J Med Ethics 35:508-511 doi:10.1136/jme.2008.029165
  • Law, ethics and medicine
    • Paper

Functional neuroimaging and withdrawal of life-sustaining treatment from vegetative patients

Open Access
  1. D J Wilkinson1,2,
  2. G Kahane1,3,
  3. M Horne4,
  4. J Savulescu1,3
  1. 1
    Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
  2. 2
    The Ethox Centre, University of Oxford, Oxford, UK
  3. 3
    The Oxford Centre for Neuroethics, University of Oxford, Oxford, UK
  4. 4
    Neural Injury and Repair Group, Howard Florey Institute and the Centre for Neuroscience, The University of Melbourne, Melbourne, Australia
  1. Professor J Savulescu, Oxford Uehiro Centre for Practical Ethics, University of Oxford, Littlegate House, St Ebbes Street, Oxford OX1 1PT, UK; julian.savulescu{at}
  • Received 29 December 2008
  • Revised 30 April 2009
  • Accepted 27 May 2009


Recent studies using functional magnetic resonance imaging of patients in a vegetative state have raised the possibility that such patients retain some degree of consciousness. In this paper, the ethical implications of such findings are outlined, in particular in relation to decisions about withdrawing life-sustaining treatment. It is sometimes assumed that if there is evidence of consciousness, treatment should not be withdrawn. But, paradoxically, the discovery of consciousness in very severely brain-damaged patients may provide more reason to let them die. Although functional neuroimaging is likely to play an increasing role in the assessment of patients in a vegetative state, caution is needed in the interpretation of neuroimaging findings.


  • Funding: This work is supported by the Wellcome Trust (086041/2/08/2). DJW is supported by an Oxford Nuffield Medical Fellowship, Eric Burnard Fellowship and Royal Australasian College of Physicians Astra-Zeneca Medical Fellowship. The funders had no involvement in this work.

  • Competing interests: None.

  • Provenance and peer review: Not commissioned; externally peer reviewed.