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Current controversies and irresolvable disagreement: the case of Vincent Lambert and the role of ‘dissensus’
  1. Dominic Wilkinson1,2,3,
  2. Julian Savulescu1,3
  1. 1 Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
  2. 2 John Radcliffe Hospital, Oxford, UK
  3. 3 Murdoch Children’s Research Institute, Melbourne, Australia
  1. Correspondence to Professor Dominic Wilkinson, Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford OX1 1PT, UK; dominic.wilkinson{at}


Controversial cases in medical ethics are, by their very nature, divisive. There are disagreements that revolve around questions of fact or of value. Ethical debate may help in resolving those disagreements. However, sometimes in such cases, there are opposing reasonable views arising from deep-seated differences in ethical values. It is unclear that agreement and consensus will ever be possible. In this paper, we discuss the recent controversial case of Vincent Lambert, a French man, diagnosed with a vegetative state, for whom there were multiple court hearings over a number of years. Both family and health professionals were divided about whether artificial nutrition and hydration should be withdrawn and Lambert allowed to die. We apply a ‘dissensus’ approach to his case and argue that the ethical issue most in need of scrutiny (resource allocation) is different from the one that was the focus of attention.

  • clinical ethics
  • disability
  • resource allocation
  • prolongation of life and euthanasia
  • neuroethics

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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  • Contributors DW and JS conceived of the paper. DW wrote the first draft of this paper, edited it and approved the final draft. JS edited the paper and approved the final draft.

  • Funding DW and JS were supported for this work by grants from the Wellcome Trust WT106587/Z/14/Z, WT 104848/Z/14/Z, WT203132/Z/16/Z. JS was also supported by the Victorian Government’s Operational Infrastructure Support Program.

  • Competing interests None declared.

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

  • Patient consent for publication Not required.

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