Having been originally introduced as a term to facilitate discussion of a specific group of patients regarded as entering a state of unawareness following coma, the 'Persistent Vegetative State' (PVS) has established itself as an apparently discrete medical condition with clear-cut implications for ethicists and lawyers that exceed any scientifically based understanding. As a consequence of this upgrading, conclusions drawn about the status and hence the management of this uncommon condition have been increasingly extended to other patients with much more common forms of disability. This book traces the origins of prevailing perceptions about PVS and submits these to critical examination. In doing this it comes to the conclusion that inadequate attention has been paid to acknowledging what is not known about affected individuals and that assumptions have consistently come to be traded as facts. Re-examination of the basis of the PVS and the adoption of a more scientific approach is long overdue and is owed to the community at large which has generally been provided by many medical practitioners with a 'dumbed-down' account of the condition. The book will be of interest to philosophers, medical graduates and neuroscientists but is also intended to remain accessible to the general reader with an interest in the wider implications of trends in medical thinking for attitudes towards many classes of patient. It has an extensive bibliography and will be of specific interest to bioethicists and lawyers with professional interests in PVS.

The first half of the book is aimed at quantitative research workers in biology, medicine, ecology and genetics. The book as a whole is aimed at graduate students in statistics, biostatistics, and other quantitative disciplines. Ten detailed examples show how the author approaches real-world statistical problems in a principled way that allows for adequate compromise and flexibility. The need to accommodate correlations associated with space, time and other relationships is a recurring theme, so variance-components models feature prominently. Statistical pitfalls are illustrated via examples taken from the recent scientific literature. Chapter 11 sets the scene, not just for the second half of the book, but for the book as a whole. It begins by defining fundamental concepts such as baseline, observational unit, experimental unit, covariates and relationships, randomization, treatment assignment, and the role that these play in model formulation. Compatibility of the model with the randomization scheme is crucial. The effect of treatment is invariably modelled as a group action on probability distributions. Technical matters connected with space-time covariance functions, residual likelihood, likelihood ratios, and transformations are discussed in later chapters.

Having been originally introduced as a term to facilitate discussion of a specific group of patients regarded as entering a state of unawareness following coma, the Persistent Vegetative State (PVS) has established itself as an apparently discrete medical condition with clear-cut implications for ethicists and lawyers that exceed any scientifically based understanding. As a consequence of this upgrading, conclusions drawn about the status and hence the management of this uncommon condition have been increasingly extended to other patients with much more common forms of disability.

This book traces the origins of prevailing perceptions about PVS and submits these to critical examination. In doing this it comes to the conclusion that inadequate attention has been paid to acknowledging what is not known about affected individuals and that assumptions have consistently come to be traded as facts. Re-examination of the basis of the PVS and the adoption of a more scientific approach is long overdue and is owed to the community at large which has generally been provided by many medical practitioners with a dumbed-down account of the condition.

The book will be of interest to philosophers, medical graduates and neuroscientists but is also intended to remain accessible to the general reader with an interest in the wider implications of trends in medical thinking for attitudes towards many classes of patient. It has an extensive bibliography and will be of specific interest to bioethicists and lawyers with professional interests in PVS. "