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The right to die in the minimally conscious state
  1. L Syd M Johnson
  1. Correspondence to Dr L Syd M Johnson, Dalhousie University, 1234 LeMarchant Street, Halifax, NS B3H3P7 Canada; syd.johnson{at}


The right to die has for decades been recognised for persons in a vegetative state, but there remains controversy about ending life-sustaining medical treatment for persons in the minimally conscious state (MCS). The controversy is rooted in assumptions about the moral significance of consciousness, and the value of life for patients who are conscious and not terminally ill. This paper evaluates these assumptions in light of evidence that generates concerns about quality of life in the MCS. It is argued that surrogates should be permitted to make decisions to withdraw life-sustaining medical treatment from patients in the MCS.

  • Consciousness disorders
  • general
  • living wills/advance directives
  • minimally conscious state
  • right to die
  • vegetative state

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  • Funding Research funded by Canadian Institutes of Health Research, MOP 77670, therapeutic hopes and ethical concerns: clinical research in the neurosciences and NNF 80045, states of mind: emerging issues in neuroethics.

  • Competing interests None declared.

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

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