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This Element examines the main ethical aspects of consciousness It argues that consciousness is not intrinsically valuable but has value or disvalue for individuals depending on its phenomenology (what it is like to be aware) and content (what one is aware of). These two components of awareness shape normative judgments about how ordered, disordered, altered, restored, diminished and suppressed conscious states can benefit or harm individuals. They also influence moral judgments about whether intentionally causing these states is permissible or impermissible and how these states can affect behavior. After describing its neurobiological basis, this Element discusses ethical and legal issues in six categories of consciousness: phenomenal and access consciousness; intraoperative awareness; prolonged disorders of consciousness, dissociative disorders, the role of consciousness in determining death; and altering and suppressing awareness near the end of life.
To present an updated version of the ‘Post-acute Level Of Consciousness scale’ (PALOC-s), in accordance with the latest scientific insights.
Methods:
Within the context of a research project, 20 years ago, the PALOC-s was developed for the purpose of following the development of the level of consciousness of young unconscious patients participating in a rehabilitation program. Meanwhile, the understanding of the behavior related to different levels of consciousness has developed and terminology has changed, resulting in the need to revise the PALOC-s. With the preservation of the original description of the eight hierarchical levels of PALOC-s, adaptations are made in the terminology and grouping of these levels.
Results and conclusion:
This manuscript presents the revised version of PALOC-sr, which is suitable for use in clinical practice. The validation of this scale is recommended for its optimal use in future (international) research projects.
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