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 It is sometimes assumed that if there is evidence of consciousness, treatment should not be withdrawn.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.
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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.
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