Biomaterial Database

What difference does consciousness make? 2009

Neil Levy

Oxford Centre for Neuroethics, Oxford University.

The question whether and when it is morally appropriate to withdraw life-support from patients diagnosed as being in the persistent vegetative state is one of the most controversial in bioethics. Recent work on the neuroscience of consciousness seems to promise fundamentally to alter the debate, by demonstrating that some entirely unresponsive patients are in fact conscious. In this paper, I argue that though this work is extremely important scientifically, it ought to alter the debate over the moral status of the patients very little. First, the data presented is complex and difficult to interpret; we should be wary of taking the claimed discovery entirely at face value (though the remaining questions will probably be settled by future research). Second, though the demonstration that some of the patients are in fact conscious would show that they are moral patients, and therefore beings whose welfare must be taken into account, it would not, by itself at any rate, show that they have an interest in continued life.

UI	MeSH Term	Description	Entries
D011782	Quadriplegia	Severe or complete loss of motor function in all four limbs which may result from BRAIN DISEASES; SPINAL CORD DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; or rarely MUSCULAR DISEASES. The locked-in syndrome is characterized by quadriplegia in combination with cranial muscle paralysis. Consciousness is spared and the only retained voluntary motor activity may be limited eye movements. This condition is usually caused by a lesion in the upper BRAIN STEM which injures the descending cortico-spinal and cortico-bulbar tracts.	Quadriparesis,Spastic Quadriplegia,Tetraplegia,Flaccid Quadriplegia,Flaccid Tetraplegia,Paralysis, Spinal, Quadriplegic,Spastic Tetraplegia,Flaccid Quadriplegias,Flaccid Tetraplegias,Quadripareses,Quadriplegia, Flaccid,Quadriplegia, Spastic,Quadriplegias,Quadriplegias, Flaccid,Quadriplegias, Spastic,Spastic Quadriplegias,Spastic Tetraplegias,Tetraplegia, Flaccid,Tetraplegia, Spastic,Tetraplegias,Tetraplegias, Flaccid,Tetraplegias, Spastic
D001931	Brain Mapping	Imaging techniques used to colocalize sites of brain functions or physiological activity with brain structures.	Brain Electrical Activity Mapping,Functional Cerebral Localization,Topographic Brain Mapping,Brain Mapping, Topographic,Functional Cerebral Localizations,Mapping, Brain,Mapping, Topographic Brain
D003243	Consciousness	Sense of awareness of self and of the environment.	Consciousnesses
D003657	Decision Making	The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.	Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D005066	Euthanasia, Passive	Failing to prevent death from natural causes, for reasons of mercy by the withdrawal or withholding of life-prolonging treatment.	Allowing to Die,Euthanasia, Negative,Negative Euthanasia,Passive Euthanasia
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001315	Australia	The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.	Canton and Enderbury Islands,Christmas Island,Christmas Island (Australia)
D018458	Persistent Vegetative State	Vegetative state refers to the neurocognitive status of individuals with severe brain damage, in whom physiologic functions (sleep-wake cycles, autonomic control, and breathing) persist, but awareness (including all cognitive function and emotion) is abolished.	Minimally Conscious State,Permanent Vegetative State,Post-Traumatic Vegetative State,Vegetative State, Persistent,PVS (Persistent Vegetative State),Persistent Unawareness State,Post-Comatose Unawareness State,Post-Traumatic Unawareness State,Postcomatose Unawareness State,Posttraumatic Unawareness State,Prolonged Post-Traumatic Unawareness,Transient Vegetative State,Vegetative State,Minimally Conscious States,PVSs (Persistent Vegetative State),Permanent Vegetative States,Persistent Unawareness States,Persistent Vegetative States,Post Comatose Unawareness State,Post Traumatic Unawareness State,Post Traumatic Vegetative State,Post-Comatose Unawareness States,Post-Traumatic Unawareness States,Post-Traumatic Unawareness, Prolonged,Post-Traumatic Unawarenesses, Prolonged,Post-Traumatic Vegetative States,Postcomatose Unawareness States,Posttraumatic Unawareness States,Prolonged Post Traumatic Unawareness,Prolonged Post-Traumatic Unawarenesses,State, Minimally Conscious,State, Permanent Vegetative,State, Persistent Unawareness,State, Persistent Vegetative,State, Post-Comatose Unawareness,State, Post-Traumatic Unawareness,State, Post-Traumatic Vegetative,State, Postcomatose Unawareness,State, Posttraumatic Unawareness,State, Transient Vegetative,State, Vegetative,States, Minimally Conscious,States, Permanent Vegetative,States, Persistent Unawareness,States, Persistent Vegetative,States, Post-Comatose Unawareness,States, Post-Traumatic Unawareness,States, Post-Traumatic Vegetative,States, Postcomatose Unawareness,States, Posttraumatic Unawareness,States, Transient Vegetative,States, Vegetative,Transient Vegetative States,Unawareness State, Persistent,Unawareness State, Post-Comatose,Unawareness State, Post-Traumatic,Unawareness State, Postcomatose,Unawareness State, Posttraumatic,Unawareness States, Persistent,Unawareness States, Post-Comatose,Unawareness States, Post-Traumatic,Unawareness States, Postcomatose,Unawareness States, Posttraumatic,Unawareness, Prolonged Post-Traumatic,Unawarenesses, Prolonged Post-Traumatic,Vegetative State, Permanent,Vegetative State, Post-Traumatic,Vegetative State, Transient,Vegetative States,Vegetative States, Permanent,Vegetative States, Persistent,Vegetative States, Post-Traumatic,Vegetative States, Transient
D026712	Value of Life	The intrinsic moral worth ascribed to a living being. (Bioethics Thesaurus)	Economic Value of Life,Life Valuation, Economic,Economic Life Valuation,Economic Value, Life,Economic Values, Life,Life Economic Value,Life Economic Values,Respect for Life,Right to Life,Sanctity of Life,Valuation, Economic Life,Economic Life Valuations,Life Sanctities,Life Sanctity,Life Valuations, Economic,Life, Respect for,Life, Right to,Valuations, Economic Life
D028723	Personhood	The state or condition of being a human individual accorded moral and/or legal rights. Criteria to be used to determine this status are subject to debate, and range from the requirement of simply being a human organism to such requirements as that the individual be self-aware and capable of rational thought and moral agency.