Can People with Severe Disorders of Consciousness Be Wronged?

Many bioethicists accept the Consciousness Condition (CC): roughly, that a person can be wronged only if she can be benefited or harmed, which is possible only if she retains the capacity for consciousness. We argue that CC is false. People can be wronged even if they permanently lack consciousness and thus have no ability to experience benefit or harm. In support of this claim, we introduce a clinical case in which a profoundly vegetative patient is subjected to unauthorized pelvic examinations for the benefit of medical trainees, then show that the truth of CC falsely implies the patient is not thereby wronged. We also offer a different explanation of the wrong done to patients by such behavior: they have been treated as objects—specifically, as tools for the purposes of others. We argue that our view—the instrumentalization account—not only yields the correct verdict on that case but that it enjoys advantages not shared by bare appeals to respect for autonomy or human dignity.