The 1994 Multi-Society Task Force consensus statement on the Persistent Vegetative State: a critical analysis.

摘要: The Multi-Society Task Force (MSTF) on Persistent Vegetative State (PVS) recently released a landmark two-part consensus statement entitled "Medical Aspects of the State," which, in 1994, was published New England Journal Medicine.(1) This approved by governing bodies several medical societies, including American Academy Neurology, Neurological Association, Association Surgeons, and Child Neurology Society. Those who contributed to drafting this important document included, among others, an impressive group neurologists, pediatricians, neurosurgeons, whom have been forefront discussions contemporary ethics literature concerning metaphysical moral status PVS patients.(2) In spite their credentials, though, many influential contributions philosophical neurological condition, present collective effort makes me quite uneasy. primary source unease can be traced MSTF's conceptually misshapen defense thesis that all patients are unconscious. is defective at least two ways. First, MSTF fails convincingly motivate conceptual propriety utilizing particular characterization (un)consciousness it has, fact, chosen employ domain. I shall argue, commits itself conception incoherent. Second, argue even if were adopt coherent plausible consciousness (and cognition more generally construed), has thus far given us no good reason think lack so construed. further careful, rigorous analysis context discussion promises yield those tools necessary for precisely delineating boundary between locked-in state, as well properly situating akinetic mutism other intermediate disorders cognitive continuum spans chasm paradigmatic states which occupy polar positions continuum. perceived dispensability patients, portrayed recent essays literature,(3) typically predicated allegedly well-grounded conjecture cognitively quiescent. widespread acceptance claim conjunction with (to my mind, mistaken) view live human being is, essentially, member specific biological kind instantiates certain specific, functionally intact, highly complex neuroarchitectural structures, tempted thinkers deny persons toward charity directed or, extreme cases, beings all.(4) process dehumanization profound, deeply troubling ethical implications-implications regarding best neutral worst complicit. What Are Medical Facts? views simply summarizing "the facts about persistent vegetative state," insisting "it does not address associated ethical, legal, or issues."(5) disclaimer misleading. alleged "medical facts" claims really pieces complex, contentious, subtle philosophy. One cannot help but engaging activity when dealing reflectively such matters consciousness, evidence, purposiveness, awareness, irreversibility, self. begins its pointing out "[t]he term `persistent state' coined [Bryan] Jennett [Fred] Plum 1972 describe condition severe brain damage coma progressed state wakefulness without detectable awareness. …