Editorial Persistent vegetative state, withdrawal of artificial nutrition and hydration, and the patient's "best interests" In this issue of the journal Anthea Fenwick, an Edinburgh University graduate law student, robustly challenges the use of "best interests" by English judges in the context of permitting withdrawal of life-supporting nutrition and hydra-tion from patients in persistent vege...

I N THE COURSE OF CARING FOR A critically ill patient it may become apparent that further intervention will only prolong the final stages of the dying process. At this point, further intervention is often described as futile. There has been controversy in the literature and in clinical practice regarding what constitutes futile intervention. Clinical paradigms of futile care often involve life-...

Consciousness in experimental subjects is typically inferred from reports and other forms of voluntary behaviour. A wealth of everyday experience confirms that healthy subjects do not ordinarily behave in these ways unless they are conscious. Investigation of consciousness in vegetative state (VS) patients has been based on the search for neural evidence that such broad functional capacities ar...

OBJECTIVE The number of children surviving in a persistent vegetative state is increasing with advances in medical technology. Caring for a neurologically devastated child presents unique challenges not previously described. Our objective was to gain an understanding of the pediatric nurse's experience of caring for children in a persistent vegetative state. DESIGN Qualitative phenomenologic ...

The decision in Bland centred on the withdrawal of artificial nutrition and hydration from a patient in a persistent vegetative state (PVS). Since then, a new medical condition has emerged, known as a minimally conscious state (MCS). In W v M, the Court of Protection was asked to authorise the withdrawal of artificial nutrition and hydration from a patient in a MCS. Baker J refused to grant the...

OBJECTIVES To determine whether proton magnetic resonance spectroscopy (MRS), a newer radiographic technology, would be useful in the evaluation of the thalamus of patients in vegetative states resulting from traumatic brain injury. METHODS 14 victims of severe traumatic brain injury who were in the vegetative state and whose magnetic resonance images of the thalamus were normal underwent bil...