Original Paper


, Volume 6, Issue 1, pp 13-23

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Knowledge of Partial Awareness in Disorders of Consciousness: Implications for Ethical Evaluations?

  • Orsolya FriedrichAffiliated withInstitute of Ethics, History and Theory of Medicine, LMU MunichInstitute of Neuroscience and Medicine, Ethics in the Neurosciences (INM-8), Jülich Forschungszentrum Email author 


Recent results from neuroimaging appear to indicate that some patients in a vegetative state have partially intact awareness. These results may demonstrate misdiagnosis and suggest the need not only for alternative forms of treatment, but also for the reconsideration of end-of-life decisions in cases of disorders of consciousness. This article addresses the second consequence. First, I will discuss which aspects of consciousness may be involved in neuroimaging findings. I will then consider various factors relevant to ethical end-of-life decision-making, and analyse whether and to what extent the above consequence applies to these factors. It will be shown that knowledge of the existence of partial awareness in patients with disorders of consciousness only influences end-of-life decision-making if certain background assumptions are made.


Disorders of consciousness Awareness End-of-life decisions Neuroimaging