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May 1976

Who Should Decide to Withhold Care in Chronic Coma?

Arch Neurol. 1976;33(5):371. doi:10.1001/archneur.1976.00500050057011

In a widely publicized recent case, a New Jersey court considered the extent of its power to direct a patient's attending physician to discontinue life-support measures.1 The patient was a young woman who was hospitalized after lapsing into coma and becoming apneic. The cause of her coma was not established, but infection, neoplasia, and intracranial bleeding were excluded. As part of her initial care, she was placed on a respirator. She failed to regain consciousness and entered into a chronic vegetative state. When respiratory support was temporarily withdrawn, she became hypoxemic, despite some spontaneous respiratory function. Accordingly, use of the respirator was continued. After being informed by her physicians that there was little hope of meaningful neurologic recovery, her parents asked her attending physician to discontinue respiratory support. When he refused this request, they petitioned the court for an order appointing one of them as guardian of the patient

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