PVS/MCS and the courts: a further contribution

In an open access article published today (16 December) in the Journal of Medical Ethics, Lynne Turner-Stokes makes a further important contribution to the debate started (or kindled) by Baker J’s Shrieval Lecture as to the role of courts in the context of the withdrawal of treatment from those in a PVS/MCS.   The article, “A matter of life and death: controversy at the interface between clinical and legal decision-making in prolonged disorders of consciousness,” sets out the background and discussion and attempts to give a more accurate representation of the facts. Importantly, and “in the spirit of transparency,” Professor Turner-Stokes presents a mortality review of all the patients in VS/MCS who have died under the care of her own unit in the last decade—with or without referral to the court, but always, she considers, in accordance with the law. These data demonstrate that clinicians regularly undertake best interests decision-making in conjunction with families that may include life and death decisions (sometimes even the withdrawal or withholding of clinically assisted nutrition and hydration); and that these can be made within the current legal framework without necessarily involving the court in all cases. This is the first published case series of its kind.

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