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Coma and Disorders of Consciousness
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Despite the difficulties, there are some useful predictors of outcome. In general, the longer a person is in an unconscious or partially conscious state, the less likely they are to recover, and the less likely they are to make a complete recovery (Andrews, 1993). If a person loses or does not regain their most fundamental reflexes—those of the eye's pupil—a poor outcome is reliably predicted (Zandbergen, 2008). Additionally, the older a person is, the less likely they are to recover (Estraneo & Trojano, 2018). In theory, brain scans can also be used to predict improvement by detecting brain activity that is not expressed as behavior—for example, the person may be asked to imagine playing tennis or to imagine navigating rooms of a house, and then their brain activity may indicate that they are doing so—and people who show this difference seem more likely to recover than people in which this brain activity is not as pronounced (Stender et al., 2014).
Crime Scene Investigation
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
Guy N. Rutty, Frances E. Hollingbury
Although homicides and suicidal hangings can also be discovered in the urban outdoors setting, other mechanisms of asphyxia, often accidental in nature, may also be encountered. Individuals intoxicated with drugs including alcohol may be found sat against walls or fences, their unprotected airway having become obstructed by flexion of the head in an unconscious state. They may also be found bent across walls or benches, or even trapped while trying to enter or exit a property through a window, resulting in a positional asphyxia. The authors have encountered a case of positional asphyxia in a burglar who became trapped in a chimney flue while attempting to enter a premises (Figure 7.3). This particular case presented a number of challenges when extracting the deceased from the chimney while ensuring that the structural integrity of the building was maintained.
Hypothetical consent
Published in Andreas Müller, Peter Schaber, The Routledge Handbook of the Ethics of Consent, 2018
Let’s reserve the term “hypothetical consent” for what we find in cases in which the affected party consents in some relevant possible world. Some such cases also involve previous or subsequent consent. Perhaps the patient has issued instructions in advance about what to do if he arrives unconscious at the hospital. Or perhaps the patient awakes and consents, retrospectively, to what was done to him. But hypothetical consent cases do not all involve previous or subsequent consent, and, more importantly, the moral position of such cases does not seem to depend on it. Rather, the fact that a particular non-actual, hypothetical version of the person consents seems, under at least some conditions, to be of such significance as to warrant a moral assessment of the conduct of the parties identical to what would have been appropriate if consent had actually been given.6
A study of factors affecting the alcohol consumption in Turkey
Published in Journal of Substance Use, 2022
Kübranur Çebi Karaaslan, Abdulkerim Karaaslan
Studies in the literature have shown that reducing alcohol consumption is always beneficial in terms of increasing life expectancy and decreasing mortality (Daskalopoulou et al., 2018). This output shows that keeping alcohol consumption under control will have long-term positive contributions to society. Reasons for alcohol consumption include developing social relationships, relieving stress, and celebrating (Chung & Lee, 2012). Knowing the factors affecting alcohol consumption as well as reasons for alcohol consumption can help to make alcohol use more conscious and controlled. Concerns about alcohol abuse have been a major source of concern both yesterday and today. Unconscious alcohol use causes many unfortunate events such as cancer, cirrhosis, traffic accidents, and tendency to violence, etc. (Chaloupka et al., 2002; Corrao et al., 2004; Eashwar et al., 2019).
Standard Racism: Trying to Use “Crisis Standards of Care” in the COVID-19 Pandemic
Published in The American Journal of Bioethics, 2021
George J. Annas, Sondra S. Crosby
Even in a crisis, basic legal and ethical rules apply (the way human rights law continues to apply in wartime): patients cannot be legally or ethically treated without their consent (if they are capable of giving it), or the consent of their next of kin or health care agent (if the patient is incapable of giving it). There are some rare emergencies where the patient is unconscious and no surrogate is available when the rule changes to: in an emergency, treat first and ask legal questions later. That is accepted as good medicine and good law. It also means that we should do whatever we can to encourage all potential patients (that includes all of us) to designate a trusted friend or relative to be our “health care agent,” with the authority to make healthcare decisions for us when we are not able to make them ourselves. This could even be seen as an ethical responsibility in the time of pandemic.
Post-traumatic stress in the medical setting
Published in American Journal of Clinical Hypnosis, 2020
Trauma experience related to childhood illness can also impact later life. Unconscious contents may express themselves symbolically through various forms and symptoms. I once treated a woman with a fear of heights. Her boyfriend, a colleague of mine, had brought her to me to treat her fear as he wanted to take her on a ski trip. Under hypnosis, I first used Edelstein’s (1988) “corridor in time”. She retrieved a memory long forgotten. She saw herself as a toddler in a hospital isolation room holding onto the bars of a high crib and crying as she saw her parents, looking at her through the window of the isolation room. I suggested she look at the situation that her younger self was in and recognize and understand from her adult perspective what the toddler could not have known or understood. I then asked her to imagine going back in time and comforting the toddler and letting her know that she would feel better soon and be reunited with her parents once more. I also suggested that she could liberate the toddler from the isolation room and bring her to the present where she could grow and flourish under her own self-care. This was a single session intervention and follow-up post-ski-trip indicated that she had no problems with being in the mountains and learning to ski. This is an example of how traumatic experiences not metabolized and assimilated can find expression in symbolic ways.