions about the quality of life of persons with DOCs remain a source of uncertainty and distress. Yet, despite the importance of quality of life in end-of-life decision making, there are no validated methods for assessing quality of life in this population. A significant obstacle to doing so is the inability of these patients to communicate. Read the rest of this entry »