Ethical aspects of disordered states of consciousness.

The medical care of patients in disordered states of consciousness, including vegetative and minimally conscious states, raises some of the most intricate ethical questions in medicine. There is inherent ambiguity and uncertainty involved in diagnosing such patients and evaluating their level of awareness and prognosis for recovery. The care of these patients requires the weighing of competing ethical values, including respect for personal autonomy, protection of vulnerable patients, nonmaleficence, and the just use of limited medical resources. We highlight some of the major ethical issues in caring for patients with severe brain injury.