Credits to
Piergiorgio Strata

Clinical evaluation of the state of consciousness in the light of new technologies

Issue 7-8/2019

We are pleased to publish the report presented by Prof. Piergiorgio Strata at the Conference held on 15 October 2018 at the Parliamentary Group Chamber, Rome, entitled “Fine vita. Il dovere di informare ed il diritto ad essere informati per la libertà di scelta e la dignità delle cure: la legge 219/2017”.


Abstract. In recent decades, people have been dying in completely new conditions, which has led to the emergence of ethical problems that have prompted a review of our rights and obligations in the face of death. The circumstances surrounding death are related to the use of tools and machines aimed at prolonging life, but with no guarantee that the patient will retain their bodily functions. This is an ethically controversial issue to which science always offers new knowledge and which requires a careful analysis. The focus in this area is to assess the state of consciousness in a patient. To address the subject, I will briefly summarise the basic concepts of physiological and pathological states of consciousness. I will then focus on the new results obtained via neuroimaging. Italian scholars have contributed to this extraordinary progress, notably Marcello Massimini’s group in Milan, and other groups directed by Steven Laureys in Belgium and by Adrian Owen in Canada. The topic is interesting not only from a medical-scientific point of view, but also from a legal one: it concerns both those who have to assist and decide how to treat a patient, and those who, under the new law of 22 December 2017 – “Norme in materia di consenso informato e di disposizioni anticipate di trattamento” (DAT) – wish to express that the choice to end their life is made of their own volition.  


SUMMARY: 1. Introduction. – 2. Consciousness. – 3. Content of consciousness. – 4. Disorder of consciousness. – 5. Evaluating awareness. – 6. Wakefulness and awareness. – 7. Images. – 8. Repercussions. – 9. The right to make our own decisions?


To read the Reflection, click on “open file”.


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