An Ethics of Welfare for Patients Diagnosed as Vegetative With Covert Awareness

Authors

Mackenzie Graham, Western University
Charles Weijer, Western University
Damian Cruse, Western University
Davinia Fernandez-Espejo, Western University
Teneille Gofton, Western University
Laura E. Gonzalez-Lara, Western University
Andrea Lazosky, London Health Sciences Centre
Lorina Naci, Western University
Loretta Norton, Western University
Andrew Peterson, Western UniversityFollow
Kathy N. Speechley, Western University
Bryan Young, Western University
Adrian M. Owen, Western University

Document Type

Article

Publication Date

1-1-2015

Journal

AJOB Neuroscience

First Page

31

Last Page

41

URL with Digital Object Identifier

10.1080/21507740.2015.1014072

Abstract

© 2015, Copyright © Taylor & Francis Group, LLC. Recent research suggests that a minority of patients diagnosed as vegetative using traditional behavioral assessments may be covertly aware. One of the most pressing concerns with respect to these patients is their welfare. This article examines foundational issues concerning the application of a theory of welfare to these patients, and develops a research agenda with patient welfare as a central focus. We argue that patients diagnosed as vegetative with covert awareness likely have sentient interests, and because sentient interests are sufficient for moral status, others have an obligation to take the welfare interests of these patients seriously. However, we do not view sentient interests as necessary for moral status, and thus it is possible that vegetative patients who lack such interests have moral status for other reasons. We propose four areas in which future research is needed to guide the ethical treatment of these patients: the assessment and management of pain; the development of quality of life assessments; end-of-life decision making; and enriching the day-to-day lives of these patients.