An ethics of welfare for patients diagnosed as vegetative with covert awareness

Research output: Contribution to journalArticlepeer-review


  • Mackenzie Graham
  • Charles Weijer
  • Teneille Gofton
  • Laura E. Gonzalez-Lara
  • Andrea Lazosky
  • Lorina Naci
  • Loretta Norton
  • Andrew Peterson
  • Kathy N. Speechley
  • Bryan Young
  • Adrian M. Owen

Colleges, School and Institutes

External organisations

  • Western University
  • London Health Sciences Center


Recent research suggests that a minority of patients diagnosed as vegetative using traditional behavioral assessments may be covertly aware. One of the most pressing concerns with respect to these patients is their welfare. This article examines foundational issues concerning the application of a theory of welfare to these patients, and develops a research agenda with patient welfare as a central focus. We argue that patients diagnosed as vegetative with covert awareness likely have sentient interests, and because sentient interests are sufficient for moral status, others have an obligation to take the welfare interests of these patients seriously. However, we do not view sentient interests as necessary for moral status, and thus it is possible that vegetative patients who lack such interests have moral status for other reasons. We propose four areas in which future research is needed to guide the ethical treatment of these patients: the assessment and management of pain; the development of quality of life assessments; end-of-life decision making; and enriching the day-to-day lives of these patients.


Original languageEnglish
Pages (from-to)31-41
Number of pages11
JournalAJOB Neuroscience
Issue number2
Publication statusPublished - 1 Jun 2015


  • consciousness, fMRI, sentience, vegetative state, welfare

ASJC Scopus subject areas