Tiffany was seventeen when injury to her brain stem put her in the intensive care unit on life-sustaining treatment and in a permanently locked-in state-fully conscious but able to control no bodily movements other than her eye movements. As a clinical ethicist at the hospital, I was consulted by her neurologist, who had established a blink-once-for-yes, twice-for-no system of communication so that Tiffany could respond to questions. Her mother wanted Tiffany to continue receiving treatment that could prolong her life for years, potentially decades. In a meeting with the neurologist and family, I felt like suggesting what nobody seemed willing to suggest: that we should ask Tiffany what she wants.
Keywords: autonomy; clinical ethics; decision-making; decision-making for adolescents; disorders of consciousness; end of life; locked in.
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