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
