Should People in the Minimally Conscious State have a (recognised) Right to Reassessment?

Abstract

Developments in medical sciences mean that more people survive serious brain injuries than in previous years. Nevertheless, some survivors are left with protracted or permanent severely disordered consciousness. Expert care and treatment of people in the minimally conscious state is expensive and accur¬ate assessment, and reassessment, of their condition is necessary for optimal management and targeting of healthcare resources. This empirical study sought to identify whether minimally conscious people should have a ‘right’ to be reassessed. A grounded theory approach was used to ascertain policy and perspectives of senior decision-makers (including clinicians, lawyers, commissioners and healthcare managers). The results are contextualised within a theoretical framework of recent common law and professional guidance in England and Wales. The findings reveal that whether minimally conscious patients have access to specialist assessment and treatment services depends largely on the vagaries of circumstances, expertise and the availability of validated neurological assessment tools.