Conscious in a Vegetative State? A Critique of the PVS Concept
Having been originally introduced as a term to facilitate discussion of a specific group of patients regarded as entering a state of unawareness following coma, the 'Persistent Vegetative State' (PVS) has established itself as an apparently discrete medic
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INTERNATIONAL LIBRARY OF ETHICS, LAW, AND THE NEW MEDICINE Founding Editors DAVID C. THOMASMA† DAVID N. WEISSTUB, Université de Montréal, Canada THOMASINE KIMBROUGH KUSHNER, University of California, Berkeley, U.S.A.
Editor DAVID N. WEISSTUB, Université de Montréal, Canada
Editorial Board TERRY CARNEY, University of Sydney, Australia MARCUS DÜWELL, Utrecht University, Utrecht, the Netherlands SØREN HOLM, University of Cardiff, Wales,United Kingdom GERRIT K. KIMSMA, Vrije Universiteit, Amsterdam, the Netherlands DAVID NOVAK, University of Toronto, Canada EDMUND D. PELLEGRINO, Georgetown University, Washington D.C., U.S.A. DOM RENZO PEGORARO, Fondazione Lanza and University of Padua, Italy DANIEL P. SULMASY, Saint Vincent Catholic Medical Centers, New York, U.S.A. LAWRENCE TANCREDI, New York University, New York, U.S.A.
VOLUME 23
The titles published in this series are listed at the end of this volume.
CONSCIOUS IN A VEGETATIVE STATE? A CRITIQUE OF THE PVS CONCEPT
by
Peter McCullagh
KLUWER ACADEMIC PUBLISHERS NEW YORK, BOSTON, DORDRECHT, LONDON, MOSCOW
eBook ISBN: Print ISBN:
1-4020-2630-7 1-4020-2629-3
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Print ©2004 Kluwer Academic Publishers Dordrecht All rights reserved
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For Ted Freeman
CONTENTS
Acknowledgements................................................................................... xiii Introduction................................................................................................ xv Chapter 1: History and Context of the Persistent Vegetative State ............. 1 1.1. 1.2. 1.3. 1.4. 1.5. 1.6. 1.7. 1.8. 1.9. 1.10. 1.11. 1.12. 1.13. 1.14. 1.15.
Twenty-five years on: an idea ................................................................... 1 Responses to an idea ................................................................................. 3 The naming of PVS ................................................................................... 5 Pre-existing names .................................................................................... 8 Perceptions engendered by a name ......................................................... 10 The interface between PVS and brain death............................................ 13 Revising brain death: implications for PVS ............................................ 16 Semantic implications ............................................................................. 18 Evolution of the title................................................................................ 19 Alive or dead? ......................................................................................... 20 Dying for how long? An exercise in terminal sema
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