Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Persistent Vegetative State: Where Do We Go From Here?

Persistent Vegetative State: Where Do We Go From Here? Abstract A number of "new" diseases have been discovered in the waning decades of the 20th century. Some are the result of newly evolved or more aggressive pathogenic organisms, eg, acquired immunodeficiency syndrome, while other conditions are the result of the application of modern medical technology. The persistent vegetative state (PVS) is an example of the latter type of "new" disease. Patients with this devastating neurological entity rarely, if ever, survived for long before the advent of modern medical interventions, such as intravenous antibiotics and intravenous and/or enteral nutritional support. Unfortunately, prolonged survival of patients with PVS has created a very difficult moral and ethical dilemma for the health care profession. Should these patients receive intense, life-prolonging therapy? Who should make crucial life and death decisions for these individuals? What are the legal implications of continuing vs withdrawing intensive care or technological support? Can we as a society afford to pay References 1. Bone RC, Rackow EC, Weg JG, and the ACCP/SCCM Consensus Panel. Ethical and moral guidelines for the initiation, continuation, and withdrawal of intensive care . Chest. 1990;97:949-958.Crossref 2. Ruark JE, Raffin TA, and the Stanford University Medical Center Committee on Ethics. Initiating and withdrawing life support: principles and practice in adult medicine . N Engl J Med. 1988;318:25-30.Crossref 3. Ethics Committee, American College of Physicians. American College of Physicians ethics manual, I: history; the patient; other physicians . Ann Intern Med. 1989;111:245-252.Crossref 4. Ethics Committee, American College of Physicians. American College of Physicians ethics manual, II: the physician and society; research; life-sustaining treatment; other issues . Ann Intern Med. 1989;111:327-335.Crossref 5. Paris JJ, Reardon FE. Ethical and legal dilemmas in the Coronary Care Unit . In: Francis GS, Alpert JS, eds. Modern Coronary Care . Boston, Mass: Little Brown & Co Inc; 1990:747-767. 6. Tresch DD, Sims FH, Duthie EH, Goldstein MD, Lane PS. Clinical characteristics of patients in persistent vegetative state . Arch Intern Med. 1991;151:930-932.Crossref 7. Brophy v New England Sinai Hospital, 497 NE2d 626 (Mass 1986). http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Persistent Vegetative State: Where Do We Go From Here?

Archives of Internal Medicine , Volume 151 (5) – May 1, 1991

Loading next page...
 
/lp/american-medical-association/persistent-vegetative-state-where-do-we-go-from-here-duqP22p5B7
Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400050009002
Publisher site
See Article on Publisher Site

Abstract

Abstract A number of "new" diseases have been discovered in the waning decades of the 20th century. Some are the result of newly evolved or more aggressive pathogenic organisms, eg, acquired immunodeficiency syndrome, while other conditions are the result of the application of modern medical technology. The persistent vegetative state (PVS) is an example of the latter type of "new" disease. Patients with this devastating neurological entity rarely, if ever, survived for long before the advent of modern medical interventions, such as intravenous antibiotics and intravenous and/or enteral nutritional support. Unfortunately, prolonged survival of patients with PVS has created a very difficult moral and ethical dilemma for the health care profession. Should these patients receive intense, life-prolonging therapy? Who should make crucial life and death decisions for these individuals? What are the legal implications of continuing vs withdrawing intensive care or technological support? Can we as a society afford to pay References 1. Bone RC, Rackow EC, Weg JG, and the ACCP/SCCM Consensus Panel. Ethical and moral guidelines for the initiation, continuation, and withdrawal of intensive care . Chest. 1990;97:949-958.Crossref 2. Ruark JE, Raffin TA, and the Stanford University Medical Center Committee on Ethics. Initiating and withdrawing life support: principles and practice in adult medicine . N Engl J Med. 1988;318:25-30.Crossref 3. Ethics Committee, American College of Physicians. American College of Physicians ethics manual, I: history; the patient; other physicians . Ann Intern Med. 1989;111:245-252.Crossref 4. Ethics Committee, American College of Physicians. American College of Physicians ethics manual, II: the physician and society; research; life-sustaining treatment; other issues . Ann Intern Med. 1989;111:327-335.Crossref 5. Paris JJ, Reardon FE. Ethical and legal dilemmas in the Coronary Care Unit . In: Francis GS, Alpert JS, eds. Modern Coronary Care . Boston, Mass: Little Brown & Co Inc; 1990:747-767. 6. Tresch DD, Sims FH, Duthie EH, Goldstein MD, Lane PS. Clinical characteristics of patients in persistent vegetative state . Arch Intern Med. 1991;151:930-932.Crossref 7. Brophy v New England Sinai Hospital, 497 NE2d 626 (Mass 1986).

Journal

Archives of Internal MedicineAmerican Medical Association

Published: May 1, 1991

References