For professionals

Introduction

The primary goal of medicine has been classically to prolong life. Over the past century, survival rates for the most serious injuries and illnesses have increased dramatically (1, 2). Early in the 1950s, the idea arose that the benefits of this progress were not exclusively positive. After overcoming the critical first hours to days after acute brain damage, patients remained in a state without 'evidence suggesting that they are in contact with their environment'(3). The general public in the Netherlands first heard about such results in 1966, when the father of a young woman named Mia Versluis caught the public's attention. She had permanently lost consciousness due to hypoxemia during an elective surgical procedure (4).

In 1972, British neurosurgeon Bryan Jennett and American neurologist Fred Plum proposed the term "persistent vegetative state" to describe a state of autonomic vital signs and spontaneous eye opening without evidence of conscious consciousness(5). It was previously known as 'coma vigil' and 'apallic syndrome'. In the years that followed, 'vegetative' patients after acute, acquired brain injury increasingly came into the neuroscientific, clinical and public interest. These three perspectives intersected regularly, but were not as intertwined as would have been beneficial to the patients, families, and healthcare professionals involved.