{"id":"https://openalex.org/W4392022522","doi":"https://doi.org/10.1093/brain/awae060","title":"Limitation of life sustaining therapy in disorders of consciousness: ethics and practice","display_name":"Limitation of life sustaining therapy in disorders of consciousness: ethics and practice","publication_year":2024,"publication_date":"2024-02-22","ids":{"openalex":"https://openalex.org/W4392022522","doi":"https://doi.org/10.1093/brain/awae060","pmid":"https://pubmed.ncbi.nlm.nih.gov/38387081","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/11224617"},"language":"en","primary_location":{"id":"doi:10.1093/brain/awae060","doi":"https://doi.org/10.1093/brain/awae060","is_oa":true,"landing_page_url":"https://doi.org/10.1093/brain/awae060","pdf_url":"https://academic.oup.com/brain/article-pdf/147/7/2274/58447085/awae060.pdf","source":{"id":"https://openalex.org/S118357697","display_name":"Brain","issn_l":"0006-8950","issn":["0006-8950","1460-2156"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Brain","raw_type":"journal-article"},"volume":null,"type":"review","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://academic.oup.com/brain/article-pdf/147/7/2274/58447085/awae060.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5086220030","display_name":"India A. Lissak","orcid":"https://orcid.org/0009-0003-7342-658X","observed_orcids":["https://orcid.org/0009-0003-7342-658X"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4210087915","display_name":"Massachusetts General Hospital","ror":"https://ror.org/002pd6e78","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210087915","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"India A Lissak","raw_affiliation_strings":["Department of Neurology, Massachusetts General Hospital and Harvard Medical School , Boston, MA 02114 , USA"],"raw_orcid":"https://orcid.org/0009-0003-7342-658X","affiliations":[{"raw_affiliation_string":"Department of Neurology, Massachusetts General Hospital and Harvard Medical School , Boston, MA 02114 , USA","institution_ids":["https://openalex.org/I136199984","https://openalex.org/I4210087915"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5011354546","display_name":"Michael J. Young","orcid":"https://orcid.org/0000-0001-6661-0811","observed_orcids":["https://orcid.org/0000-0001-6661-0811"]},"institutions":[{"id":"https://openalex.org/I136199984","display_name":"Harvard University","ror":"https://ror.org/03vek6s52","country_code":"US","type":"education","lineage":["https://openalex.org/I136199984"]},{"id":"https://openalex.org/I4210087915","display_name":"Massachusetts General Hospital","ror":"https://ror.org/002pd6e78","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210087915","https://openalex.org/I48633490"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Michael J Young","raw_affiliation_strings":["Department of Neurology, Massachusetts General Hospital and Harvard Medical School , Boston, MA 02114 , USA"],"raw_orcid":"https://orcid.org/0000-0001-6661-0811","affiliations":[{"raw_affiliation_string":"Department of Neurology, Massachusetts General Hospital and Harvard Medical School , Boston, MA 02114 , USA","institution_ids":["https://openalex.org/I136199984","https://openalex.org/I4210087915"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5011354546"],"corresponding_institution_ids":["https://openalex.org/I136199984","https://openalex.org/I4210087915"],"apc_list":{"value":4562,"currency":"GBP","value_usd":5831},"apc_paid":null,"fwci":2.3534,"has_fulltext":true,"cited_by_count":32,"citation_normalized_percentile":{"value":0.89973298,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":98,"max":100},"biblio":{"volume":"147","issue":"7","first_page":"2274","last_page":"2288"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":0.9204000234603882,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":0.9204000234603882,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14437","display_name":"Ethics and Legal Issues in Pediatric Healthcare","score":0.051500000059604645,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13147","display_name":"Ethics and bioethics in healthcare","score":0.012000000104308128,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/disorders-of-consciousness","display_name":"disorders of consciousness","score":0.9269999861717224},{"id":"https://openalex.org/keywords/life-sustaining-treatment","display_name":"life-sustaining treatment","score":0.9729999899864197},{"id":"https://openalex.org/keywords/withdrawal-of-life-sustaining-treatment","display_name":"withdrawal of life-sustaining treatment","score":0.7549999952316284},{"id":"https://openalex.org/keywords/severe-brain-injury","display_name":"severe brain injury","score":0.777999997138977},{"id":"https://openalex.org/keywords/clinical-decision-making","display_name":"clinical decision-making","score":0.6470000147819519},{"id":"https://openalex.org/keywords/prognostic-uncertainty","display_name":"prognostic uncertainty","score":0.8270000219345093},{"id":"https://openalex.org/keywords/pain-perception","display_name":"pain perception","score":0.7110000252723694},{"id":"https://openalex.org/keywords/patient-autonomy","display_name":"patient autonomy","score":0.7089999914169312},{"id":"https://openalex.org/keywords/surrogate-decision-making","display_name":"surrogate decision-making","score":0.7990000247955322},{"id":"https://openalex.org/keywords/goal-concordant-care","display_name":"goal-concordant care","score":0.8410000205039978}],"concepts":[{"id":"https://openalex.org/C2777938509","wikidata":"https://www.wikidata.org/wiki/Q139720","display_name":"Persistent vegetative state","level":4,"score":0.875808835029602},{"id":"https://openalex.org/C65414064","wikidata":"https://www.wikidata.org/wiki/Q484105","display_name":"Autonomy","level":2,"score":0.7979414463043213},{"id":"https://openalex.org/C186720457","wikidata":"https://www.wikidata.org/wiki/Q7087","display_name":"Consciousness","level":2,"score":0.642388641834259},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.5036486983299255},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.4688701927661896},{"id":"https://openalex.org/C2780572471","wikidata":"https://www.wikidata.org/wiki/Q18206027","display_name":"Clinical Ethics","level":2,"score":0.43724074959754944},{"id":"https://openalex.org/C26760741","wikidata":"https://www.wikidata.org/wiki/Q160402","display_name":"Perception","level":2,"score":0.4353402256965637},{"id":"https://openalex.org/C542102704","wikidata":"https://www.wikidata.org/wiki/Q183257","display_name":"Psychotherapist","level":1,"score":0.4123454988002777},{"id":"https://openalex.org/C95124753","wikidata":"https://www.wikidata.org/wiki/Q875686","display_name":"Environmental ethics","level":1,"score":0.3511731028556824},{"id":"https://openalex.org/C2778170955","wikidata":"https://www.wikidata.org/wiki/Q1093388","display_name":"Minimally conscious state","level":3,"score":0.33240097761154175},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3226472735404968},{"id":"https://openalex.org/C55587333","wikidata":"https://www.wikidata.org/wiki/Q1133029","display_name":"Engineering ethics","level":1,"score":0.301699697971344},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.2062574028968811},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.1701425015926361},{"id":"https://openalex.org/C199539241","wikidata":"https://www.wikidata.org/wiki/Q7748","display_name":"Law","level":1,"score":0.15631189942359924},{"id":"https://openalex.org/C138885662","wikidata":"https://www.wikidata.org/wiki/Q5891","display_name":"Philosophy","level":0,"score":0.0},{"id":"https://openalex.org/C169760540","wikidata":"https://www.wikidata.org/wiki/Q207011","display_name":"Neuroscience","level":1,"score":0.0},{"id":"https://openalex.org/C127413603","wikidata":"https://www.wikidata.org/wiki/Q11023","display_name":"Engineering","level":0,"score":0.0}],"mesh":[{"descriptor_ui":"D000066491","descriptor_name":"Clinical Decision-Making","qualifier_ui":"Q000941","qualifier_name":"ethics","is_major_topic":false},{"descriptor_ui":"D003244","descriptor_name":"Consciousness Disorders","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008020","descriptor_name":"Life Support Care","qualifier_ui":"Q000941","qualifier_name":"ethics","is_major_topic":true},{"descriptor_ui":"D028761","descriptor_name":"Withholding Treatment","qualifier_ui":"Q000941","qualifier_name":"ethics","is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1093/brain/awae060","doi":"https://doi.org/10.1093/brain/awae060","is_oa":true,"landing_page_url":"https://doi.org/10.1093/brain/awae060","pdf_url":"https://academic.oup.com/brain/article-pdf/147/7/2274/58447085/awae060.pdf","source":{"id":"https://openalex.org/S118357697","display_name":"Brain","issn_l":"0006-8950","issn":["0006-8950","1460-2156"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Brain","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:11224617","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11224617","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11224617/pdf/awae060.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Brain","raw_type":"Text"},{"id":"pmid:38387081","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/38387081","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Brain : a journal of neurology","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1093/brain/awae060","doi":"https://doi.org/10.1093/brain/awae060","is_oa":true,"landing_page_url":"https://doi.org/10.1093/brain/awae060","pdf_url":"https://academic.oup.com/brain/article-pdf/147/7/2274/58447085/awae060.pdf","source":{"id":"https://openalex.org/S118357697","display_name":"Brain","issn_l":"0006-8950","issn":["0006-8950","1460-2156"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Brain","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9391000270843506,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[{"id":"https://openalex.org/G2474907165","display_name":null,"funder_award_id":"OT2OD0327-01","funder_id":"https://openalex.org/F4320309945","funder_display_name":"Common Fund for Commodities"},{"id":"https://openalex.org/G4403456761","display_name":null,"funder_award_id":"Bridge2AI","funder_id":"https://openalex.org/F4320332161","funder_display_name":"National Institutes of Health"},{"id":"https://openalex.org/G5815987255","display_name":"An Ethical Approach to Detecting Covert Consciousness","funder_award_id":"F32MH123001","funder_id":"https://openalex.org/F4320337346","funder_display_name":"National Institute of Mental Health"},{"id":"https://openalex.org/G8003940076","display_name":null,"funder_award_id":"F32MH123001","funder_id":"https://openalex.org/F4152001309","funder_display_name":"BRAIN Initiative"}],"funders":[{"id":"https://openalex.org/F4152001309","display_name":"BRAIN Initiative","ror":null},{"id":"https://openalex.org/F4320308392","display_name":"American Academy of Neurology","ror":"https://ror.org/00mv9dj85"},{"id":"https://openalex.org/F4320309945","display_name":"Common Fund for Commodities","ror":"https://ror.org/03xnf5k89"},{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"},{"id":"https://openalex.org/F4320337346","display_name":"National Institute of Mental Health","ror":"https://ror.org/04xeg9z08"},{"id":"https://openalex.org/F4320338403","display_name":"Common Fund","ror":"https://ror.org/001d55x84"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4392022522.pdf","grobid_xml":"https://content.openalex.org/works/W4392022522.grobid-xml"},"referenced_works_count":183,"referenced_works":["https://openalex.org/W57601297","https://openalex.org/W1523992664","https://openalex.org/W1532062207","https://openalex.org/W1552328892","https://openalex.org/W1575354697","https://openalex.org/W1590429631","https://openalex.org/W1591095976","https://openalex.org/W1829346027","https://openalex.org/W1833130763","https://openalex.org/W1848745377","https://openalex.org/W1966314663","https://openalex.org/W1967836750","https://openalex.org/W1968905734","https://openalex.org/W1970545979","https://openalex.org/W1971807217","https://openalex.org/W1975344296","https://openalex.org/W1975360203","https://openalex.org/W1976672636","https://openalex.org/W1978096125","https://openalex.org/W1980476631","https://openalex.org/W1985264354","https://openalex.org/W1985556152","https://openalex.org/W1986734057","https://openalex.org/W1990059717","https://openalex.org/W1990887980","https://openalex.org/W1991339447","https://openalex.org/W1995201687","https://openalex.org/W1996557276","https://openalex.org/W2004405500","https://openalex.org/W2004915819","https://openalex.org/W2005036109","https://openalex.org/W2007582132","https://openalex.org/W2008106371","https://openalex.org/W2010183513","https://openalex.org/W2010285514","https://openalex.org/W2012404050","https://openalex.org/W2014095905","https://openalex.org/W2014868834","https://openalex.org/W2015892351","https://openalex.org/W2021927512","https://openalex.org/W2030059098","https://openalex.org/W2039321214","https://openalex.org/W2043390130","https://openalex.org/W2044031400","https://openalex.org/W2047069657","https://openalex.org/W2051548959","https://openalex.org/W2058913966","https://openalex.org/W2059270934","https://openalex.org/W2059471040","https://openalex.org/W2060312460","https://openalex.org/W2064582034","https://openalex.org/W2065458232","https://openalex.org/W2066503257","https://openalex.org/W2069345471","https://openalex.org/W2070221555","https://openalex.org/W2072944933","https://openalex.org/W2074272596","https://openalex.org/W2076612275","https://openalex.org/W2079786974","https://openalex.org/W2079919177","https://openalex.org/W2080221263","https://openalex.org/W2083244292","https://openalex.org/W2085681551","https://openalex.org/W2086322912","https://openalex.org/W2091245445","https://openalex.org/W2092654879","https://openalex.org/W2093127969","https://openalex.org/W2095005031","https://openalex.org/W2095804600","https://openalex.org/W2096056306","https://openalex.org/W2097780989","https://openalex.org/W2098314640","https://openalex.org/W2099574893","https://openalex.org/W2100767707","https://openalex.org/W2102947050","https://openalex.org/W2107463225","https://openalex.org/W2107634712","https://openalex.org/W2108308769","https://openalex.org/W2109762611","https://openalex.org/W2111591336","https://openalex.org/W2113371352","https://openalex.org/W2115269069","https://openalex.org/W2122393210","https://openalex.org/W2123477708","https://openalex.org/W2124118965","https://openalex.org/W2125852732","https://openalex.org/W2126086977","https://openalex.org/W2128985328","https://openalex.org/W2130868065","https://openalex.org/W2131807433","https://openalex.org/W2132288352","https://openalex.org/W2133572306","https://openalex.org/W2143246930","https://openalex.org/W2143913385","https://openalex.org/W2144154303","https://openalex.org/W2148391814","https://openalex.org/W2148768030","https://openalex.org/W2150469511","https://openalex.org/W2152325645","https://openalex.org/W2152474896","https://openalex.org/W2155860263","https://openalex.org/W2158368599","https://openalex.org/W2158806017","https://openalex.org/W2161974347","https://openalex.org/W2166148696","https://openalex.org/W2166174531","https://openalex.org/W2168575964","https://openalex.org/W2169040579","https://openalex.org/W2170006676","https://openalex.org/W2213613989","https://openalex.org/W2245171164","https://openalex.org/W2264239227","https://openalex.org/W2316243930","https://openalex.org/W2334443226","https://openalex.org/W2335139981","https://openalex.org/W2338604149","https://openalex.org/W2345956474","https://openalex.org/W2399219256","https://openalex.org/W2400298811","https://openalex.org/W2547670325","https://openalex.org/W2560735800","https://openalex.org/W2611027309","https://openalex.org/W2613656844","https://openalex.org/W2619991506","https://openalex.org/W2730923810","https://openalex.org/W2769876835","https://openalex.org/W2775179629","https://openalex.org/W2800630935","https://openalex.org/W2803518112","https://openalex.org/W2806131220","https://openalex.org/W2885206576","https://openalex.org/W2885777898","https://openalex.org/W2888518813","https://openalex.org/W2890097306","https://openalex.org/W2905457180","https://openalex.org/W2912728982","https://openalex.org/W2914805721","https://openalex.org/W2922311680","https://openalex.org/W2924888982","https://openalex.org/W2954180786","https://openalex.org/W2958510524","https://openalex.org/W2974591972","https://openalex.org/W3002479645","https://openalex.org/W3003475444","https://openalex.org/W3021774144","https://openalex.org/W3024521874","https://openalex.org/W3036362877","https://openalex.org/W3113180287","https://openalex.org/W3136911342","https://openalex.org/W3156673007","https://openalex.org/W3157093243","https://openalex.org/W3184997240","https://openalex.org/W3186738481","https://openalex.org/W3189735699","https://openalex.org/W3191219243","https://openalex.org/W3199139594","https://openalex.org/W3203598446","https://openalex.org/W3215395896","https://openalex.org/W4210927762","https://openalex.org/W4213153710","https://openalex.org/W4220662211","https://openalex.org/W4225381841","https://openalex.org/W4225414052","https://openalex.org/W4225907590","https://openalex.org/W4231099946","https://openalex.org/W4255411484","https://openalex.org/W4285384781","https://openalex.org/W4300716223","https://openalex.org/W4312130139","https://openalex.org/W4319461130","https://openalex.org/W4322624151","https://openalex.org/W4327979582","https://openalex.org/W4362560500","https://openalex.org/W4366367046","https://openalex.org/W4366523868","https://openalex.org/W4372233760","https://openalex.org/W4378640470","https://openalex.org/W4387008208","https://openalex.org/W4387410811","https://openalex.org/W4387497846","https://openalex.org/W4387966799","https://openalex.org/W4391014599","https://openalex.org/W4391304009"],"related_works":["https://openalex.org/W4404727797","https://openalex.org/W4407782432","https://openalex.org/W3024904523","https://openalex.org/W4403258165","https://openalex.org/W7167505291","https://openalex.org/W2332190289","https://openalex.org/W4387966799","https://openalex.org/W4293560105","https://openalex.org/W3093758264","https://openalex.org/W4403414718"],"abstract_inverted_index":{"Clinical":[0],"conversations":[1],"surrounding":[2],"the":[3,70,77,107,130,144],"continuation":[4],"or":[5],"limitation":[6],"of":[7,21,56,100,109,132,149,166],"life-sustaining":[8,83],"therapies":[9],"(LLST)":[10],"are":[11],"both":[12],"challenging":[13],"and":[14,31,47,72,75,81,96,106,128,134,142,146,151,159],"tragically":[15],"necessary":[16],"for":[17],"patients":[18,63,125,150,170],"with":[19,64,126,171],"disorders":[20],"consciousness":[22],"(DoC)":[23],"following":[24],"severe":[25],"brain":[26],"injury.":[27],"Divergent":[28],"cultural,":[29],"philosophical":[30],"religious":[32,135,147],"perspectives":[33,136,148],"contribute":[34],"to":[35,41,124,139,155],"vast":[36],"heterogeneity":[37],"in":[38,44,118],"clinical":[39,71],"approaches":[40,138],"LLST-as":[42],"reflected":[43],"regional":[45],"differences":[46],"inter-clinician":[48],"variability.":[49],"Here":[50],"we":[51,114],"provide":[52],"an":[53],"ethical":[54,73],"analysis":[55],"factors":[57,89],"that":[58,90],"inform":[59],"LLST":[60,92,119],"decisions":[61],"among":[62],"DoC.":[65,172],"We":[66,85],"begin":[67],"by":[68],"introducing":[69],"challenge":[74],"clarifying":[76],"distinction":[78],"between":[79],"withdrawing":[80],"withholding":[82],"therapy.":[84],"then":[86],"describe":[87],"relevant":[88],"influence":[91],"decision-making":[93,168],"including":[94],"diagnostic":[95],"prognostic":[97],"uncertainty,":[98],"perception":[99],"pain,":[101],"defining":[102],"a":[103],"'good'":[104],"outcome,":[105],"role":[108],"clinicians.":[110],"In":[111],"concluding":[112],"sections,":[113],"explore":[115],"global":[116],"variation":[117],"practices":[120],"as":[121],"they":[122],"pertain":[123],"DoC":[127],"examine":[129],"impact":[131],"cultural":[133,145],"on":[137],"LLST.":[140],"Understanding":[141],"respecting":[143],"surrogates":[152],"is":[153],"essential":[154],"protecting":[156],"patient":[157],"autonomy":[158],"advancing":[160],"goal-concordant":[161],"care":[162],"during":[163],"critical":[164],"moments":[165],"medical":[167],"involving":[169]},"counts_by_year":[{"year":2026,"cited_by_count":15},{"year":2025,"cited_by_count":10},{"year":2024,"cited_by_count":7}],"updated_date":"2026-11-06T12:05:46.655746","created_date":"2024-02-23T00:00:00"}