Matthew Minor, 16, the star of the Kirkland High School football team, has suffered 3 concussions of varying levels of severity. His coach, Jack Jox, is required to report all concussions to Kirkland's athletic director, but Jox only reports "serious" concussions because many of his players, like Matthew, need an athletic scholarship to attend college. Jox and Matthew's father agreed to report only 1 of Matthew's concussions. The athletic director suspects Matthew has had more than 1 concussion, but he has not questioned Jox, who is in the middle of a winning season. Kirkland, like other area high schools, restricts players from continuing to play football after 4 concussions in light of the increasing evidence that multiple concussions are dangerous for teenagers. At the homecoming game, Matthew is knocked down, but Coach Jox sends him back in after a brief rest. At home later, Matthew becomes dizzy and has ringing in his ear. At 8 p.m., his mother takes him to the emergency room and explains that Matthew was knocked down during a football game. The ER physician, Dr. Ball, orders a CT Scan to determine if there is bleeding in Matthew's brain. Eagle Health Care, the managed care company that insures Matthew, refuses to authorize the CT Scan until Matthew has been observed for 6 hours. Dr. Ball admits Matthew for overnight observation by the hospitalist staff and orders a neurology consult for first thing in the morning. Before he leaves, he notices Matthew's alertness fading but suspects Matthew is simply tired so he does not note his observation in Matthew's medical record. Neither of Matthew's parents tells the physician or hospital staff that Matthew has had multiple prior concussions. Matthew develops severe headaches around 1:00 a.m. and tells the nurses on duty. The hospital is extremely busy so the nurses do not give him pain medication until 1:30 a.m. and they do not phone Dr. Ball or the hospitalist. At around 3:15 a.m., Matthew begins vomiting. The nurses believe the vomiting is a reaction to the pain medication and give him anti-vomiting medication, but they call the hospitalist, Dr. Smith, to check on him at 3:30. Dr. Smith is busy with another patient and he doesn't arrive until 4:00. He finds Matthew non responsive and orders a CT Scan immediately. The scan shows widespread swelling of Matthew's brain. A neurosurgeon performs emergency surgery several hours later to alleviate the pressure on Matthew's brain. Matthew survives the surgery but he does not open his eyes or respond to stimuli. Hospital physicians tell Matthew's parents that it is likely Matthew may stay in a temporary coma for 2 to 3 weeks. After 12 months, however, Matthew remains unconscious with only reflex responses to pain and the hospital physicians determine he is in a persistent vegetative state. Although patients in a persistent vegetative state after a traumatic brain injury can regain awareness, after 12 months it is extremely unlikely. Overcome with guilt, Matthew's father asks that his feeding/hydration tube be removed, while his exwife adamantly disagrees. Matthew's father has legal custody of Matthew as a result of the divorce. You are legal counsel for the hospital and you have been asked to assess the medical malpractice case Matthew's parents have filed against the hospital. Hospital administrators also want to know what they should do about removal of Matthew's feeding tube. What do you advise?