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Locked in syndrome, PVS and ethics at the end of life
Gillett, Grant Chisholm, Nick
Gillett, Grant
Chisholm, Nick
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GE Subjects
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Abstract
LiS (also known as coma vigilante) poses problems for clinicians who often do not understand that their patient is a silent and unresponsive witness to everything that is happening to themii. In fact it is usually relatives rather than medical staff who realise the patient’s predicament (they tend to notice that the patient is registering what is going on). In Nick’s case, his mother and his girlfriend pleaded with medical staff to see that he was aware of what was happening and when that realization finally dawned, the climate of care changed. A patient in LiS cannot interact with us because he has lost the ability to control his body (except, in most cases, the ability to move the eyes up and down in the orbit) but the subliminal cues that intuitively alert us to the presence of another person are all that is needed for the suspicion to form and then the diagnosis to be confirmed by imaging and bedside interaction.
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2007-11
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With permission of the license/copyright holder