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Families are warned they can’t decide treatment for incapacitated relatives

New national guidelines on the diagnosis and management of people with prolonged disorders of consciousness—vegetative state and minimally conscious state—have been issued this week by the Royal College of Physicians.1

The guidance, from a multidisciplinary group that included lawyers as well as clinicians and that had input from patients’ families, expands on the college’s 2003 working party report on the vegetative state and incorporates developments over the past 10 years.

Derick Wade, professor of neurological rehabilitation at University College London and co-chairman of the guideline group, said that the guidance was “much more” than an update of the 2003 report. “It has the potential to improve dramatically the experience of care and treatment as seen by both patients and families and also to improve significantly the outcome for patients and thus society.”

The group …