抄録
In 1994,the Science Council of Japan approved of withdrowal of nutrition and hydration from patients in persistent vegetative state (PVS), if they have had "living-will". The term "persistent vegetative state" was coined by Jennett and Plum in 1972 to describe the condition of patients with a state of wakefulness without detectable awareness, and the Japanese Neurosurgical Society proposed a clinical criteria of PVS for getting public financial help on these patient's family. In 1994,the American Multi-society Task Force on PVS expressed the consensus statement of the persistent vegetative state. Bioethical issuses concerning patients in PVS are 1) a vague conception, 2) obscure clinical criteria, 3) various prognosis, 4) possible very long survival (41 years), 5) usually unclear patient's will, 6) death with dignity. For each patient it is important to have a living-will, and medical staffs should be treating a patient in PVS same as conscious one, so if the patient had the living-will physician should respect it. Before deciding cease life-suporting measures physician had to have enough time to discuss about various conflicts among nureses and patient's family.
