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Semin Neurol 2018; 38(05): 515-521
DOI: 10.1055/s-0038-1667383
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ethical Issues in Vascular Neurology

Natalie C. Wheeler
1   Department of Neurology, University of Wisconsin, Madison, Wisconsin
,
Sadhana Murali
1   Department of Neurology, University of Wisconsin, Madison, Wisconsin
,
Justin A. Sattin
1   Department of Neurology, University of Wisconsin, Madison, Wisconsin
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
15. Oktober 2018 (online)

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Abstract

There are ethical aspects to each of the three phases of cerebrovascular disease: hyperacute management, acute prognostication and management of early complications, and long-term recovery and reintegration with the community. This article addresses ethical concerns pertinent to each phase. First, we discuss ethical issues regarding consent for thrombolysis and endovascular treatment for acute ischemic stroke, including a review of considerations regarding the provision of acute stroke treatment advice over the telephone. Next, we discuss capacity for consent and prognostication after ischemic stroke and intracranial hemorrhage, with a focus on the problems of the self-fulfilling prophecy. Finally, we discuss residual disability and patients' return to driving. Consideration of these ethical dimensions of cerebrovascular disease will assist neurologists in caring for patients and families suffering from this complex condition.

Keywords

stroke - ethics - capacity - consent - prognostication
 

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