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The Value of Consciousness in Medicine

Diane O’ Leary

Oxford Studies in Philosophy of Mind Volume 1 March 18, 2021 DOI: 10.1093/oso/9780198845850.003.0003 (opens in new tab)

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Characteristics Theoretical or philosophical paper Peer reviewed
Key points Argues that medicine's conceptual and ethical foundations should be grounded in recognition of phenomenal consciousness rather than personhood alone, using patients in vegetative state as the key case. Proposes that under holism, recognizing conscious states secures medicine's moral value, and that respect for autonomy should be understood as respect for an experiencer's dominion over their bodily experience, so patients command full respect even without decision-making capacity.

Abstract

Abstract: generally accept that medicine’s conceptual and ethical foundations are grounded in recognition of personhood. With patients in vegetative state, however, we’ve understood that the ethical implications of phenomenal consciousness are distinct from those of personhood. This suggests a need to reconsider medicine’s foundations. What is the role for recognition of consciousness (rather than personhood) in grounding the moral value of medicine and the specific demands of clinical ethics? I suggest that, according to holism, the moral value of medicine is secured when conscious states are recognized in everyday medical science. Moreover, consciousness fully motivates traditional principles of clinical ethics if we understand respect for autonomy as respect for the dominion of an experiencer in the private, inescapable realm of bodily experience. When medicine’s foundations are grounded in recognition of consciousness, we understand how patients fully command respect even when they lack capacity to exercise their bodily dominion through decision-making.

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