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CMAJ
CMAJ - July 14, 1998JAMC - le 14 juillet

CPR for patients in a persistent vegetative state?

CMAJ 1998;159:19


See response from: C. Weijer
Dr. Weijer argues reasonably for accepting a family's refusal of a DNR order because of strong religious beliefs about the sanctity of life and therefore about the value of preserving the life of a family member even if that person is permanently unconscious. He argues that the joint statement is "neither ethically nor legally defensible" and "ought to be amended," since treatment of a patient in a PVS is considered "futile" and, according to the joint statement, the patient would be "unable to experience any benefit."

An alternative view would be that the joint statement is valid, but, in the absence of outcome probabilities, it must be interpreted together with the patient's and the family's values. If the case is interpreted by hospital staff who understand and defend the values of the patient and the family, not their own personal values, the case would not be considered futile. The patient would be considered to experience benefit because in this value system an unconscious life is worth preserving.

Paul Walker, MD
Grey Nuns Community Hospital & Health Centre
Caritas Health Group
Edmonton, Alta.
lbykewic@caritas.ab.ca

Reference

  1. Joint statement on resuscitative interventions (update 1995). CMAJ 1995;153(11):1652A-C.

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