Quality of Life and End-of-Life Decisions After Brain Injury

  • Athena DemertziEmail author
  • Olivia Gosseries
  • Didier Ledoux
  • Steven Laureys
  • Marie-Aurélie Bruno
Part of the Social Indicators Research Series book series (SINS, volume 52)


The locked-in syndrome (LIS) is a neurologic disorder characterized by the presence of sustained eye opening, intact cognitive function, aphonia, and quadriplegia, most frequently caused by a vascular brainstem lesion. Primary mode of communication is eye movements or blinking. The mortality of acute LIS is about 75 % for vascular etiology, and nearly 90 % of deaths occur in the first 4 months. However, if they survive the first year and have medically stabilized, over 80 % of people with LIS live for 10 years. There are no widely accepted guidelines for management of LIS patients, and medical professionals may have difficulties in assessing LIS patient’s remaining quality of life and believe that chronic LIS survivors want to die. However, the correlation between motor symptoms and quality of life is neither simple nor direct. People with LIS should not be denied the right to die with dignity, but also they should also be allowed to live with dignity, with the best possible pain and symptom management, and with revalidation. In this chapter, we emphasize LIS patients’ right to autonomy and their ability to exercise it, including taking end-of-life decisions.


Minimally Conscious State Basilar Artery Occlusion Minimally Conscious State Patient Unresponsive Wakefulness Syndrome Intact Cognitive Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Athena Demertzi
    • 1
    Email author
  • Olivia Gosseries
    • 1
  • Didier Ledoux
    • 1
  • Steven Laureys
    • 1
  • Marie-Aurélie Bruno
    • 1
  1. 1.Coma Science Group, Cyclotron Research Center and Neurology DepartmentUniversity of LiègeLiègeBelgium

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