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What should clinicians do when a patient does not regain full consciousness? How do they decide whether to continue life-prolonging treatment when the patient cannot participate in the decision? For a long time, there were no clear answers. There was no structured decision-making process, misdiagnoses were common, and ethical uncertainty prevailed. Doctors often found themselves without guidance, lacking both knowledge and a defined procedure.

A well-known early example is the Stinissen case in the 1980s. Ineke Stinissen spent eleven years in a nursing home without signs of consciousness. Her husband, unable to end what he considered unnecessary suffering, eventually turned to the courts and the media. The case drew international attention.

Jan Lavrijsen & Willemijn van Erp