J Med Ethics doi:10.1136/medethics-2013-101799
  • Law, ethics and medicine
  • Paper

Withdrawing artificial nutrition and hydration from minimally conscious and vegetative patients: family perspectives

Open Access
  1. Jenny Kitzinger2
  1. 1Chronic Disorders of Consciousness Research Centre, Department of Sociology, University of York, York, UK
  2. 2Chronic Disorders of Consciousness Research Centre, School of Journalism, Media and Cultural Studies, Cardiff University, Cardiff, UK
  1. Correspondence to Professor Celia Kitzinger, Chronic Disorders of Consciousness Research Centre, Department of Sociology, University of York, Heslington, York YO10 5DD, UK; celia.kitzinger{at}
  • Received 26 August 2013
  • Revised 1 October 2013
  • Accepted 5 November 2013
  • Published Online First 14 January 2014


In W v M, family members made an application to the Court of Protection for withdrawal of artificial nutrition and hydration from a minimally conscious patient. Subsequent scholarly discussion has centred around the ethical adequacy of the judge's decision not to authorise withdrawal. This article brings a different perspective by drawing on interviews with 51 individuals with a relative who is (or was) in a vegetative or minimally conscious state (MCS). Most professional medical ethicists have treated the issue as one of life versus death; by contrast, families—including those who believed that their relative would not have wanted to be kept alive—focused on the manner of the proposed death and were often horrified at the idea of causing death by ‘starvation and dehydration’. The practical consequence of this can be that people in permanent vegetative state (PVS) and MCS are being administered life-prolonging treatments long after their families have come to believe that the patient would rather be dead. We suggest that medical ethicists concerned about the rights of people in PVS/MCS need to take this empirical data into account in seeking to apply ethical theories to medico-legal realities.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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