This blog post deeply explores the criteria for a moral community—including vegetative states—by comparing receptivity, phenomenal consciousness, and relational perspectives.
Members of the moral community, as entities subject to moral consideration, are divided into moral agents and moral patients. Moral agents are the subjects of moral actions, capable of bearing responsibility for the consequences of their actions. Conversely, moral passives are beings incapable of moral action, lacking reason or self-awareness, like infants. Yet, it is our common sense that infants are subjects of moral consideration. This is because even infants possess responsiveness—the capacity to feel pleasure or pain. Since they feel pleasure or pain, they have a moral interest in pursuing or avoiding it, and thus should be subjects of moral consideration.
Many philosophers, including Singer and Curd, use sentience as the criterion for moral consideration for this reason. Singer argues that animals, like infants, possess sentience and should therefore be included in the moral community. Curd, however, excludes animals from the moral community by requiring higher-order consciousness as the standard for sentience. Following this argument would also exclude infants from moral consideration. One might argue that infants are potential members because such consciousness will eventually emerge. However, the problem arises with persistent, irreversible vegetative states, which lack even this potential. Vegetative patients are thought to lack not only higher-order consciousness but also sentience. Should they then be excluded from the moral community?
The common judgment that vegetative patients are unconscious stems from behaviorist observations that they fail to respond to any stimuli. This observation concludes that vegetative patients lack a qualitative experience of that stimulus—that is, phenomenal consciousness. If someone lacks phenomenal consciousness, they would lack responsiveness. Conversely, however, lacking responsiveness does not necessarily mean lacking phenomenal consciousness. That is, the concepts of phenomenal consciousness and responsiveness are not identical. This is because one can possess a passive qualitative feeling of receiving sensory information, even if that information lacks positive or negative active meaning in relation to external stimuli. In contrast, responsiveness includes an active aspect—the desire to seek or avoid such information—beyond the passive dimension. Since this implies the capacity to care about how one is treated, philosophers who use responsiveness as a criterion for moral consideration believe moral consideration should extend to such individuals. Mental states not captured by behaviorist criteria are not considered objects of moral consideration.
Then, are vegetative patients, who lack responsiveness and possess only phenomenal consciousness, not objects of moral consideration? Some argue that moral consideration is not determined by the moral attributes an entity possesses, but by the concrete relationship a moral agent forms with that entity. Various beings interact in daily life, and membership in the moral community is determined by such relationships. However, this relational approach risks defending discrimination that prioritizes treatment based on closer ties, such as race or gender. Furthermore, it raises the problem that the same vegetative state individual might belong to the moral community in one specific relationship and not in another. Ultimately, to consider vegetative patients morally, we must identify morally significant attributes in them.
Imagine a person with no sensory perception whatsoever, possessing only the passive aspect of phenomenal consciousness—a ‘sensory-perception paralysis patient’. While they have phenomenal consciousness, they do not feel pain or scream when a nail pierces their foot. However, unlike when walking in a safe environment, they would receive information that something has happened to their foot. At first glance, this state seems to lack something necessary to be considered a subject of moral consideration. Yet, the person with paralyzed responsiveness actually demonstrates an aspect of the daily life of a responsive human being. For example, someone who has used a computer keyboard for a long time can type a document without looking at which key corresponds to which letter. This person is not in a state requiring special active attention, but rather in a passive conscious state where information about external stimuli is minimally received. The argument that this state cannot be morally considered simply because the degree is minimal lacks persuasiveness. Similarly, if a vegetative state patient, while unable to feel pain, still possesses a subjective conscious state, this suggests there is room for acceptance within the moral community.
