ETHICAL ASPECTS OF CLASHING TITANS: TRAUMATIC BRAIN INJURY VERSUS AUTONOMY
ETHICAL ASPECTS OF CLASHING TITANS: TRAUMATIC BRAIN INJURY VERSUS AUTONOMY

Summary/Abstract: Traumatic brain injury has become a leading cause of mortality and morbidity in both civilians and military, considered the modern version of a silent epidemic, since its real incidence is on the rise. In the field of medical ethics, “autonomy” represents endogenous determination that does not withstand controlling interferences not personal limitations. Traumatic brain injury (TBI) might affect cognitive capacities critical to the adequate exercise of autonomy. The hallmark of this disorder is the possibility of producing survivors who preserve normal, almost-normal or border-line intellectual capacities, certified as being competent and not in the need of a guardian or substitute decision maker, even though an impaired capacity to evaluate their own behaviors and limitations accurately is widely encountered. Aiming to reflect the proposed pattern, a questionnaire echoing self-awareness was apprised by patient and associated family member. The study revealed population at risk for TBI resembling childhood age, elderly, low-come individuals, unmarried people and patients with previous history of TBI or psychiatric pathology, with equal sex ratio distribution. Moreover, a difference of opinions has been noticed when evaluating the arisen topics from the questionnaire. In such cases, conserving the right of autonomy is not such as forthright as one might consider, thus requiring different ethical commitments and tactics. A slight look inside the neurologic pathology of TBI and its neurocognitive consequences seems to yield the basics of understanding situations that decline autonomy with preserved legal rights.

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