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Table 1 Medical facts, treatment-plan, Advance Directive (AD), Advance Care Planning (ACP) and family agreement at time of MD

From: 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

 

Case 1 patient A

Case 2 patient B

Duration of VS/UWS

10 years

20 years

Age at time of incident

41 years

17 years

Cause of brain injury

Cardiac arrest

Traffic accident

Medical treatment plan

Tube feeding

Tube feeding is to be withdrawn in time

Diabetes Mellitus treatment

Seizure control

Bronchial toilet

Constipation control

Constipation control

No more physiotherapy

Physiotherapy

Attempts by social worker, psychologist and mental healthcare to alleviate the burden of the family

Advance Directive by the patient

No prior AD (written or oral)

No prior AD written

Reconstructed wish of the patient by the mother: her son would not have accepted to be in a state like this.

End-of-life decisions in ACP

No admission to hospital for any treatment of life threatening complications.

No admission to hospital for any treatment of life threatening complications

Maximum of 3 different antibiotics

If not successful: palliative care

Family agreement

No, the family demands all treatment including ICU

Ambivalent, possibly the family accept no hospital admission policy, They insist on treatment by antibiotics