ArticleBMC medical ethics2018
Moral dilemmas and conflicts concerning patients in a vegetative state/unresponsive wakefulness syndrome: shared or non-shared decision making? A qualitative study of the professional perspective in two moral case deliberations.
Article in BMC medical ethics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Reconstruction of patients' treatment preferences in disorders of consciousness: a systematic review.BMC medical ethics · 2025Pooled it
- Multimodal prediction of residual consciousness in the intensive care unit: the CONNECT-ME study.Brain : a journal of neurology · 2023Trial
- Can digital brain twins dissolve the uncertainties surrounding unresponsive wakefulness?BMC medical ethics · 2026Article
- Ethics support for ethics support: the development of the Confidentiality Compass for dealing with moral challenges concerning (breaching) confidentiality in moral case deliberation.BMC medical ethics · 2024Article
- Perspectives on consciousness in patients with disorders of consciousness from brain injury: group concept mapping study across clinic, research, and families.BMC health services research · 2023Article
- Prolonged disorders of consciousness: Damaged brains, damaged minds?Brain & spine · 2023Article
- Pain Perception in Disorder of Consciousness: A Scoping Review on Current Knowledge, Clinical Applications, and Future Perspective.Brain sciences · 2021Article
- How do healthcare professionals respond to ethical challenges regarding information management? A review of empirical studies.Global bioethics = Problemi di bioetica · 2021Article
- Intensive neurorehabilitation for patients with prolonged disorders of consciousness: protocol of a mixed-methods study focusing on outcomes, ethics and impact.BMC neurology · 2021Article
- Unresponsive wakefulness syndrome: Outcomes from a vicious circle.Annals of neurology · 2020Observational
- Information Seeking Experiences of Family Caregivers of Patients with Persistent Vegetative State: A Qualitative Study.Iranian journal of nursing and midwifery researchArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term care of patients in VS/UWS.
methodsA qualitative study of transcripts on 2 Moral Deliberations (MD's) in 2 cases of patients in VS/UWS in long-term care facilities.
resultsSix themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes.
conclusionsDifferent visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making.
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