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. 2022 Apr 26;29(8):2181–2191. doi: 10.1111/ene.15354
Theme Question
Definitions
Persistent vegetative state (PVS)
  • How would you define PVS?

Minimally conscious state (MCS)
  • How would you define MCS?

Comparison between the two conditions
  • What are the main differences between the two conditions?

Main clinical decisions in adult patients
PVS
  • Which are the main clinical decisions when managing adult patients in PVS?

MCS
  • Which are the main clinical decisions when managing adult patients in MCS?

Main clinical decisions in pediatric patients
PVS
  • Which are the main clinical decisions when managing pediatric patients in PVS?

MCS
  • Which are the main clinical decisions when managing pediatric patients in MCS?

Criteria for decision‐making
  • Why do you think different clinical decisions are made in similar clinical situations, but in different hospitals or departments?

  • Are there guidelines for clinical decision‐making with PVS and MCS adult/pediatric patients in your hospital (or in other hospitals in which you worked)? If so, what role do they play in your decision‐making process?

  • Can you think of factors that play a role during your decision‐making process and that challenge such guidelines?

Quality of life/health status
  • What do you take into consideration when evaluating the child's/adolescent's quality of life prior to the trauma/event?

  • What role does the initial health status of the child/adolescent play in your evaluation of his/her quality of life prior to the trauma/event?

  • How would you define the quality of life of a child/adolescent in PVS/MCS from birth?

Etiology
  • What role does etiology play on your decision‐making, compared to prognosis?

  • Think about different etiologies; what difference does it make if the patient had traumatic or nontraumatic (hypoxia) brain injuries from birth?

Diagnosis
  • What role does diagnosis play on your decision‐making, compared to prognosis?

Prognosis
  • What do you take into account when making a prognosis?

Treatment
  • What do you consider to be an “aggressive treatment”?

  • How do different treatments affect PVS/MCS patients' quality of life?

  • When deciding on treatment, would it make a difference whether the child/adolescent has been in PVS/MCS since birth? If so, how?

Role of family members
  • Think about the role of PVS patients' family members on your clinical decision‐making process; what comes to your mind?

  • Think about the role of MCS patients' family members on your clinical decision‐making process; what comes to your mind?

Distributive justice
  • Do you do anything to ensure that management/treatment costs are equally distributed? If so, what?

Autonomy
  • What do you think is the best way to respect the autonomy of a child/adolescent in PVS? What do you do?

  • What do you think is the best way to respect the autonomy of a child/adolescent in MCS? What do you do?

  • Who should be the guardian of this autonomy? Who, in fact, is?