Vegetative state: guidance on diagnosis and management

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The assessment and management of people in a permanent vegetative state has changed since the publication of The permanent vegetative state, in 1996. These changes, together with a suggestion from the Official Solicitor that the courts would appreciate further help in terms of diagnosis and prognosis of the condition, provided the impetus for this guidance, published in 2003.

The guidance provides information about the nature of the vegetative state in the light of current research evidence, it explores the clinical features which are expected and those which are less typical of the condition, and defines other similar states which must be differentially diagnosed. It also describes the medical management of patients in a vegetative state and sets out the criteria for making a diagnosis of permanent vegetative state. The procedures and legal requirements regarding the withdrawal of nutrition and hydration, and of life-sustaining medication, are clearly presented. Finally, a separate section, which is designed to be photocopied, provides accessible information for lay people who tragically have friends or relatives in the vegetative state.

This guidance, which is available to download as a pdf, will provide definitive reference for clinical neurologists, intensivists, rehabilitationists, surgeons, healthcare teams working in the field of neuroscience and neurorehabilitation, and legal practitioners.

Contents

  • Introduction - background and definitions
  • Criteria for the diagnosis of the vegetative state
  • Management of the vegetative state - medical care; assessment and diagnosis of the permanent vegetative state; decisions concerning life support; notes on children and young people
  • Checklist for the diagnosis of the permanent vegetative state
  • Four vignettes illustrating definitions used in the report
  • Information on the vegetative state for relatives, carers and friends

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