Moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuries

Cervical spinal cord injuries (SCIs) are accompanied by significant physiologic challenges as well as psychologic burdens. Patient with high cervical SCI face severe physical disability and daily medical needs, which may include long-term mechanical ventilation. Given the substantial change in quali...

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Main Authors: L Erin Miller, Jennifer J Misenhimer, Luke T Sabal, John M Green
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:Trauma Surgery & Acute Care Open
Online Access:https://tsaco.bmj.com/content/10/2/e001765.full
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author L Erin Miller
Jennifer J Misenhimer
Luke T Sabal
John M Green
author_facet L Erin Miller
Jennifer J Misenhimer
Luke T Sabal
John M Green
author_sort L Erin Miller
collection DOAJ
description Cervical spinal cord injuries (SCIs) are accompanied by significant physiologic challenges as well as psychologic burdens. Patient with high cervical SCI face severe physical disability and daily medical needs, which may include long-term mechanical ventilation. Given the substantial change in quality of life, it is crucial to include such patients in early goals of care discussions, when possible. Although there exists a depth of literature considering the medical benefits of early tracheostomy for patients with cervical SCI, there is a paucity of discussion regarding the ethical considerations. With an improved ability to communicate, early tracheostomy may improve subjective quality of life and augment the patient’s sense of autonomy. Using a framework guided by the principles of medical ethics, we aim to emphasize the role of early tracheostomy for patients with high cervical SCI with a review of current literature and a case presentation from our institution.
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series Trauma Surgery & Acute Care Open
spelling doaj-art-b19f2b0f34354e16b029bb7f404b440d2025-08-20T02:23:28ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762025-06-0110210.1136/tsaco-2025-001765Moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuriesL Erin Miller0Jennifer J Misenhimer1Luke T Sabal2John M Green3Neurosurgery, Atrium Health Carolinas Medical Center, Charlotte, North Carolina, USAGeneral Surgery, Atrium Health Carolinas Medical Center, Charlotte, North Carolina, USAUniversity of Minnesota Medical School, Minneapolis, Minnesota, USAGeneral Surgery, Atrium Health Carolinas Medical Center, Charlotte, North Carolina, USACervical spinal cord injuries (SCIs) are accompanied by significant physiologic challenges as well as psychologic burdens. Patient with high cervical SCI face severe physical disability and daily medical needs, which may include long-term mechanical ventilation. Given the substantial change in quality of life, it is crucial to include such patients in early goals of care discussions, when possible. Although there exists a depth of literature considering the medical benefits of early tracheostomy for patients with cervical SCI, there is a paucity of discussion regarding the ethical considerations. With an improved ability to communicate, early tracheostomy may improve subjective quality of life and augment the patient’s sense of autonomy. Using a framework guided by the principles of medical ethics, we aim to emphasize the role of early tracheostomy for patients with high cervical SCI with a review of current literature and a case presentation from our institution.https://tsaco.bmj.com/content/10/2/e001765.full
spellingShingle L Erin Miller
Jennifer J Misenhimer
Luke T Sabal
John M Green
Moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuries
Trauma Surgery & Acute Care Open
title Moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuries
title_full Moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuries
title_fullStr Moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuries
title_full_unstemmed Moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuries
title_short Moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuries
title_sort moral and ethical considerations of early tracheostomy for patients with complete high cervical spinal cord injuries
url https://tsaco.bmj.com/content/10/2/e001765.full
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