Economic aspects of the care of patients in the vegetative state

The raising of economic issues related to the care of patients in the vegetative state (V.S.) is troublesome to both health-care practitioners and to the public opinion, given the general perception that economics and ethics are incompatible. The main purpose of this article is to show that economic considerations are not merely reconcilable with ethical concerns, they nourish, enrich, and complement them. Three areas of intersection between ethics and economics are described: economic considerations can help bring to the surface the choices involved in decision-making, whether they are explicit or not; these considerations are a natural outgrowth of a well thought-out ethical approach; an economic analysis can accommodate and take into consideration ethical criteria. The second part presents the results of a study conducted in France between 1987 and 1993 which attempted to evaluate the costs of hospital care of comatose patients hospitalized for short and medium term periods. The article concludes with an examination of the economic issues that may be raised in future debates about how much effort should be expended in the care of patients afflicted by V.S.