Termination of nutrition and hydration in a child with vegetative state
C. R. Leicher and F. J. DiMario Jr
Department of Pediatrics, Hartford Hospital, CT.
A child in a vegetative state may present difficult decisions for
physicians and families regarding the course of treatment. We report a case
of a child who entered a prolonged vegetative state following status
epilepticus. The child's parents requested termination of artificial means
of nutrition and hydration. That request culminated in a complex legal
intervention by multiple state agencies and attracted local media
attention. This article presents the details of the case and discusses the
medical and legal complexities encountered. The diagnosis and prognosis of
the persistent vegetative state in children have recently been defined.
Decision making in these circumstances should be based on adequate, careful
clinical evaluation of the medical facts. Hospital ethics committees can
provide an independent forum in which the diverse viewpoints in a case may
be examined. Decision making should optimally be accomplished between
families and caretakers.
