Making health-care decisions without a prognosis: Life in a Brain-Trauma-Unit (Tracing the nuances of practical decision making through traditional ethical theory)

When the author's daughter was hit by a car and remained unconscious for ov er seven months, she found that thee were certain factors where traditional ethical theory was not sufficiently nuanced to guide her practical decisio n making in regard to her daughter's health care. This article concentrates on three of those factors. They are: (1) no reliable prognosis can be offe red for many brain-injured individuals; (2) a patient's age and the relatio nship between the patient and the caregiver affect the context of caring; a nd (3) there are severe difficulties in obtaining and sustaining chronic ca re and accessing scarce resources.