Directors: Antonio M. Battro, Kurt W. Fischer and Fernando Vidal
Program officer: María Lourdes Majdalani
Person, death and decision-making: the case of permanent vegetative state
Decision-making related to healthcare and end of life issues remains a hotly debated question in bioethics. Dominant positions, particularly in the Anglo-American context, postulate the patient’s autonomy as a key element in resolving conflictive medical situations. They thereby depict the person chiefly as an autonomous subject, as a patient who is essentially defined by the ability of self-determination. Regardless of whether this characterization is correct or not, an additional concern in recent years has been how to decide when an adult person is no longer able to make autonomous choices. This presentation explores an extreme case of such a situation, that of patients in Permanent Vegetative State (PVS). Starting from this difficult and particular pathology, it is proposed to examine the link between criteria for determining death (whole brain, higher brain and cardiopulmonary criteria) and different approaches to the concept of “person“. The questions are when a «person» should be considered dead, and whether patients in PVS are to be considered «persons». Based on a critical study of some current proposals on the notion of «person», it is analyzed whether the criteria for determining death should be consistent with it, and the extent to which such arguments affect decisions in PVS cases.