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September 23, 2008; 71 (13) Views and Reviews

Media coverage of the persistent vegetative state and end-of-life decision-making

E. Racine, R. Amaram, M. Seidler, M. Karczewska, J. Illes
First published August 6, 2008, DOI: https://doi.org/10.1212/01.wnl.0000320507.64683.ee
E. Racine
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Media coverage of the persistent vegetative state and end-of-life decision-making
E. Racine, R. Amaram, M. Seidler, M. Karczewska, J. Illes
Neurology Sep 2008, 71 (13) 1027-1032; DOI: 10.1212/01.wnl.0000320507.64683.ee

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Abstract

Background: Conflicting perspectives about the diagnosis and prognosis of the persistent vegetative state (PVS) as well as end-of-life (EOL) decision-making were disseminated in the Terri Schiavo case. This study examined print media coverage of these features of the case.

Methods: We retrieved print media coverage of the Schiavo case from the LexisNexis Academic database and used content analysis to examine headlines and text of articles describing Schiavo’s neurologic condition, behavioral repertoire, prognosis, and withdrawal of life support. The accuracy of claims about PVS was assessed.

Results: Our search yielded 1,141 relevant articles published (1990–2005) in the four most prolific American newspapers for this case. The most frequent headline themes featured legal (31%), EOL (25%), and political (22%) aspects of the case. Of the articles analyzed, 21% reported that Schiavo “might improve” and 7% that she “might recover.” Statements explicitly denying the PVS diagnosis were found in 6% of articles. Explanations of PVS and other chronic disorders of consciousness were rare (≤1%). Most frequently cited descriptions of behaviors were that the patient responds (10%), reacts (9%), is incapacitated (6%), smiles (5%), and laughs (5%). Withdrawal of life support was described as murder in 9% of articles.

Conclusions: Media coverage included refutations of the persistent vegetative state (PVS) diagnosis, attributed behaviors inconsistent with PVS, and used charged language to describe end of life decision-making. Strategies are needed to achieve better internal agreement within the professional community and effective communication with patient communities, families, the media, and stakeholders.

Glossary

CDC=
chronic disorders of consciousness;
EOL=
end-of-life;
PVS=
persistent vegetative state.
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Disputes & Debates: Rapid online correspondence

  • Media coverage of the persistent vegetative state and end-of-life decision-making
    • Robert L. Folmer, PhD, Oregon Health & Science University, 3710 S.W. U.S. Veterans Hospital Road (NCRAR), Portland, OR 97239folmerr@ohsu.edu
    Submitted February 10, 2009
  • Reply from the Editorialist
    • James L. Bernat, MD, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756bernat@dartmouth.edu
    Submitted February 10, 2009
  • Reply from the authors
    • Eric Racine, Institut de recherches cliniques de Montréal, University of Montreal, McGill University, 110 Pine Avenue West, Montreal QC, H2W 1R7, Canadaeric.racine@ircm.qc.ca
    • Rakesh Amaram, Matthew Seidler, Marta Karczewska, and Judy Illes
    Submitted February 10, 2009
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