Neurosurgical Study Finds Long Term Disabled May Adapt To Severe Disability

MedicalResearch:com Interview with:
Stephen Honeybul FDS RCS (Eng), FRCS (SN), FRACS
Consultant Neurosurgeon
Sir Charles Gairdner Hospital
HOD Royal Perth Hospital
Perth WA Australia

MedicalResearch: What are the main findings of this study? 

Dr. Honeybul: Amongst those patients who had been adjudged severely disabled or in a vegetative state at 18 months, remained as such at the three years follow up.

Most patients who were able to provide a response said that they would have provided consent to the “life saving” intervention even if they had known their final outcome

MedicalResearch: Were any of the findings unexpected?

Dr. Honeybul: These findings were, at least to the senior authors, unexpected and could on face value lend support to the ongoing use of decompressive surgery even if there are an increasing number of survivors with severe neurocognitive disability. It may well be that they have adapted to a level of neurological disability that they might previously have deemed unacceptable.

MedicalResearch: What should patients and clinicians take away from this report?

Dr. Honeybul: These findings may help alleviate some of the difficulties faced by clinicians when considering surgical intervention and there is concern regarding survival with severe disability. This may be deemed “unfavourable’ but may not always be necessarily “unacceptable”

Citation:

Long-term survival with unfavourable outcome: a qualitative and ethical analysis

Stephen Honeybul, Grant R Gillett, Kwok M Ho, Courtney Janzen, Kate Kruger

J Med Ethics medethics-2013-101960Published Online First: 25 June 2014 doi:10.1136/medethics-2013-101960