Precautionary Personhood: We Should Treat Patients With Disorders of Consciousness As Persons

Abstract

Allocating scarce healthcare resources to patients with disorders of consciousness solely on consequentialist, welfare-maximizing grounds presents severe moral hazards. Remaining agnostic about the moral status of these patients risks violating their fundamental rights, notably the right to life-sustaining aid and fair distribution of medical resources. High rates of clinical misdiagnosis demonstrate that substantial numbers of individuals diagnosed as being in a vegetative state retain covert consciousness, cognitive capacities sufficient for personhood, and the potential for meaningful recovery. Furthermore, widespread disability bias and ableist attitudes systematically distort external evaluations, leading observers to underestimate both the subjective well-being and the desire to live among severely brain-injured individuals. Because allowing an individual to die who wishes to live is morally graver than sustaining one who does not, ethical allocation policies must not ignore personhood. Rather than relying exclusively on social utility or cost-effectiveness, allocation models must integrate a precautionary presumption of personhood, recognizing patients with disorders of consciousness as rights-bearing persons while balancing prospective benefits and resource utility under diagnostic uncertainty. – AI-generated abstract.