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May 1991

Persistent Vegetative State: Where Do We Go From Here?

Author Affiliations

Department of Medicine University of Massachusetts Medical Center 55 Lake Ave N Worcester, MA 01655

Arch Intern Med. 1991;151(5):855-856. doi:10.1001/archinte.1991.00400050009002

A number of "new" diseases have been discovered in the waning decades of the 20th century. Some are the result of newly evolved or more aggressive pathogenic organisms, eg, acquired immunodeficiency syndrome, while other conditions are the result of the application of modern medical technology. The persistent vegetative state (PVS) is an example of the latter type of "new" disease. Patients with this devastating neurological entity rarely, if ever, survived for long before the advent of modern medical interventions, such as intravenous antibiotics and intravenous and/or enteral nutritional support.

Unfortunately, prolonged survival of patients with PVS has created a very difficult moral and ethical dilemma for the health care profession. Should these patients receive intense, life-prolonging therapy? Who should make crucial life and death decisions for these individuals? What are the legal implications of continuing vs withdrawing intensive care or technological support? Can we as a society afford to pay

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