The persistent vegetative state in children: report of the Child Neurology Society Ethics Committee.
Increasing concern about children in a persistent vegetative state (PVS) prompted a survey of members of the Child Neurology Society regarding aspects of the diagnosis and management of this disorder. Major findings of those responding to this survey (26% response rate) were as follows: (1) 93% believed that a diagnosis of PVS can be made in children, but only 16% believed that this applied to infants younger than 2 months and 70% in the 2-month to 2-year group; (2) a period of 3 to 6 months was believed to be the minimum observation period required before a diagnosis of PVS could be made; (3) 86% believed that the age of the patient would affect the duration of time needed to make the diagnosis of PVS; (4) 78% thought a diagnosis of PVS could be made in children with severe congenital brain malformations; (5) 75% believed that neurodiagnostic studies would be of value and supportive of the clinical diagnosis of PVS; (6) members' opinions as to the average life expectancy (in years) for the following age groups after the patients were considered vegetative were: newborn to 2 months, 4.1; 2 months to 2 years, 5.5; 2 to 7 years, 7.3; and more than 7 years, 7.4; (7) 20% believed that infants and children in a PVS experience pain and suffering; and (8) 75% "never" withhold fluid and nutrition from infants and children in a PVS and 28% "always" give medication for pain and suffering.(ABSTRACT TRUNCATED AT 250 WORDS)
Ashwal
S
S
Department of Pediatrics, Loma Linda University School of Medicine, CA 92350.
Bale
J F
JF
Coulter
D L
DL
Eiben
R
R
Garg
B P
BP
Hill
A
A
Myer
E C
EC
Nordgren
R E
RE
Shewmon
D A
DA
Sunder
T R
TR
D026683:Advisory Committees; D001927:Brain Diseases; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D004569:Electroencephalography; D004992:Ethics, Medical; D006801:Humans; D007223:Infant; D008017:Life Expectancy; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D015995:Prevalence; D012955:Societies, Medical; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D035501:Uncertainty; D028761:Withholding Treatment