This report proposes a policy for discontinuing dialysis in persistent vegetative state (PVS) patients and attempts to address autonomy and community-based values while maintaining professional moral agency.
It is recommended that the policy be adopted at a regional level (eg, the ESRD Network).
The involved physicians and ethicists would communicate with the next-of-kin and surrogate decision-makers, and the local ethics committee would perform a double review of the case to assure the appropriateness of the policy to the case.
Given the unique nature of PVS with its permanent loss of consciousness and autonomy, we hold that a community-based consensus can form a guideline that limits futile dialysis while respecting patient and professional moral agency.
Prior consent of dialysis patients to the regional policy at a time shortly after initiating dialysis will add to its ethical impetus.
Mots-clés Pascal : Etat végétatif, Traitement associé, Dialyse, Critère décision, Arrêt traitement, Ethique, Homme, Système nerveux pathologie, Trouble neurologique, Trouble conscience, Coma, Epuration extrarénale
Mots-clés Pascal anglais : Vegetative state, Combined treatment, Dialysis, Decision criterion, Withdrawal, Ethics, Human, Nervous system diseases, Neurological disorder, Consciousness impairment, Coma, Extrarenal dialysis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0460314
Code Inist : 002B30A09. Création : 03/02/1998.