Residual Cognitive Capacities in Patients With Cognitive Motor Dissociation, and Their Implications for Well-Being

Journal of Medicine and Philosophy 46 (6):729-757 (2021)
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Abstract

Patients with severe disorders of consciousness are thought to be unaware of themselves or their environment. However, research suggests that a minority of patients diagnosed as having a disorder of consciousness remain aware. These patients, designated as having “cognitive motor dissociation”, can demonstrate awareness by imagining specific tasks, which generates brain activity detectable via functional neuroimaging. The discovery of consciousness in these patients raises difficult questions about their well-being, and it has been argued that it would be better for these patients if they were allowed to die. Conversely, I argue that CMD patients may have a much higher level of well-being than is generally acknowledged. It is far from clear that their lives are not worth living, because there are still significant gaps in our understanding of how these patients experience the world. I attempt to fill these gaps, by analyzing the neuroscientific research that has taken place with these patients to date. Having generated as comprehensive a picture as possible of the capacities of CMD patients, I examine this picture through the lens of traditional philosophical theories of well-being. I conclude that the presumption that CMD patients do not have lives worth living is not adequately supported.

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Mackenzie Graham
University of Oxford

Citations of this work

Well-Being and Health.Richard Kim & Daniel M. Haybron - 2021 - Journal of Medicine and Philosophy 46 (6):645-655.

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Reasons and Persons.Derek Parfit - 1984 - Oxford, GB: Oxford University Press.
Sour grapes: studies in the subversion of rationality.Jon Elster - 1983 - Paris: Editions de la Maison des sciences de l'homme.
Achievement.Gwen Bradford - 2015 - Oxford, GB: Oxford University Press.

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