Applying best interests to persistent vegetative state--a principled distortion?

Fenwick AJ

doi:10.1136/jme.24.2.86

Abstract

"Best interests" is widely accepted as the appropriate foundation principle for medico-legal decisions concerning treatment withdrawal from patients in persistent vegetative state (PVS). Its application appears to progress logically from earlier use regarding legally incompetent patients. This author argues, however, that such confidence in the relevance of the principle of best interests to PVS is misplaced, and that current construction in this context is questionable on four specific grounds. Furthermore, it is argued that the resulting legal inconsistency is distorting both the principle itself and, more particularly, individual patient interests.

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J Med Ethics. 1998 Apr; 24(2): 86–92.

https://doi.org/10.1136/jme.24.2.86

PMCID: PMC1377452

PMID: 9602994

Applying best interests to persistent vegetative state--a principled distortion?

A J Fenwick

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See commentary "Persistent vegetative state, withdrawal of artificial nutrition and hydration, and the patient's "best interests"." on page 75.

See letter "Best interests and persistent vegetative state." on page 350b.

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Abstract

"Best interests" is widely accepted as the appropriate foundation principle for medico-legal decisions concerning treatment withdrawal from patients in persistent vegetative state (PVS). Its application appears to progress logically from earlier use regarding legally incompetent patients. This author argues, however, that such confidence in the relevance of the principle of best interests to PVS is misplaced, and that current construction in this context is questionable on four specific grounds. Furthermore, it is argued that the resulting legal inconsistency is distorting both the principle itself and, more particularly, individual patient interests.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

Mason JK, Mulligan D. Euthanasia by stages. Lancet. 1996 Mar 23;347(9004):810–811. [Abstract] [Google Scholar]
Craig GM. On withholding nutrition and hydration in the terminally ill: has palliative medicine gone too far? J Med Ethics. 1994 Sep;20(3):139–145. [Europe PMC free article] [Abstract] [Google Scholar]
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Articles in the Open Access Subset are available under a Creative Commons license. This means they are free to read, and that reuse is permitted under certain circumstances. There are six different Creative Commons licenses available, see the copyright license for this article to understand what type of reuse is permitted.
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J Med Ethics, 35(8):508-511, 01 Aug 2009
Cited by: 21 articles | PMID: 19644010 | PMCID: PMC2711351
Articles in the Open Access Subset are available under a Creative Commons license. This means they are free to read, and that reuse is permitted under certain circumstances. There are six different Creative Commons licenses available, see the copyright license for this article to understand what type of reuse is permitted.
Free full text in Europe PMC
"Neglected personhood" and neglected questions: remarks on the moral significance of consciousness.
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Cited by: 13 articles | PMID: 16877624 | PMCID: PMC2563380
Review Free full text in Europe PMC

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Applying best interests to persistent vegetative state--a principled distortion?

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Abstract

Free full text

Applying best interests to persistent vegetative state--a principled distortion?

Abstract

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

Associated Data

Full text links

Citations & impact

Impact metrics

Citations of article over time

Smart citations by scite.ai
Explore citation contexts and check if this article has been supported or disputed.
https://scite.ai/reports/10.1136/jme.24.2.86

Article citations

The theorisation of 'best interests' in bioethical accounts of decision-making.

How many patients in a prolonged disorder of consciousness might need a best interests meeting about starting or continuing gastrostomy feeding?

Functional neuroimaging and withdrawal of life-sustaining treatment from vegetative patients.

"Neglected personhood" and neglected questions: remarks on the moral significance of consciousness.

Is it in the best interests of an intellectually disabled infant to die?

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