¿Dolor sin consciencia? Repensar el dolor-sufrimiento en pacientes con desórdenes de la consciencia
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Los desórdenes de la consciencia (DoC) son un desafío para la comprensión del dolor y del sufrimiento, ya que son experiencias subjetivas complejas que involucran múltiples redes neuronales. Estudios neurofisiológicos y de neuroimagen sugieren que algunos pacientes en estado vegetativo podrían experimentar dolor y que aquellos con consciencia encubierta tienen mayor probabilidad de percibirlo. Sin embargo, los pacientes al no poderlo expresar son ignorados por el personal médico. Esta revisión narrativa aborda las investigaciones neurocientíficas recientes sobre el dolor en estos pacientes, resaltando la necesidad de reconsiderarlo en la práctica clínica. En un contexto de incertidumbre diagnóstica y pronóstica, es fundamental profundizar en la investigación y establecer marcos éticos que garanticen el respeto a la autonomía y el bienestar de estos pacientes, por lo que se abordan los dilemas bioéticos derivados del uso de neurotecnologías en pacientes que no pueden expresar su consentimiento.
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