Moral dilemmas and conflicts concerning patients in a vegetative state/unresponsive wakefulness syndrome: shared or non-shared decision making? A qualitative study of the professional perspective in two moral case deliberations

BMC Medical Ethics
Conny A M F H Span-SluyterRaymond T C M Koopmans

Abstract

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD's) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and b...Continue Reading

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Citations

Oct 2, 2019·Current Opinion in Critical Care·Jeroen T J M van DijckUNKNOWN all focus group participants
Nov 2, 2019·Annals of Neurology·Willemijn S van ErpRaymond T C M Koopmans
Aug 26, 2020·International Journal of Palliative Nursing·Zahra Imani-Goghary, Mahnaz Ghaljeh
Dec 22, 2020·Iranian Journal of Nursing and Midwifery Research·Fateme GoudarziKourosh Zarea
Apr 27, 2021·Global Bioethics = Problemi Di Bioetica·Cornelius EwuosoKris Dierickx

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