weeks without any effect and then discontinued. The wife became angry at the discontinuation. She would have sued if there had been a law requiring treatment. What is ethical in this case? Is it to treat the patient or to follow family demands or professional judgment?
Is there any connection between the question of whether rehabilitation is worthwhile and for everyone and its cost-effectiveness?
The issue of cost containment cannot be dealt with as long as effectiveness of therapies are not proved. The question of who can be treated cannot be solved without scientific evidence as to what treatments are effective with certain individuals.
A need exists for an international task force to develop guidelines for neuropsychological rehabilitation. The panel and audience agree that neuropsychological rehabilitation is worthwhile and should be given to those who need it, as stated in the WHO definition for rehabilitation and following ethical considerations. Furthermore, it is cost-effective for individuals and society when alternatives without it are considered.
Other factors in rehabilitation noted during the discussion include an increasing need to assist patients in becoming more aware of their circumstances without taking away hope so they can deal realistically with their individual situations and recover. To do this requires trained specialists with a high level of knowledge and experience. It also requires an interactive, two-way process between patients and specialists.
World Health Organization ( 1987). Optimum care of disabled people. "Report of a WHO meeting", Turku, Finland.