This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
The tragic case of Terri Schiavo raised to public consciousness the issue of whether a lawful surrogate is empowered to refuse artificial hydration and nutrition (AHN) on behalf of a patient in a persistent vegetative state (PVS) based on preferences she orally expressed while competent. Thoughtful commentators pointed out that decisions by surrogates in such cases are constrained by the accuracy of medical diagnosis and prognosis and by the degree of confidence that the surrogate is expressing the true wishes of the patient.1 However, some also raised the question of whether it is ever ethically acceptable for physicians to order withdrawal of AHN.
Medical practice standards, ethical guidelines, and law support the right of patients to refuse life-sustaining therapies in specified circumstances.2,3 This right was clearly articulated by the US Supreme Court in the Cruzan case in 1990.4 The justices determined that the choice of a person in a PVS to decline life support is a protected liberty interest under the 14th amendment to the federal constitution, and that …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
- The controversy over artificial hydration and nutrition
- The controversy over artificial hydration and nutrition
- Reply from the Authors
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Association of Neurofilament Light With the Development and Severity of Parkinson Disease
Dr. Rodolfo Savica and Dr. Parichita Choudhury
► Watch
Topics Discussed
Alert Me
Recommended articles
Terminating artificial nutrition and hydration in persistent vegetative state patients
End-of-life care
Position statement on laws and regulations concerning life-sustaining treatment, including artificial nutrition and hydration, for patients lacking decision-making capacity
The neurologist and the dying patient