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Do New Neuroimaging Findings Challenge the Ethical Basis of Advance Directives in Disorders of Consciousness?

Published online by Cambridge University Press:  10 September 2018

ORSOLYA FRIEDRICH ,
ANDREAS WOLKENSTEIN ,
RALF J. JOX ,
NIEK ROGGER  and
CLAUDIA BOZZARO
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Abstract:

Some authors have questioned the moral authority of advance directives (ADs) in cases in which it is not clear if the author of the AD is identical to the person to whom it later applies. This article focuses on the question of whether the latest results of neuroimaging studies have moral significance with regard to the moral authority of ADs in patients with disorders of consciousness (DOCs). Some neuroimaging findings could provide novel insights into the question of whether patients with DOCs exhibit sufficient psychological continuity to be ascribed diachronic personal identity. If those studies were to indicate that psychological continuity is present, they could justify the moral authority of ADs in patients with DOCs. This holds at least if respect for self-determination is considered as the foundation for the moral authority of ADs. The non-identity thesis in DOCs could no longer be applied, in line with clinical and social practice.

Keywords

disorders of consciousnessadvance directivespersonal identitypsychological continuityneuroimaging
Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 27 , Special Issue 4: Clinical Neuroethics , October 2018 , pp. 675 - 685
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

We thank Mary Clare O’Donnell for editing the manuscript.

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Notes

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