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'Best interests 'is widely accepted as the appropriate foundation principle for medico-legal decisions concerning treatment withdrawal from patients in persistent vegetative state (PVS). Its application appears to progress logically from earlier use regarding legally incompetent patients. This author argues, however, that such confidence in the relevance of the principle of best interests to PVS is misplaced, and that current construction in this context is questionable on four specific grounds. Furthermore, it is argued that the resulting legal inconsistency is distorting both the principle itself and, more particularly, individual patient interests. Keywords: Persistent vegetative state; 'best interest'; legal decisions

Persistent vegetative state provokes powerful emotional responses in caregivers and family members. Patients in this state may have periods of wakefulness but are unaware of their environment, so neurological nurses often must consult with family to make difficult decisions about life sustaining treatments. Nurses should also make clear the importance of informing family about advance care directives., Introduction Persistent vegetative state (PVS) is a rare neurologic condition, but one which evokes many psychosocial, bioethical, legal and economic concerns. Families and surrogates often have to make difficult decisions [...]

The High Court decision to terminate the feeding of persistent vegetative state patient, Anthony Bland raises ethical problems. The Law Lords failed to rule whether Bland was alive or dead. They should have determined whether he was still a person and whether withdrawal of feeding constituted murder. They admitted possible fallibility on ethical issues. They recognised the ethical dilemma for nurses but their decision ignored nursing values. Termination of feeding contradicts the principles of nursing. Nurses should participate in the subsequent Parliamentary review.

It is proper to stop or triage life-sustaining care for persistent vegetative state (PVS) patients. PVS patients are not really persons on moral grounds but simply not dead. It is more difficult to justify an end to nutrition and hydration or active euthanasia, and a request for care can be justified, but economic considerations or questions of provider integrity are valid for stopping care.

During the final days of his life, Oscar Wilde, aware that death was imminent, lost interest in food but drank whenever one of his visitors brought him a bottle. In [...]

The case presented for consideration concerns a "Mr. Stevens," a forty-nine year old man who received a severe head wound in an automobile accident. Various medical tests have been performed [...]

If I were requested to testify at trial as a "bioethical expert" my services would generally be contingent on two conditions. First, under ideal circumstances, I would prefer to be [...]

Moral reasoning in clinical decisionmaking does not consist of drawing formal deductions from invariable abstract principles. It requires discerning judgment that weighs the uncertainties, complexities, and probabilities that the facts [...]

Important moral discussions can degenerate into sloganeering, emotional hype, and name calling. But important moral discussions require patience, careful reasoning, and insight into a particular case where principles, norms, and [...]

Patients in a persistent vegetative state have permanently lost the function of the cerebral cortex.[1] Their prolonged survival presents dilemmas for their families and carers as well as for society. [...]

On March 20, speaking to participants in an international congress on the 'vegetative' state, Pope John Paul II profoundly changed the worldwide debate on how to respond to this condition. [...]

We are surprised and alarmed that America's editors made numerous unauthorized changes to our article in the August 4-11 issue that explains the recent Response from the Congregation for the [...]

Pope John Paul II's statement about the moral obligation to feed and hydrate patients who are in a "persistent vegetative state" has caused a flurry of questions among health care […]