Pain Without Consciousness? Rethinking pain-suffering in Disorders of Consciousness
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Disorders of consciousness (DoC) are a challenge for understanding pain and suffering, as they are complex subjective experiences involving multiple neural networks. Neurophysiological studies and neuroimaging suggest that some patients in a vegetative state may experience pain, and those with covert consciousness are more likely to perceive it. However, these patients are often ignored by medical staff because they cannot express it. This narrative review addresses recent neuroscientific research on pain in these patients, highlighting the need to reconsider it in clinical practice. In the context of diagnostic and prognostic uncertainty, it is crucial to deepen and establish ethical frameworks to ensure respect for the autonomy and well-being of there patients, addressing the bioethical dilemmas derived from the uso of neurotechnologies in patients who cannot express consent.
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