Joseph J. Fins, Megan S. Wright, Claudia Kraft, Alix Rogers, Marina B. Romani, Samantha Godwin & Michael R. Ulrich
Journal of Law, Medicine and Ethics 44 (1):182-193 (2016)
AbstractAs improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions.
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Citations of this work
The Case of Hannah Capes: How Much Does Consciousness Matter?Lois Shepherd, C. William Pike, Jesse B. Persily & Mary Faith Marshall - 2022 - Neuroethics 15 (1):1-16.
Disorders of Consciousness, Past, Present, and Future.Joseph J. Fins - 2019 - Cambridge Quarterly of Healthcare Ethics 28 (4):603-615.
Differences That Make a Difference in Disorders of Consciousness.Joseph J. Fins & Nicholas D. Schiff - 2017 - American Journal of Bioethics Neuroscience 8 (3):131-134.
References found in this work
Rethinking disorders of consciousness: New research and its implications.Joseph J. Fins - 2005 - Hastings Center Report 35 (2):22-24.
Neuroethics and neuroimaging: Moving toward transparency.Joseph J. Fins - 2008 - American Journal of Bioethics 8 (9):46 – 52.
Rethinking Disorders of Consciousness: New Research and Its Implications.Joseph J. Fins - 2005 - Hastings Center Report 35 (2):22.
Conflicts of interest in deep brain stimulation research and the ethics of transparency.Joseph J. Fins & Nicholas D. Schiff - 2010 - Journal of Clinical Ethics 21 (2):125-132.