End-Of-Life Decisions in Chronic Disorders of Consciousness: Sacrality and Dignity as Factors

Rocco Salvatore Calabrò, Antonino Naro, Rosaria De Luca, Margherita Russo, Lory Caccamo, Alfredo Manuli, Bernardo Alagna, Angelo Aliquò, Placido Bramanti

Research output: Contribution to journalArticlepeer-review

Abstract

The management of patients suffering from chronic disorders of consciousness (DOC) inevitably raises important ethical questions about the end of life decisions. Some ethical positions claim respect of human life sacredness and the use of good medical practices require allowing DOC patients to live as long as possible, since no one can arbitrarily end either his/her or others’ life. On the other hand, some currents of thought claim respect of human life dignity, patients’ wishes, and the right of free choice entail allowing the withdrawal of life sustaining therapy. This could happen when patients (or surrogates) believe their own life to be not worth living, or if therapy is not very beneficial, excessively burdensome, or even futile. Indeed, the decision to withdraw therapies in a DOC patient should be guided by reliable information about DOC diagnosis and prognosis and on how the patient would wish to be treated in such a condition. Taking into account such issues, it would be possible to make the decision that more adequately fits a DOC patient’s best interest. This review aims to overview the range of ethical issues referring to end-of-life decisions in DOC patients, with regard to the thorny debate on the sacredness and dignity of human life.

Original languageEnglish
Pages (from-to)85-102
Number of pages18
JournalNeuroethics
Volume9
Issue number1
DOIs
Publication statusPublished - Apr 1 2016

Keywords

  • Artificial nutrition and hydration
  • Dignity of life
  • Minimally conscious state
  • Right to die
  • Sacredness of life
  • Vegetative state

ASJC Scopus subject areas

  • Health Policy
  • Neurology
  • Psychiatry and Mental health

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