The miracles of modern medicine have
created scenarios where persons with clinical conditions previously
considered “fatal” and/or ”permanent” have in fact shown recovery.
Inherent in aggressive and advanced medical treatment has also been
a phenomenon leading to an increased number of persons in such
states relying on life-sustaining treatments. In many cases, such
patients remain dependent on these life-sustaining treatments for
years. Possibly, one of the most dramatic examples of such a
clinical scenario is the vegetative state (VS), a clinical condition
that occurs when an individual, following a cerebral insult either
through an event such as trauma or anoxia or by means of a
neurodegenerative disorder, enters a neurological state marked by
periods of wakefulness and arousal but without associated
demonstrable awareness/consciousness. There is extensive debate as
to whether assisted nutrition and hydration (ANH) should be
withdrawn from patients in VS, permanent or otherwise. This book
will provide cutting edge information to many scientists and
clinicians interested in this clinical topic. It could also be a
source of anthropological, philosophical and ethical reflection and
inspiration to all those who encounter individuals in low-level
neurological states. The many dilemmas raised by the medical,
religious, ethical and societal response to persons in VS go well
beyond the clinical condition itself and have profound implications
for the fundamental values in our global society. It is for this
reason that the authors thought it was important to also provide a
vehicle, not only for scientific and bioethical reflections, but
also for the religious views and tenants of Judeo-Christian thought
on the controversial topic of VS and, inherent in that conversation,
the controversy of withdrawal and withholding of care.
(Foreword. Gian Luigi Gigli and Nathan
David Zasler)