Dementia Challenging ethical problems arise in the management of patients with dementia as a consequence of their inexorably progressive intellectual impairment and of physicians’ psychological discomfort in treating patients with…

States of Profound Paralysis with Intact Cognition Challenging ethical issues arise in neurological disorders that produce chronic profound paralysis of voluntary muscles while preserving consciousness and cognition. Disorders that produce…

Severe Neurological Disorders in Neonates Over the past three decades, the neonatal intensive care unit (NICU), also called the intensive care nursery (ICN), has been the site of a continuing…

Disorders of Consciousness Managing patients with disorders of consciousness presents challenging ethical issues for neurologists and neurosurgeons and raises vexing questions. How can physicians be certain that the patient is…

Brain Death “Brain death” is a colloquial term for human death determined by brain criteria. It is used when observable functions of the brain have ceased irreversibly even though other…

Medical Futility The concept of medical futility continues to provoke bioethical controversy although scholarly debate about it has diminished over the past decade. A requested therapy may be said to…

Physician-Assisted Suicide and Voluntary Active Euthanasia In the preceding chapter, I showed that over the past three decades, Western society has accepted the ethical and legal rights of terminally ill…

Refusal of Life-Sustaining Treatment A defining characteristic of Western medicine over the past three decades is the formalization of the right of patients to refuse unwanted medical therapy including life-sustaining…

Dying and Palliative Care The management of the dying patient is the focus of many ethical issues in medicine in general and neurology in particular. Ethical issues arise frequently in…

Resolving Ethical Dilemmas Clinical-ethical dilemmas can be defined as clinical problems in which all feasible solutions require breaking a moral rule. Whether to continue painful aggressive treatment of an incompetent,…