• ethics

The papers in this special issue consider important legal, ethical, clinical and practical implications of decisions to withdraw clinically assisted nutrition and hydration (CANH) from patients who are either in a persistent vegetative state (PVS) or a minimally conscious state (MCS). They grapple with a range of difficult questions that decisions of this kind raise. For a start, what are PVS and MCS and is it possible to categorise (or categorise definitively) a patient as falling within one rather than another category? Even if this is possible, is it useful (clinically) or necessary (legally) to do so? What is the law that governs how we should treat such patients? What is meant by the term ‘best interests’ in the context of withdrawal of CANH? And who should be charged with making the decision about withdrawing this treatment?

These are challenging questions and this special edition of the journal draws on interdisciplinary expertise from leading scholars and practitioners in their field to shed light on how they should be answered. The authors include an experienced Court of Protection judge who has helped shape the law in this field, a practising lawyer, a philosopher, ethicists, sociologists and clinicians including those working in the field of rehabilitation and treatment of patients in PVS or MCS.