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Consciousness

How should we infer consciousness in unresponsive patients?

Farisco M, Pennartz C, Annen J, et al. · BMC medical ethics · 2022

Open access · cc by · source: Europe PMC

Consciousness as subjective experience can only be inferred third-personally; a list of operational indicators is used to guide recognition in hard cases, including disorders of consciousness.

Key findings

Assessing others’ consciousness is inferential: we rely on subjective reports or proxies. Activity in (named) systems has been found in some behaviourally unresponsive patients. Indicators are not the same as a metaphysical definition of consciousness.

Methodology

Starting from a recently introduced indicator list (also aimed at non-human and other challenging cases), the authors spell ethical implications for DoC care when imaging or behaviour under-determines awareness.

Limitations

This is neuroethics of criteria, not a new fMRI series. It does not settle every DoC treatment duty.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsEmpirical Bioethicsmethod

    One study used the method to derive care implications from evidence about consciousness in behaviourally unresponsive patients. Because consciousness can only be inferred third-personally from reports or proxies, and activity in named systems has been found in some such patients, the authors use an operational indicator list to guide recognition of awareness when imaging or behaviour under-determines it.

    Evidence for the claim as stated.

  • SupportsEmpirical Bioethicsmethod

    A recurring move is to separate a mechanism from what the mechanism is taken to justify. Snoek's three-part analysis keeps the BDMA's mechanisms while rejecting the leap to chronic disease; the consciousness paper stresses that indicators are not the same as a metaphysical definition; the Dubos study shows a similar pattern in history of science, where virulence turned out not to be a property of microbes alone once host physiology and environment were considered.

    Evidence for the claim as stated.

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