This article explores the taxing legal questions that are raised in the context of withdrawing life sustaining treatment from patients who are in a minimally conscious state. The Court of Protection, for the first time in England, was recently asked to rule on this issue. This paper analyses the legal and ethical implications of this decision moving forward.
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This naturally feeds into the bigger question of whether or not patients in a MCS have the ‘right’ to die. For a recent and interesting discussion see: SydL, JohnsonM. The right to die in the minimally conscious state. J Med Ethics2011;37:175–8
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For an interesting recent discussion, which calls into question the validity of advance decisions in MCS patients, see: VareliusJ. Respect for autonomy, advance directives, and minimally conscious state. Bioethics2011;25:505–15
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Whilst to this author it is clear that M's earlier views should apply to her now, there is considerable theoretical debate about whether in fact a patient's former views should apply in the future. See: MacleanAR. Advance directives and the rocky waters of anticipatory decision-making. Med Law Rev2008;16:1–22; Maclean AR. Advance directives, future selves and decision-making. Med Law Rev 2006;14:291–320
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For a recent and interesting discussion in respect of a breakthrough in assessing levels of consciousness in brain damaged patients using an electroencephalography technique (EEG) see: CruseD, ChennuS, ChatelleC, Bedside detection of awareness in the vegetative state: a cohort study. Lancet2011;378:2088–94
