Conversely, there is also fear that people may associate attitudes with higher-functioning people in minimally conscious state with people in persistent vegetative state, thus minimizing the value of their lives. Regulating therapeutic nihilism
Currently, risk aversion dominates the ethical landscape when research involves those with impaired decision-making abilities. Fears of therapeutic adventurism has led to a disproportionate view about the under-appreciation of potential benefits and an overstatement of risks. Thus, recognizing this distortion is important in order to calculate the right balance between protecting vulnerable populations that cannot provide autonomous consent and potentially restorative clinical trials. Notable examples
Jackie Wilson (June 9, 1934 – January 21, 1984) American soul and rock and roll singer who fell into a coma after collapsing on stage, woke up but quickly fell back into a coma for the rest of his life. Jan Grzebski (1942–2008), a Polish railroad worker who fell into a minimally conscious state in 1988 and woke up in 2007. Terry Wallis (1964-2022). This American man was in a coma for nearly a year after a truck accident, then a minimally conscious state for 19 years. Martin Pistorius (born 1975). Because of a mystery illness, the South African spent three years in a vegetative state, four years in a minimally conscious state, and five years unable to move anything other than his eyes (locked-in syndrome). In 1999, he fully awakened, and has since recovered to the point that he was able to become a web designer, developer, and author.
These 3 patients were diagnosed with MCS and had suffered from traumatic brain injuries.In summary, those with minimally conscious state and non-traumatic brain injuries will not progress as well as those with traumatic brain injuries while those in vegetative states have an all around lower to minimal chance of recovery. Because of the major differences in prognosis described in this study, this makes it crucial that MCS be diagnosed correctly. Incorrectly diagnosing MCS as vegetative state may lead to serious repercussions related to clinical management. History
Prior to the mid-1990s, there was a lack of operational definitions available to clinicians and researchers to guide the differential diagnosis among disorders of consciousness. As a result, patients were lumped together into broad categories often based on the severity of the disability (e.g. moderate, severe, extremely severe). These diagnoses were performed without regard to salient differences in behavioral and pathological characteristics. In a three-year period spanning from 1994 to 1996, three position statements regarding the diagnostic criteria of disorder of consciousness were published. The "Medical Aspects of the Persistent Vegetative State" was published by
the American Academy of Neurology (AAN) in 1994. In 1995, "Recommendations for Use of Uniform Nomenclature Pertinent to Patients With Severe Alterations in Consciousness" was published by the American Congress of Rehabilitation Medicine (ACRM). In 1996 the "International Working Party on the Management of the Vegetative State: Summary Report" was published by a group of international delegates from neurology, rehabilitation, neurosurgery, and neuropsychology.