Ethics Consultants' Recommendations for Life-Prolonging Treatment of Patients in a Persistent Vegetative State

摘要: Objective. —Surprisingly little is known about the content of ethics consultants' recommendations. We chose to study this issue using hypothetical persistent vegetative state (PVS) cases. addressed four questions: What recommendations do consultants give regarding life-prolonging treatment (LPT) in PVS cases? To what degree there consensus? factors influence recommendations? Do conform established guidelines? Design. —Questionnaire survey. Our questionnaire asked subjects they would recommend for seven vignettes involving a patient that varied with respect advance directives and family wishes. also questioned demographic characteristics, consultation experience, personal preference LPT PVS. Subjects. —Attendees at an annual meeting Society Bioethics Consultation (n=154). Results. —The response rate was 77%. Eighty-one percent respondents were committee members 62% consultants. There general agreement among only one vignettes: case whose directive agree be stopped, 93% recommended stopping all LPT. Responses other considerably. Although wishes important factor influencing recommendations, none adhered invariably patient's directive. Recommendations influenced by wishes, resource allocation considerations, legal constraints, Guidelines we examined generally too equivocal useful evaluating Conclusions. finding wide variability suggests need clarify standards consultation. (JAMA. 1993;270:2578-2582)