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Neuroethics

, Volume 9, Issue 1, pp 85–102 | Cite as

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
Review Paper

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.

Keywords

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

Notes

Acknowledgment

We wish to thank Prof. Agata Grosso for having revised the manuscript in the English language.

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Copyright information

© Springer Science+Business Media Dordrecht 2016

Authors and Affiliations

  • Rocco Salvatore Calabrò
    • 1
  • Antonino Naro
    • 1
  • Rosaria De Luca
    • 1
  • Margherita Russo
    • 1
  • Lory Caccamo
    • 2
  • Alfredo Manuli
    • 1
  • Bernardo Alagna
    • 1
  • Angelo Aliquò
    • 1
  • Placido Bramanti
    • 1
  1. 1.IRCCS Centro Neurolesi “Bonino-Pulejo”MessinaItaly
  2. 2.Department of PsychologyUniversity of PadovaPadovaItaly

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