abstract:

Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness (2015) by Joseph J. Fins offers rich narratives of families and patients who experience disorders of consciousness in flawed health-care systems that are not clinically, structurally, financially, or ethically prepared to respond to the inherent complexities of these conditions. In 2018, only a few years after the publication of this book, the medical guidelines for these disorders officially changed with key publications in Neurology. Fins has called on bioethicists to respond to these significant developments, and this paper serves as a response to that call. This article offers a critical analysis of a couple of Fins’s arguments. But it also emphasizes the importance of these developments and Fins’s work for thinking through bedside and organizational ethics issues that arise in advocating for patients with disorders of consciousness.

摘要：

权利要牢记：约瑟夫·J·芬斯（Joseph J. Fins）撰写的《脑损伤，道德和意识斗争》（2015年），为家庭和患者提供了丰富的叙述，他们在有缺陷的医疗保健系统中经历了意识障碍，而这在临床上，结构上，财务上都没有，或道德上准备应对这些条件的内在复杂性。在本书出版仅数年之后的2018年，针对这些疾病的医学指南随神经病学的主要出版物而正式改变。Fins呼吁生物伦理学家对这些重大发展做出回应，而本文就是对此呼吁的回应。本文对Fins的一些论点进行了批判性分析。但是它也强调了这些发展和Fins的工作对于思考床位和组织道德问题的重要性，这些问题是在倡导意识障碍患者时出现的。