Article Text
Abstract
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 It is sometimes assumed that if there is evidence of consciousness, treatment should not be withdrawn.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.
Statistics from Altmetric.com
Footnotes
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.
Other content recommended for you
- Ethical issues in diagnosis and management of patients in the permanent vegetative state
- A matter of life and death: controversy at the interface between clinical and legal decision-making in prolonged disorders of consciousness
- The vegetative state
- Withdrawing life-sustaining treatment: a stock-take of the legal and ethical position
- How family caregivers' medical and moral assumptions influence decision making for patients in the vegetative state: a qualitative interview study
- Prevalence and characteristics of patients in a vegetative state in Dutch nursing homes
- Withdrawing clinically assisted nutrition and hydration (CANH) in patients with prolonged disorders of consciousness: is there still a role for the courts?
- Preserved consciousness in vegetative and minimal conscious states: systematic review and meta-analysis
- Back to the bedside? Making clinical decisions in patients with prolonged unconsciousness
- Thalamic proton magnetic resonance spectroscopy in vegetative state induced by traumatic brain injury