Mother on her daughter's life-support question:"let Janova go in peace"

By Margarita Snegireva. The emotionally shaken father of a 16-year-old girl in an irreversible coma at Montefiore Medical Center is wavering in his opposition to ending what's left of her life.

"I'm 85% changed in my mind now, but I don't know the legality," said Leonard Peters, whose daughter Javona Peters is in a permanent vegetative state after what was supposed to be a routine operation on Oct. 17.

Javona's mother, Janet Joseph, has said she wants "to let Javona go in peace" by taking her off her feeding tube. The case is set for a Jan. 7 hearing in Bronx Supreme Court.

A persistent vegetative state (PVS) is a condition of patients with severe brain damage in whom coma has progressed to a state of wakefulness without detectable awareness.

As opposed to brain death, PVS is not recognized as death in any legal system. This legal grey area has led to several court cases involving people in a PVS, those who believe that they should be allowed to die, and those who are equally determined that, if recovery is possible, care should continue. This ethical issue raises questions about autonomy, quality of life, appropriate use of resources, the wishes of family members, professional responsibilities, and many more.

Terminology in this area is somewhat confused. While the term persistent vegetative state is the most frequent in media usage and legal provisions, it is discouraged by neurologists, who favour the terminology of the Royal College of Physicians (RCP) which refers only to the vegetative state, the continuing vegetative state, and the permanent vegetative state. 

The vegetative state is a chronic or long-term condition. This condition differs from a persistent vegetative state (PVS, a state of coma that lacks both awareness and wakefulness) since patients have awakened from coma, but still have not regained awareness. In the vegetative state patients can open their eyelids occasionally and demonstrate sleep-wake cycles. They also completely lack cognitive function. The vegetative state is also called coma vigil. The continuing vegetative state describes a patient's diagnosis prior to confirmation of the permanence of the condition

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