Objective: Decisions about life-sustaining
treatment for patients in the vegetative state
have often been taken to court in recent years.
In this study, we retrospectively analyzed
these court decisions with regard to their ethical
foundation. Material and methods: All
published German court decisions about patients
in the vegetative state between 1994
and 2010 were identified in databases. The
texts passed a document analysis, using the
method of Qualitative Content Analysis. Results:
We identified 30 judgments, most of
which concerned civil law proceedings. They
related to 17 patients, and each case was
about the administration of artificial nutrition
and hydration. In ten cases, social conflicts led
to the proceedings. The judgments are based
on the ethical principles of patient autonomy
and patient wellbeing. The latter was associated
by the judges with awareness and the
ability to communicate, while prognosis also
played an important role. Conclusions: The
judgments have now led to a clear state of
law that gives physicians legal certainty. An
ethical challenge that remains is the question
of medical indication.