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[Resistant vegetative state: considerations regarding bioethics of contemporary medicine]
1Clínica de Lesiones Estáticas Encefálicas, Centro Internacional de Restauración Neurológica, CIREN, La Habana, Cuba. acabrera@neuro.sld.cu
Introduction:
The diagnosis and conduct toward persistent vegetative state (PVS) is one of the emergent themes in bioethic in our contemporary society. This clinical condition is defined.
Development:
To homologate PVS with brain death (BD) is one of the most discussed present controversies at the bioethic international area. If we keep in mind the present concepts of BD, it's not correct to homologate both terms. There is an increasing practice in admitting the end of medical treatment in PVS. In fact, with the introduction of cost-effectiveness concept in intensive medicine, the right to treatment of these patients is discussed at Intensive Care Units. Some present criteria about this are presented, taking age into consideration, diagnostic certainty and the establishment of function recovery prognosis.
Conclusions:
The introduction of recently developed models for the rehabilitation of patients with severe brain injuries and PVS may lead to substantial improvements in outcome and may also be cost efficient. It is not ethical to make an arbitrary decision to withdraw a medical treatment of a patient, when we know there is the structural possibility of recovering some functions.