Recent research from electroencephalography (EEG) and functional magnetic resonance (fMRI) studies appears to indicate that some patients diagnosed in a vegetative state may have some level of awareness and should instead be understood to be in a minimally conscious state (MCS). These results further suggest that, with the help of neuroimaging, at least once the technology has been developed further, we may be able to communicate with some MCS patients. This article addresses ethical implications of the possibility of communication with minimally conscious patients. First, I discuss these patients’ level of awareness and communicative capacities discovered by recent neuroscientific findings. I then consider whether we are capable of formulating the right questions to communicate with an MCS patient, whether we are capable of understanding the patient’s response, and whether it is necessary to obtain informed consent or assent from an MCS patient regarding future treatment.
Open Peer Commentaries.
- A Principled Argument, But Not a Practical One
- Dissenting on the Matter of Assent
- Distinguishing Minimal Consciousness From Decisional Capacity: Clinical, Ethical, and Legal Implications
- Never Say Never: Limitations of Neuroimaging for Communicating Decisions After Brain Injury
- Fragments of Selves and The Importance of Emotionality: Ethicolegal Challenges in Assessing Capacities, Consent, and Communicating with MCS Patients and the Need for Guidelines
- Minimally Conscious Assumptions and Dangerous Decision-Making Inferences