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Summary The vegetative state (VS) and coma are categorized as disorders of consciousness. Both are states of unconsciousness, in which patients are defined as being unaware; the VS is a state of wakeful unconsciousness, in which patients experience sleep/wake cycles, which distinguishes it from coma. It has long been suspected that the rate of misdiagnosis in the VS is as high as 40%. That is, ~40% of patients diagnosed as unconsciousness may in fact be conscious. Recent neuroscientific developments, particularly in functional neuroimaging, have identified patients who are functionally locked in, unable to respond behaviorally, but able to wilfully modulate their brain activity to indicate that they are conscious. This has resulted in an effort to rename the VS as Unresponsive Wakefulness Syndrome (UWS), both to more accurately describe the condition, and to remove the stigma and negative associations of the term "vegetative" (and the pejorative "vegetable").The key ethical issues with VS and Coma are the right to die and the value of life in a state of unconsciousness, along with ancillary questoins about precedent autonomy. Other ethical issues include the high rate of misdiagnosis, controversy concerning the concept of brain-based "behavior," and questions about quality of life and the best interests of unconscious persons.
Key works After years of clinical neglect and nihilism, a veritable explosion of research into disorders of consciousness in recent years has prompted considerable bioethical debate, as well as reconsideration of key concepts in consciousness studies. Capron provides an overview of the issues and debates here (Capron 1991). Shewmon interrogates the concept of the vegetative state (Shewmon 2004) here; Stins and Laureys (Stins & Laureys 2009); Monti et al (Monti et al 2010), and Owen et al (Owen et al 2007) discuss the ramifications of brain-based "behavior" and the detection of covert consciousness through functional imaging paradigms. Brukamp ( Brukamp 2012) considers whether a new right attaches to patients with disorders of consciousness, in light of recent neuroscientific evidence: a right to the right diagnosis. Panksepp considers the status of the "mind" in the VS (Panksepp et al 2007); and Levy&Savulescu evaluate the moral significance of phenomenal consciousness in ethical debates.
Introductions Knight 2008; Jox & Kuehlmeyer 2011; Jennett 2006; Goodman 2010; Illes & Sahakian 2011.
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  1. Nutrition and Hydration.I. Assure You That May - forthcoming - Hastings Center Report.
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  2. Medical AI, Inductive Risk, and the Communication of Uncertainty: The Case of Disorders of Consciousness.Jonathan Birch - forthcoming - Journal of Medical Ethics.
    Some patients, following brain injury, do not outwardly respond to spoken commands, yet show patterns of brain activity that indicate responsiveness. This is “cognitive-motor dissociation” (CMD). Recent research has used machine learning to diagnose CMD from electroencephalogram (EEG) recordings. These techniques have high false discovery rates, raising a serious problem of inductive risk. It is no solution to communicate the false discovery rates directly to the patient’s family, because this information may confuse, alarm and mislead. Instead, we need a procedure (...)
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  3. The French Vegetative State.M. H. Boucand & P. Ver Le Gall - forthcoming - Hastings Center Report.
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  4. Severe organic brain syndrome.Eduardo Bruera - forthcoming - Journal of Palliative Care.
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  5. Vegetative States in Children.Geoffrey Miller & Stephen Ashwal - forthcoming - Pediatric Bioethics.
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  6. Hydration and nutrition: Medical, legal, and ethical obligations.Mark Siegler - forthcoming - Scarce Medical Resources and Justice.
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  7. of Medical Nutrition and Hydration.Thomas A. Summon & Iames I. Walter - forthcoming - Bioethics: Basic Writings on the Key Ethical Questions That Surround the Major, Modern Biological Possibilities and Problems.
  8. Conscientious Objection to Aggressive Interventions for Patients in a Vegetative State.Jason Adam Wasserman, Abram L. Brummett, Mark Christopher Navin & Daniel Londyn Menkes - forthcoming - American Journal of Bioethics:1-12.
    Some physicians refuse to perform life-sustaining interventions, such as tracheostomy, on patients who are very likely to remain permanently unconscious. To explain their refusal, these clinicians often invoke the language of “futility”, but this can be inaccurate and can mask problematic forms of clinical power. This paper explores whether such refusals should instead be framed as conscientious objections. We contend that the refusal to provide interventions for patients very likely to remain permanently unconscious meets widely recognized ethical standards for the (...)
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  9. Coma and near-death experience: the beautiful, disturbing, and dangerous world of the unconscious.Alan Pearce - 2024 - Rochester, Vermont: Park Street Press. Edited by Beverley Pearce.
    Explores the extraordinary states of expanded consciousness that arise during comas, both positive and negative.
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  10. Thought experiments, sentience, and animalism.Margarida Hermida - 2023 - Synthese 202 (5):148.
    Animalism is prima facie the most plausible view about what we are; it aligns better with science and common sense, and is metaphysically more parsimonious. Thought experiments involving the brain, however, tend to elicit intuitions contrary to animalism. In this paper, I examine two classical thought experiments from the literature, brain transplant and cerebrum transplant, and a new one, cerebrum regeneration. I argue that they are theoretically possible, but that a scientifically informed account of what would actually happen shows that (...)
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  11. Memories without Survival: Personal Identity and the Ascending Reticular Activating System.Lukas J. Meier - 2023 - Journal of Medicine and Philosophy 48 (5):478-491.
    Lockean views of personal identity maintain that we are essentially persons who persist diachronically by virtue of being psychologically continuous with our former selves. In this article, I present a novel objection to this variant of psychological accounts, which is based on neurophysiological characteristics of the brain. While the mental states that constitute said psychological continuity reside in the cerebral hemispheres, so that for the former to persist only the upper brain must remain intact, being conscious additionally requires that a (...)
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  12. The Demise of Brain Death.Lukas J. Meier - 2022 - British Journal for the Philosophy of Science 73 (2):487-508.
    Fifty years have passed since brain death was first proposed as a criterion of death. Its advocates believe that with the destruction of the brain, integrated functioning ceases irreversibly, somatic unity dissolves, and the organism turns into a corpse. In this article, I put forward two objections against this assertion. First, I draw parallels between brain death and other pathological conditions and argue that whenever one regards the absence or the artificial replacement of a certain function in these pathological conditions (...)
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  13. Precautionary Personhood: We Should Treat Patients with Disorders of Consciousness as Persons.Matthew Braddock - 2021 - American Journal of Bioethics Neuroscience 12 (2-3):162-164.
    Should we allocate costly health care to patients diagnosed with disorders of consciousness (DoC), such as patients diagnosed as being in a vegetative state or minimally conscious state? Peterson, Aas, and Wasserman (2021) argue that we should in their paper “What justifies the allocation of health care resources to patients with disorders of consciousness?” Their key insight is that the expected benefits to this patient population helps to justify such allocations. However, their insight is attached to a consequentialist framework aimed (...)
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  14. Further Reflections: Surrogate Decisionmaking When Significant Mental Capacities are Retained.Jennifer Hawkins - 2021 - Cambridge Quarterly of Healthcare Ethics 30 (1):192-198.
    Mackenzie Graham has made an important contribution to the literature on decisionmaking for patients with disorders of consciousness. He argues, and I agree, that decisions for unresponsive patients who are known to retain some degree of covert awareness ought to focus on current interests, since such patients likely retain the kinds of mental capacities that in ordinary life command our current respect and attention. If he is right, then it is not appropriate to make decisions for such patients by appealing (...)
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  15. Prognostication of patients in coma after cardiac arrest: public perspectives.Mayli Mertens, Janine van Til, Eline Bouwers-Beens, Marianne Boenink, Jeannette Hofmeijer & Catherina Groothuis-Oudshoorn - 2021 - Resuscitation 169:4-10.
    Aim: To elicit preferences for prognostic information, attitudes towards withdrawal of life-sustaining treatment (WLST) and perspectives on acceptable quality of life after post-anoxic coma within the adult general population of Germany, Italy, the Netherlands and the United States of America. Methods: A web-based survey, consisting of questions on respondent characteristics, perspectives on quality of life, communication of prognostic information, and withdrawal of life-sustaining treatment, was taken by adult respondents recruited from four countries. Statistical analysis included descriptive analysis and chi2-tests for (...)
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  16. All things considered: Surrogate decision-making on behalf of patients in the minimally conscious state.L. Syd M. Johnson & Kathy L. Cerminara - 2020 - Clinical Ethics 15 (3):111-119.
    The minimally conscious state presents unique ethical, legal, and decision-making challenges because of the combination of diminished awareness, phenomenal experience, and diminished or absent comm...
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  17. Are the Irreversibly Comatose Still Here? The Destruction of Brains and the Persistence of Persons.Lukas J. Meier - 2020 - Journal of Medical Ethics 46 (2):99-103.
    When an individual is comatose while parts of her brain remain functional, the question arises as to whether any mental characteristics are still associated with this brain, that is, whether the person still exists. Settling this uncertainty requires that one becomes clear about two issues: the type of functional loss that is associated with the respective profile of brain damage and the persistence conditions of persons. Medical case studies can answer the former question, but they are not concerned with the (...)
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  18. Brain Death: What We Are and When We Die.Lukas J. Meier - 2020 - Dissertation, University of St. Andrews
    When does a human being cease to exist? For millennia, the answer to this question had remained largely unchanged: death had been diagnosed when heartbeat and breathing were permanently absent. Only comparatively recently, in the 1950s, rapid developments in intensive-care medicine called into question this widely accepted criterion. What had previously been deemed a permanent cessation of vital functions suddenly became reversible. -/- A new criterion of death was needed. It was suggested that the destruction of the brain could indicate (...)
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  19. Personhood and care in disorders of consciousness. An ontological, patient-centred perspective.Federico Zilio - 2020 - Medicina E Morale. Rivista Internazionale di Bioetica 69 (3):327-346.
    People in unresponsive wakefulness syndrome/vegetative state or minimally conscious state are characterized by the alteration – or the complete loss – of self-awareness and consciousness of the external environment. According to the functionalist and brain-centred approach, this kind of clinical situations also implies the loss of the moral status of person. This paper critically discusses this perspective and proposes an alternative paradigm of personhood concerning the disorders of consciousness (DOC). After a preliminary analysis, I will compare the function-based approach with (...)
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  20. Still Human: A Thomistic Analysis of ‘Persistent Vegetative State’.Stewart Clem - 2019 - Studies in Christian Ethics 32 (1):46-55.
    Would Aquinas hold the view that a patient in a persistent vegetative state (PVS) is something other than a human being? Some recent interpreters have argued for this position. I contend that this reading is grounded in a false symmetry between the three stages of Aquinas’s embryology and the (alleged) three-stage process of death. Instead, I show that there are textual grounds for rejecting the view that the absence of higher brain activity in a patient would lead Aquinas to say (...)
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  21. Placing Pure Experience of Eastern Tradition into the Neurophysiology of Western Tradition.Andrew And Alexander Fingelkurts - 2019 - Cognitive Neurodynamics 13 (1):121-123.
    While the presence or absence of consciousness plays the central role in the moral/ethical decisions when dealing with patients with disorders of consciousness (DOC), recently it is criticized as not adequate due to number of reasons, among which are the lack of the uniform definition of consciousness and consequently uncertainty of diagnostic criteria for it, as well as irrelevance of some forms of consciousness for determining a patient’s interests and wishes. In her article, Dr. Specker Sullivan reexamined the meaning of (...)
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  22. Actual physical potentiality for consciousness.Andrew And Alexander Fingelkurts - 2018 - American Journal of Bioethics Neuroscience 9 (1):24-25.
    Dr. Vukov analyzing patients with disorders of consciousness, proposed that medical well-regarded policy recommendations cannot be justified by looking solely to patients’ actual levels of consciousness (minimally conscious state – MCS versus vegetative state – VS), but that they can be justified by looking to patients’ potential for consciousness. One objective way to estimate this potential (actual physical possibility) is to consider a neurophysiologically informed strategy. Ideally such strategy would utilize objective brain activity markers of consciousness/unconsciousness. The Operational Architectonics (OA) (...)
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  23. 意識測量儀初登場.Timothy Joseph Lane - 2018 - Scientific American 193:38-42.
    意識是如此不可捉摸又抽象的概念,「測量」意識簡直就像科幻小說情節。科學家近年來在這方面已大有進展,藉由各項腦造影技術和實驗手法,能夠分析不同意識狀態下的大腦活動型態。.
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  24. When Does Consciousness Matter? Lessons from the Minimally Conscious State.Joseph Vukov - 2018 - American Journal of Bioethics Neuroscience 9 (1):5-15.
    Patients in a minimally conscious state (MCS) fall into a different diagnostic category than patients in the more familiar vegetative states (VS). Not only are MCS patients conscious in some sense, they have a higher chance for recovery than VS patients. Because of these differences, we ostensibly have reason to provide MCS patients with care that goes beyond what we provide to patients with some VS patients. But how to justify this differential treatment? I argue we can’t justify it solely (...)
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  25. Should We Treat Vegetative and Minimally Conscious Patients as Persons?Matthew Braddock - 2017 - Neuroethics 10 (2):267-280.
    How should we treat patients diagnosed as being in a persistent vegetative state (PVS) or minimally conscious state (MCS)? More specifically, should we treat them as having the full moral status of persons? Yes, or so we argue. First, we introduce the medical conditions of PVS, MCS, and the related conditions of Locked-in Syndrome and covert awareness. Second, we characterize the main argument for thinking diagnosed PVS patients are not persons. Third, we contend that this argument is defeated by mounting (...)
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  26. The Uncertainty of Consciousness and Why It Is important.Matthew Braddock - 2017 - American Journal of Bioethics Neuroscience 8 (3):155-157.
    How should we treat patients diagnosed with disorders of consciousness, such as patients diagnosed as minimally conscious or vegetative (yet who very well may be conscious)? Fischer and Truog (2017) argue that the consciousness and equal rights of these patients are relatively unimportant when deciding how we should treat them. That is, we should deemphasize their consciousness and equal rights and instead privilege the value judgments of the family/surrogate. We disagree. Drawing upon precautionary reasoning that we develop in Braddock (2017), (...)
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  27. Contemporary Controversies in Catholic Bioethics.Jason T. Eberl (ed.) - 2017 - Dordrecht, Netherlands: Springer.
    This volume comprises various viewpoints representing a Catholic perspective on contemporary practices in medicine and biomedical research. The Roman Catholic Church has had a significant impact upon the formulation and application of moral values and principles to a wide range of controversial issues in bioethics. Catholic leaders, theologians, and bioethicists have elucidated and marshaled arguments to support the Church’s definitive positions on several bioethical issues, such as abortion, euthanasia, and reproductive cloning. Not all bioethical issues, however, have been definitively addressed (...)
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  28. Longitudinal Dynamics of 3-Dimensional Components of Selfhood After Severe Traumatic Brain Injury: A qEEG Case Study.Andrew A. Fingelkurts & Alexander A. Fingelkurts - 2017 - Clinical EEG and Neuroscience (5):327-337.
    In this report, we describe the case of a patient who sustained extremely severe traumatic brain damage with diffuse axonal injury in a traffic accident and whose recovery was monitored during 6 years. Specifically, we were interested in the recovery dynamics of 3-dimensional components of selfhood (a 3-dimensional construct model for the complex experiential selfhood has been recently proposed based on the empirical findings on the functional-topographical specialization of 3 operational modules of brain functional network responsible for the self-consciousness processing) (...)
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  29. Unconscious Volition.Nada Gligorov - 2017 - American Journal of Bioethics Neuroscience 8 (3):151-152.
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  30. The Routledge Handbook of Neuroethics.L. Syd M. Johnson & Karen S. Rommelfanger (eds.) - 2017 - Routledge.
    _The Routledge Handbook of Neuroethics_ offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. The _Handbook_ features easy-to-follow chapters that appear here for the first time in print and—written by (...)
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  31. Consciousness, Intention, and Command-Following in the Vegetative State.Colin Klein - 2017 - British Journal for the Philosophy of Science 68 (1):27-54.
    Some vegetative state patients show fMRI responses similar to those of healthy controls when instructed to perform mental imagery tasks. Many authors have argued that this provides evidence that such patients are in fact conscious, as response to commands requires intentional agency. I argue for an alternative reading, on which responsive patients have a deficit similar to that seen in severe forms of akinetic mutism. Akinetic mutism is marked by the inability to form and maintain intentions to act. Responsive patients (...)
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  32. The morality of experience machines for palliative and end of life care.Dan Weijers - 2017 - In Mark Silcox (ed.), Experience Machines: The Philosophy of Virtual Worlds. Rowman & Littlefield. pp. 183-201.
    Experience machines, popularized in print by Robert Nozick and on the screen by the Wachowskis’ film The Matrix, provide highly or perfectly realistic experiences that are more pleasant and less painful than those generated in real life.1 The recent surge in virtual reality and neuro-prosthetic technologies is making the creation of real-world experience machines seem inevitable and perhaps imminent.2 Given the likelihood of the near-future availability of such machines, it behooves ethicists to consider the moral status of their potential uses. (...)
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  33. An Aristotelian Naturalist Perspective on Artificial Nutrition and Hydration.Paolo Biondi - 2016 - Diametros 50:138-151.
    This polemical note looks at the ethical issue of providing artificial nutrition and hydration to patients with advanced dementia from the perspective of an Aristotelian and naturalist ethics. I argue that this issue may be considered in terms of the Aristotelian notion of eudaimonia, well-being. I present a number of facts about the conditions of human life that contribute to eudaimonia. In addition, I present a number of facts about advanced dementia as well as clarify the goals of medicine. From (...)
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  34. Normal Brain Response to Propofol in Advance of Recovery from Unresponsive Wakefulness Syndrome.Stefanie Blain-Moraes, Rober Boshra, Heung Kan Ma, Richard Mah, Kyle Ruiter, Michael Avidan, John F. Connolly & George A. Mashour - 2016 - Frontiers in Human Neuroscience 10.
  35. The Future of Inductive Risk for Disorders of Consciousness.Parker Crutchfield - 2016 - American Journal of Bioethics Neuroscience 7 (1):56-57.
  36. Persistent Vegetative State, Akinetic Mutism and Consciousness.Will Davies & Neil Levy - 2016 - In Walter Sinnott-Armstrong (ed.), Finding Consciousness: The Neuroscience, Ethics, and Law of Severe Brain Damage. Oxford University Press. pp. 122-136.
  37. Response: Commentary: Cortical responses to salient nociceptive and not nociceptive stimuli in vegetative and minimal conscious state.Marina de Tommaso - 2016 - Frontiers in Human Neuroscience 10.
  38. Can self-relevant stimuli help assessing patients with disorders of consciousness?Renata del Giudice, Christine Blume, Malgorzata Wislowska, Julia Lechinger, Dominik P. J. Heib, Gerald Pichler, Johann Donis, Gabriele Michitsch, Maria-Teresa Gnjezda, Mauricio Chinchilla, Calixto Machado & Manuel Schabus - 2016 - Consciousness and Cognition 44:51-60.
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  39. The Chief Role of Frontal Operational Module of the Brain Default Mode Network in the Potential Recovery of Consciousness from the Vegetative State: A Preliminary Comparison of Three Case Reports.Andrew A. Fingelkurts, Alexander A. Fingelkurts, Sergio Bagnato, Cristina Boccagni & Giuseppe Galardi - 2016 - The Open Neuroimaging Journal 10:41-51.
    It has been argued that complex subjective sense of self is linked to the brain default-mode network (DMN). Recent discovery of heterogeneity between distinct subnets (or operational modules - OMs) of the DMN leads to a reconceptualization of its role for the experiential sense of self. Considering the recent proposition that the frontal DMN OM is responsible for the first-person perspective and the sense of agency, while the posterior DMN OMs are linked to the continuity of ‘I’ experience (including autobiographical (...)
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  40. Long-Term (Six Years) Clinical Outcome Discrimination of Patients in the Vegetative State Could be Achieved Based on the Operational Architectonics EEG Analysis: A Pilot Feasibility Study.Andrew A. Fingelkurts, Alexander A. Fingelkurts, Sergio Bagnato, Cristina Boccagni & Giuseppe Galardi - 2016 - The Open Neuroimaging Journal 10:69-79.
    Electroencephalogram (EEG) recordings are increasingly used to evaluate patients with disorders of consciousness (DOC) or assess their prognosis outcome in the short-term perspective. However, there is a lack of information concerning the effectiveness of EEG in classifying long-term (many years) outcome in chronic DOC patients. Here we tested whether EEG operational architectonics parameters (geared towards consciousness phenomenon detection rather than neurophysiological processes) could be useful for distinguishing a very long-term (6 years) clinical outcome of DOC patients whose EEGs were registered (...)
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  41. Intrinsic Brain Connectivity in Chronic Pain: A Resting-State fMRI Study in Patients with Rheumatoid Arthritis.Pär Flodin, Sofia Martinsen, Reem Altawil, Eva Waldheim, Jon Lampa, Eva Kosek & Peter Fransson - 2016 - Frontiers in Human Neuroscience 10.
  42. Assisted Nutrition and Hydration as Supportive Care during Illness.Barbara Golder, E. Wesley Ely, John Raphael, Ashley K. Fernandes & Annmarie Hosie - 2016 - The National Catholic Bioethics Quarterly 16 (3):435-448.
    Confusion surrounds Catholic teaching on the use of assisted nutrition and hydration, specifically the question of when, if ever, its refusal or removal is ethical. This paper focuses on two often-neglected considerations: the relationship between means and mechanism, and an assessment of proportionality of the mechanism from the patient’s perspective. The authors draw on two critical principles of Catholic moral teaching: only ordinary means are required, and proportionality is subject to the perspective of the patient, not just that of experts (...)
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  43. Polemical Note: Can it Be Unethical to Provide Nutrition and Hydration to Patients with Advanced Dementia?Rachel Haliburton - 2016 - Diametros 50:152-160.
    Patients suffering from advanced dementia present ethicists and caregivers with a difficult issue: we do not know how they feel or how they want to be treated, and they have no way of telling us. We do not know, therefore, whether we ought to prolong their lives by providing them with nutrition and hydration, or whether we should not provide them with food and water and let them die. Since providing food and water to patients is considered to be basic (...)
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  44. What’s Good for Them? Best Interests and Severe Disorders of Consciousness.Jennifer Hawkins - 2016 - In Walter Sinnott Armstrong (ed.), Finding Consciousness. Oxford, UK: pp. 180-206.
    I consider the current best interests of patients who were once thought to be either completely unaware (to be in PVS) or only minimally aware (MCS), but who, because of advanced fMRI studies, we now suspect have much more “going on” inside their minds, despite no ability to communicate with the world. My goal in this chapter is twofold: (1) to set out and defend a framework that I think should always guide thinking about the best interests of highly cognitively (...)
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  45. Inference and Inductive Risk in Disorders of Consciousness.L. Syd M. Johnson - 2016 - American Journal of Bioethics Neuroscience 7 (1):35-43.
    Several types of inferences are employed in the diagnosis and prognosis of patients with brain injuries and disorders of consciousness. These inferences introduce unavoidable uncertainty, and can be evaluated in light of inductive risk: the epistemic and nonepistemic risks of being wrong. This article considers several ethically significant inductive risks generated by and interacting with inferences about patients with disorders of consciousness, and argues for prescriptive measures to manage and mitigate inductive risk in the context of disorders of consciousness.
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  46. Court applications for withdrawal of artificial nutrition and hydration from patients in a permanent vegetative state: family experiences.Celia Kitzinger & Jenny Kitzinger - 2016 - Journal of Medical Ethics 42 (1):11-17.
  47. Perception of social support among family caregivers of vegetative patients: A qualitative study.Esmat Noohi, Hamid Peyrovi, Zahra Imani Goghary & Majid Kazemi - 2016 - Consciousness and Cognition 41:150-158.
  48. Neuroethics.Adina Roskies - 2016 - Stanford Encyclopedia of Philosophy.
  49. Intrinsic Functional Plasticity of the Thalamocortical System in Minimally Disabled Patients with Relapsing-Remitting Multiple Sclerosis.Fuqing Zhou, Honghan Gong, Qi Chen, Bo Wang, Yan Peng, Ying Zhuang & Chi-Shing Zee - 2016 - Frontiers in Human Neuroscience 10.
  50. Alla fine della vita: bioetica e medicina alla ricerca di un confine [At the end of life: bioethics and medicine looking for a boundary].Rosangela Barcaro - 2015 - Laboratorio dell’ISPF.
    Bioethics, neuroscience, medicine are contributing to a debate on the definition and criteria of death. This topic is very controversial, and it demonstrates clashing views on the meaning of human life and death. Official medical and legal positions agree upon a biological definition of death as irreversible cessation of integrated functioning of the organism as a whole, and whole-brain criterion to ascertain death. These positions have to face many criticisms: some scholars speak of logical and practical inconsistency, some others of (...)
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