Oxford University Press eBooks,
Journal Year:
2024,
Volume and Issue:
unknown, P. 173 - 191
Published: July 22, 2024
Abstract
Sometimes
a
person,
after
brain
injury,
displays
sleep-wake
cycles
but
has
severely
impaired,
or
entirely
absent,
responses
to
external
stimuli.
Traditionally,
attempts
have
been
made
distinguish
the
persistent
vegetative
state
(PVS)
from
minimally
conscious
(MCS).
However,
diagnostic
procedures
are
subject
high
error
rates
and
uncertainty.
There
is
also
realistic
possibility
that
midbrain
mechanisms
suffice
for
basic
valenced
experiences
even
if
cortical
injury
fully
prevents
patient
reporting
these
experiences.
Decisions
withdraw
treatment
should
be
based
on
comprehensive
best-interests
assessment,
not
PVS/MCS
distinction.
The
method
of
withdrawing
clinically
assisted
nutrition
hydration
(CANH)
would
acceptable
any
other
sentient
being,
alternatives
must
explored
discussed
by
inclusive,
democratic
processes.
In
cases
where
CANH
withdrawal
authorized,
clinicians
guaranteed
hastening
death
using
large
doses
sedatives
analgesics
will
lead
punishment.
Oxford University Press eBooks,
Journal Year:
2024,
Volume and Issue:
unknown, P. 216 - 230
Published: July 22, 2024
Abstract
Human
neural
organoids
are
showing
great
promise
as
models
of
the
human
brain.
It
would
be
hasty
to
dismiss
possibility
they
could
develop
sentience.
However,
scepticism
about
this
idea
is
appropriate
when
considering
current
(at
time
writing).
This
not
because
their
size,
but
organization:
lack
a
functioning
brainstem
or
anything
equivalent
one.
There
nonetheless
troubling
early
warning
signs
suggesting
that
organoid
research
may
create
forms
sentient
being
in
future.
Researchers
with
very
different
views
basis
sentience
can
unite
behind
‘brainstem
rule’:
if
develops
innervates
registers
and
prioritizes
its
needs,
regulates
arousal,
leads
sleep-wake
cycles,
then
it
candidate.
Artificial
substitutes
also
enough.
If
creation
candidates,
moratorium
(time-limited
ban)
indefinite
ban
on
particular
type
appropriate.
An
alternative
approach,
consistent
existing
approaches
animal
research,
require
ethical
review
harm-benefit
analysis
whenever
Oxford University Press eBooks,
Journal Year:
2024,
Volume and Issue:
unknown, P. 113 - 137
Published: July 22, 2024
Abstract
This
chapter
looks
for
points
of
consensus
across
the
zone
reasonable
disagreement.
To
do
this,
it
introduces
two
bridging
concepts:
sentience
candidates
and
investigation
priorities.
Crucially,
relatively
inclusive
theories
Panksepp,
Damasio,
Merker,
which
link
to
evolutionarily
ancient
mechanisms
in
midbrain,
describe
realistic
possibilities,
so
a
system
with
these
is
candidate.
When
evidence
falls
short
showing
that
candidate,
but
there
are
still
welfare
risks
may
call
precautionary
response,
should
be
classed
as
an
priority.
There
ethical
around
duty
avoid
causing
gratuitous
suffering
sentient
beings.
Suffering
not
if
occurs
course
defensible
activity.
activity
indefensible
or
precautions
taken
fall
what
proportionate.
These
ideas
lead
principle
proportionate
whenever
being
Oxford University Press eBooks,
Journal Year:
2024,
Volume and Issue:
unknown, P. 173 - 191
Published: July 22, 2024
Abstract
Sometimes
a
person,
after
brain
injury,
displays
sleep-wake
cycles
but
has
severely
impaired,
or
entirely
absent,
responses
to
external
stimuli.
Traditionally,
attempts
have
been
made
distinguish
the
persistent
vegetative
state
(PVS)
from
minimally
conscious
(MCS).
However,
diagnostic
procedures
are
subject
high
error
rates
and
uncertainty.
There
is
also
realistic
possibility
that
midbrain
mechanisms
suffice
for
basic
valenced
experiences
even
if
cortical
injury
fully
prevents
patient
reporting
these
experiences.
Decisions
withdraw
treatment
should
be
based
on
comprehensive
best-interests
assessment,
not
PVS/MCS
distinction.
The
method
of
withdrawing
clinically
assisted
nutrition
hydration
(CANH)
would
acceptable
any
other
sentient
being,
alternatives
must
explored
discussed
by
inclusive,
democratic
processes.
In
cases
where
CANH
withdrawal
authorized,
clinicians
guaranteed
hastening
death
using
large
doses
sedatives
analgesics
will
lead
punishment.
