Internationale Zeitschrift für Neurorehabilitation

Useful Ethical Principles during the Care of Patients with Cerebral Damage

Abstract

Antonio Catano, Paul Robert, Myriam Houa, Dan Hutanu, Sabri El Banna and Luc Bissen

This article reviews fundamental principles related to ethics and patient care, with an emphasis on neurological disorders. The respect of the principle of autonomy is essential for patients. This principle is now recognized as one of the fundamental rights of patients, not only in the legal field but also in the moral field. In ethics, other principles favour patients in their specific relationships with their physicians such as the principles of beneficence, non-maleficence and equity. Within the framework of their customary practice, doctors must also respect other ethical principles including proportionality, truthfulness and precaution. However, for patients with cerebral damage, respect for the principle of autonomy must be subordinate to effective legal competences. Otherwise, the decisions could be made by third parties such as families or doctors, at the risk of drifting from the patient’s own demands. A number of clinical situations may result in dilemmas or conflicts between the therapists or the nursing staffs and patients or their close relatives. Some specificities of Belgian law are discussed.