Termination of nutrition and hydration in a child with vegetative state.
A child in a vegetative state may present difficult decisions for physicians and families regarding the course of treatment. We report a case of a child who entered a prolonged vegetative state following status epilepticus. The child's parents requested termination of artificial means of nutrition and hydration. That request culminated in a complex legal intervention by multiple state agencies and attracted local media attention. This article presents the details of the case and discusses the medical and legal complexities encountered. The diagnosis and prognosis of the persistent vegetative state in children have recently been defined. Decision making in these circumstances should be based on adequate, careful clinical evaluation of the medical facts. Hospital ethics committees can provide an independent forum in which the diverse viewpoints in a case may be examined. Decision making should optimally be accomplished between families and caretakers.
Leicher
C R
CR
Department of Pediatrics, Hartford Hospital, CT.
DiMario
F J
FJ
D001927:Brain Diseases; D003128:Coma / Q000209:etiology / Q000628:therapy*; D003237:Connecticut; D003657:Decision Making; D034462:Dissent and Disputes; D004750:Enteral Nutrition; D017041:Ethics Committees; D028741:Ethics Committees, Clinical; D005066:Euthanasia, Passive / Q000331:legislation & jurisprudence*; D035082:Federal Government; D005260:Female; D006077:Government Agencies; D033161:Government Regulation; D006126:Group Processes; D006801:Humans; D007223:Infant; D010290:Parents; D012297:Right to Die / Q000331:legislation & jurisprudence; D013226:Status Epilepticus / Q000150:complications*; D028761:Withholding Treatment