A Life Worth Living: Seven Years after Craniectomy

ORACLE Stroke Study

“…For those who remain unsure, intervention may also be considered reasonable because they may learn to live with a level of disability that they might previously have thought to be unacceptable. 24 However, a clinician's responsibility to those participants who had indicated that that they would find survival with neurological disability and dependency to be unacceptable is quite different. In these circumstances, it cannot be assumed either that consent would be provided or that the person would want the opportunity to adapt to the disability.…”

Recommendations for the Management of Cerebral and Cerebellar Infarction With Swelling

“…[151][152][153][154][155][156][157] Outcome assessed years after hemispheric stroke is not available, but continuously improving quality of life has been described. 158 There is a discrepancy between physical disability and quality of life, with many patients and families rating a good quality of life despite severe functional handicap.…”

Outcome Following Decompressive Hemicraniectomy for Malignant Cerebral Infarction

“…A more realistic interpretation of the responses of such patients is that they may have adapted to a level of neurological disability that they might previously have deemed unacceptable, a phenomenon observed in many circumstances. 14,17 Although this may be a reflection of diminished cognitive capacity, it is perhaps of questionable relevance to assess the actual life values of the patient. Given the uncertainties, retrospective consent seems not to provide a sufficient justification for the procedure, especially when it is believed that the most likely outcome if the patient does survive is that of severe neurological disability, which in sound mind a patient may reject when faced with an antecedent choice.…”