Disorders of Consciousness

The Terri Schiavo case illustrates the heated controversy surrounding brain-damaged patients with disorders of consciousness. Some patients have suffered such severe brain damage that they have completely lost the capacity to be aware of themselves or their environment. This is known as the vegetative state. But patients with what is now known as the ‘minimally conscious state’ still possess at least rudimentary and intermittent awareness. These conditions raise difficult ethical questions. Is it in the interest of the patient to continue living in these conditions? Is it ever permissible to let such patients die rather than keep them alive at great cost? Or is life always sacred, and must never be ended, even if living is no longer a benefit to the patient? Can we be confident that awareness is really missing, and can we use neuroimaging to identify consciousness, or even communicate with seemingly non-conscious patients? If consciousness is present, but only in a rudimentary way, would this be a good thing, or rather make things worse, because only conscious patients can suffer?