Ethical issues in the management of persistent vegetative state

1997 ◽  
Vol 2 (2) ◽  
pp. 7-11 ◽  
Author(s):  
Julius Sim
Keyword(s):  
Ethical Issues ◽  
Vegetative State ◽  
Persistent Vegetative State

Ethical issues in neurology

2019 ◽  
pp. 41-52
Author(s):  
Jan J. Heimans
Keyword(s):  
Decision Making ◽  
Cognitive Functioning ◽  
Ethical Issues ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Brain Dysfunction ◽  
Emotional Disturbances ◽  
Neurologic Diseases ◽  
Surrogate Decision

Neurologic diseases may lead to brain dysfunction and consequently to impairment of consciousness, cognitive decline, and emotional disturbances. These conditions may give rise to a wide array of ethical issues. Cerebral dysfunction can be temporary but many conditions are chronic and/or progressive, and the impact of such long-lasting brain dysfunction on decision-making processes is substantial. In this chapter, disturbances of consciousness and the decision-making process, with focus on communication during the various stages of coma, persistent vegetative state, and permanent vegetative state, are discussed. Special attention is paid to the role of proxies, who often have to act as surrogate decision-makers. Further, some aspects of brain death and organ donation are reviewed and the role of the neurologist as a specialist with respect to brain functioning, but also as an advocate acting in the interest of the patient and the patients’ relatives is depicted. Subsequently, consequences of impaired decision-making capacity in dementia and other diseases leading to diminished cognitive functioning are discussed and a short reflection is dedicated to driving ability. Ultimately, ethical issues in connection with decisions on withdrawing and withholding life-sustaining treatment including end-of-life decisions are discussed, both in neurologic diseases with diminished cognitive functioning but also in neurologic disorders, like motor neuron disease, where cognitive functions are preserved.

scholarly journals Common, Difficult Questions about Providing Nutrition at End of Life: Bedside Application of Catholic Moral Teaching

2020 ◽  
Vol 87 (2) ◽  
pp. 122-130
Author(s):  
John J. Raphael ◽  
Michael A. Vacca ◽  
Annmarie Hosie ◽  
Natalie Rodden ◽  
Ashley K. Fernandes ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Feeding Tube ◽  
Artificial Nutrition ◽  
Artificial Nutrition And Hydration ◽  
Her Family ◽  
Nutrition And Hydration ◽  
Dying Patient ◽  
Specific Scenario

There is much confusion surrounding how to interpret provision of artificial nutrition and hydration (ANH) at the bedside in complicated clinical circumstances. The specific scenario that prompted these questions was a request by a patient and her family to remove a feeding tube that had become, in the patient’s eyes and opinion, disproportionately burdensome in her particular set of clinical circumstances. This clinically relevant article can be viewed as a bedside interpretation of Catholic bioethical teachings on provision of ANH to the dying patient. Please note that this article does not address specific ethical issues that pertain to persistent vegetative state, which is beyond the scope of this particular discussion.

scholarly journals Deep Brain Stimulation in Persistent Vegetative States: Ethical Issues Governing Decision Making

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sara Patuzzo ◽  
Paolo Manganotti
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Ethical Issues ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Future Perspectives ◽  
Methodological Issues ◽  
Deep Brain

The aim of the present paper was to investigate the fundamental ethical issues of Deep Brain Stimulation (DBS) on patients remaining in Persistent Vegetative State (PVS). First, the purpose of this analysis was to discuss the nature of this intervention in order to classify it such as an ordinary clinical practice, or otherwise as an extraordinary clinical practice or as experimental research. Second, ethical issues, criticisms, and methodological issues of this intervention, also in the future perspectives, are discussed, attempting to identify who could give informed consent for a patient in PVS.

scholarly journals Dualism Revisited: Body vs. Mind vs. Soul

2008 ◽  
Vol 8 (1-2) ◽  
pp. 99-115 ◽  
Author(s):  
Rebekah Richert ◽  
Paul Harris
Keyword(s):  
Stem Cell ◽  
Life Support ◽  
Ethical Issues ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Life And Death ◽  
Simple Body ◽  
And Function ◽  
The Mind ◽  
Afterlife Beliefs

AbstractA large, diverse sample of adults was interviewed about their conception of the ontological and functional properties of the mind as compared to the soul. The existence of the mind was generally tied to the human lifecycle of conception, birth, growth and death, and was primarily associated with cognitive as opposed to spiritual functions. In contrast, the existence of the soul was less systematically tied to the lifecycle and frequently associated with spiritual as opposed to cognitive functions. Participants were also asked about three ethical issues: stem cell research, life support for patients in a persistent vegetative state and cloning. As expected, participants' beliefs about the ontology and function of the soul were linked to their judgments about these ethical issues whereas their beliefs about the mind were unrelated. Overall, the findings show that many adults do not espouse a simple body-mind dualism, and any tendency toward such dualism is unlikely to explain their beliefs in an afterlife. Instead, afterlife beliefs appear to be associated with the idea of an immaterial essence, potentially dissociable from the biology of life and death.

scholarly journals Islamic perspective on end of life issues in persistent vegetative state patients - a case report

2018 ◽  
Vol 17 (2) ◽  
Author(s):  
Mohammad Yousuf Rathor ◽  
Dr Che Rosle Draman
Keyword(s):  
Traumatic Brain Injury ◽  
Case Report ◽  
Brain Injury ◽  
Ethical Issues ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Islamic Perspective ◽  
Life Issues ◽  
Life Sustaining Treatment ◽  
End Of Life Issues

Persistent vegetative state (PVS) is a clinical condition of unawareness of self and environment with preserved sleep-wake cycles. Its clinical diagnosis can be a difficult unless a physician has adequate experience and expertise in evaluating neurological syndromes. Outcome is based on aetiology and age. Decisions on limiting life-sustaining treatment (LST) for these patients are emotionally and morally challenging. We present a case of a young boy who went into PVS following traumatic brain injury (TBI) with the aim to review some of the ethical issues regarding its management from Islamic perspective.

Confronting the grey zone after severe brain injury

2019 ◽  
Vol 3 (6) ◽  
pp. 707-711 ◽  
Author(s):  
Andrew Peterson ◽  
Adrian M. Owen
Keyword(s):  
Brain Injury ◽  
Ethical Issues ◽  
Vegetative State ◽  
Clinical Care ◽  
Grey Zone ◽  
Severe Brain Injury ◽  
New Methods ◽  
Legal Decision Making ◽  
Technological Developments ◽  
The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

Persistent vegetative state in head injury

2005 ◽  
Vol 2 (2) ◽  
pp. 81-85
Author(s):  
Deepak Kumar Gupta ◽  
AK Mahapatra
Keyword(s):  
Head Injury ◽  
Vegetative State ◽  
Persistent Vegetative State
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