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Differences That Make a Difference in Disorders of Consciousness
Joseph J. Fins & Nicholas D. Schiff

We are grateful to Fischer and Truog for their thoughtful commentary on our work on the minimally conscious state (MCS), disorders of consciousness, and the rights owed to this patient population. They have provided a serious and scholarly critique, and we are grateful for this opportunity to respond. Our reply can be framed around two ironies embedded in their title: “the problem with fixating...

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Cogitas Ergo Es? Metaphysical Humility in Disorders of Consciousness
Douglas C. McAdams, W. Kevin Conley II & G. Kevin Donovan

Fischer and Truog make a valuable contribution to clinical ethics and practice by highlighting the inherent problem of giving ethical import to uncertain determinations of consciousness. Rather than making clinical care more complex, we argue that their proposal to base decisions on observable features and patient values observes a proper human ontology and metaphysical humility that can only bene...

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Target Article

The Problems With Fixating on Consciousness in Disorders of Consciousness
David Fischer & Robert D. Truog

Distinguishing between disorders of consciousness, particularly between the vegetative state/unresponsive wakefulness syndrome (VS/UWS) and the minimally conscious state (MCS), has been a growing concern. As VS/UWS patients are considered unconscious and MCS patients are considered conscious, this distinction has had profound medical, social, legal, and ethical implications. However, we argue that...

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Is That the Same Person? Case Studies in Neurosurgery
Nancy S. Jecker & Andrew L. Ko

Do neurosurgical procedures ever result in the patient prior to the procedure not being identical with the individual who wakes up postsurgery in the hospital bed? We address this question by offering an analysis of the persistence of persons that emphasizes narrative, rather than numerical, identity. We argue that a narrative analysis carries the advantage of highlighting what matters to patients...

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