Ethics roundtable debate Withdrawal of tube feeding in a patient with persistent vegetative state where the patients wishes are unclear and there is family dissension.docVIP

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Ethics roundtable debate Withdrawal of tube feeding in a patient with persistent vegetative state where the patients wishes are unclear and there is family dissension.doc

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Ethics roundtable debate Withdrawal of tube feeding in a patient with persistent vegetative state where the patients wishes are unclear and there is family dissension

Available online /content/8/2/79 Commentary Ethics roundtable debate: Withdrawal of tube feeding in a patient with persistent vegetative state where the patient’s wishes are unclear and there is family dissension Tom Buckley1, David Crippen2, Anthony L DeWitt3, Malcolm Fisher4, Antonios Liolios5, Christine L Scheetz6 and Leslie M Whetstine7 1Chief of Service, Intensive Care Unit, Princess Margaret Hospital, Lai Chi Kok, Kowloon, Hong Kong 2Associate Professor, Department of Critical Care Medicine, University of Pittsburgh Medical Centre, Pittsburgh, Pennsylvania, USA 3Attorney, Bartimus, Frickleton, Robertson and Obetz, Jefferson City, Missouri, USA 4Clinical Professor, University of Sydney, Intensive Care Unit, Royal North Shore Hospital, St Leonards, New South Wales, Australia 5Attending Intensivist, Intensive Care Unit, University Hospital of Saint Luc, Brussels, Belgium 6Director, Patient and Visitor Relations/Patient Representative Program, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA 7PhD Candidate, Department of Health Care Ethics, Duquesne University, Pittsburgh, Pennsylvania, USA Correspondence: Critical Care Editorial Office, editorial@ Published online: 6 February 2004 Critical Care 2004, 8:79-84 (DOI 10.1186/cc2451) This article is online at /content/8/2/79 ? 2004 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract The decision to withdraw or withhold life supporting treatment in moribund patients is difficult under any circumstances. When the patient becomes incompetent to clarify their wishes regarding continued maintenance in long-term facilities, surrogates sometimes cannot agree, further clouding the issue. We examine a case where the State’s interests come into play, forcing a controversial resolution. Keywords autonomy, ethics, surrogate, withdrawing (life support), withholding (life support) Introduction members; she smiles but she does not follow commands. She is hemodynamically stable and is su