Update to main text para 13.13¸ page 406

In his Oxford speech,[1] Baker J contrasted diagnosis of brainstem activity, which can be done with neurological testing, with the extreme difficulty of diagnosing a patient’s level of consciousness, commenting:

‘The principal potential weakness is that there are no definitive criteria of awareness so that such assessments depend on judgment and interpretation which may be challenging even for the professionals experienced in carrying out the assessments. Furthermore, differences may arise between the observations professionals carrying out assessments and those of family members who, while they may lack the objectivity which the professional possesses, have spent far more time with the patient and have greater experience of interpreting their behaviour.' 

This identifies the critical difficulty facing clinicians: even where the proper assessments have been carried out, the results may be open to different interpretations, and the subjective views of both professional carers and family members may also interpret the same behaviour in very different ways.

[1] 11 October 2016, http://bit.ly/2kDa4PC