Persistent Vegetative State: A Presumption to Treat
Theoretical Medicine. 1997 Sep; 18(3): 263-281.
The article briefly analyzes the concept of a person, arguing that personhood does not coincide with the actual enjoyment of certain intellectual capacities, but is coextensive with the embodiment of a human individual. Since in PVS patients we can observe a human individual functioning as a whole, we must conclude that these patients are still human persons, even if in a condition of extreme impairment. It is then argued that some forms of minimal treatment may not be futile for these patients; they may constitute a form of respect for their human dignity and benefit these patients, even if they are not aware of that. Moreover, it is important to consider the symbolic significance of care: while many believe that PVS is a kind of imprisonment, for others providing food and fluids is the only way to testify our proximity to these persons. The best policy would be to provide, as a general rule, artificial nutrition and hydration to PVS patients: this treatment could be withdrawn, after a period of observation and reflection by the family and proxies, on the basis of the proxies' objection to the continuation or of the patient's advance directives specifically referring to this situation.
Advance Directives; Allowing to Die; Artificial Feeding; Attitudes; Beneficence; Compassion; Consensus; Consent; Decision Making; Family Members; Food; Forms; Futility; Human Dignity; International Aspects; Life; Medicine; Moral Obligations; Moral Policy; Nutrition; Obligations of Society; Patient Care; Patients; Persistent Vegetative State; Personhood; Philosophy; Physicians; Prolongation of Life; PVS; Quality of Life; Third Party Consent; Value of Life; Values; Withholding Treatment;
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