Sense and Moral Sensibility in Vegetative States

摘要

Patients with covert awareness who present as being vegetative raise the question of moral status and clinical decisions about those who have suffered major brain injuries. When the idea of moral status is not divorced from prior metaphysical determinations but rather factored into a responsive equilibrium that is well informed about the human experience involved, a way ahead is easier to clarify. The experience involved in such cases is often not well analyzed from the point of functional neuroanatomy, and that task needs to be done before any moral analyses can be performed. In the proposed framework of analysis the metaphysical status emerges as a distillate of conceptual considerations about such a state and the elements of conscious experience involved. Among the interwoven subsets of cognitive functions that constitute consciousness, certain combinations of function underpin certain kinds of sense and sensibility about our dealings with the individual concerned. These forms of sensibility and responsivity dovetail with a wider set of moral judgments about human beings and their longitudinal form as sentient beings in the world among us, such that we arrive at a conception of treating "like as like and unlike as unlike" within a sustainable account of justice.