Unresponsiveness Is Not Unconsciousness

This recent article in JAMA cautions us to carefully distinguish unresponsiveness from unconsciousness. 

"Covert consciousness, the enduring capacity for subjective experience even when all behavioral signs have ceased, challenges controlled donation. If a patient who appears insensate is in fact conscious despite being unable to move or communicate, the likelihood is increased that care decisions will rest on the mistaken presumption that the patient has permanently lost consciousness or the potential to recover it." 

"The implications of covert consciousness extend to WLST decisions more broadly, sharpening the need for diagnostic and prognostic humility, clear communication of uncertainty, and neurologically informed safeguards."