Is not the same as assisted suicide or euthanasia

Over the past few decades the American legal system has repeatedly confronted the legal dilemmas of stopping treatment for patients in a persistent vegetative state. From 1975 to 1990, 33 cases reached the higher courts. At least half of these concerned the withdrawal of artificial feeding. The British legal system has also had to address the same questions—first in the case of Tony Bland, crushed at Hillsborough football stadium, and now more recently in the case of Thomas Creedon, a 22 month old child who is said to be severely brain damaged and unable to hear, speak, or see.1 As legal systems are increasingly confronted with these cases, it is important to consider the basic medical, ethical, and legal principles that have unfolded over recent years.

The most critical factor from a medical perspective is when the persistent vegetative state (lasting longer than one month but potentially reversible) becomes permanent (irreversible). Recent American standards developed by the Persistent Vegetative State Taskforce discuss a range of 3-12 months, depending on the aetiology of the condition and the age of the patient.2 3 European authorities such as …