Editing Coma (section)

=== Bioethics ===
A person in a coma is said to be in an  [[Unconsciousness|unconscious]] state. Perspectives on [[personhood]], [[Identity (social science)|identity]] and [[consciousness]] come into play when discussing the [[Metaphysics|metaphysical]] and [[Bioethics|bioethical]] views on comas.

It has been argued that unawareness should be just as ethically relevant and important as a state of awareness and that there should be metaphysical support of unawareness as a state.<ref name=":3" />

In the ethical discussions about disorders of consciousness (DOCs), two abilities are usually considered as central: ''experiencing well-being'' and ''having interest''. Well-being can broadly be understood as the positive effect related to what makes life good (according to specific standards) for the individual in question.<ref name=":1">{{cite book |doi=10.1093/acprof:oso/9780190280307.003.0011 |chapter=What is Good for Them? Best Interests and Severe Disorders of Consciousness |title=Finding Consciousness |date=2016 |last1=Hawkins |first1=Jennifer |pages=180–206 |isbn=978-0-19-028030-7 }}</ref> The only condition for well-being broadly considered is the ability to experience its 'positiveness'. That said, because experiencing positiveness is a basic emotional process with [[Phylogenetics|phylogenetic]] roots, it is likely to occur at a completely unaware level and, therefore, introduces the idea of an unconscious well-being.<ref name=":3">{{Cite journal|last1=Farisco|first1=Michele|last2=Evers|first2=Kathinka|date=December 2017|title=The ethical relevance of the unconscious|journal=Philosophy, Ethics, and Humanities in Medicine|volume=12|issue=1|pages=11|doi=10.1186/s13010-017-0053-9|pmid=29284489 |pmc=5747178 |doi-access=free }} [[File:CC-BY icon.svg|50px]] Material was copied from this source, which is available under a [https://creativecommons.org/licenses/by/4.0/ Creative Commons Attribution 4.0 International License].</ref> As such, the ability of having interests is crucial for describing two abilities which those with comas are deficient in. Having an interest in a certain domain can be understood as having a stake in something that can affect what makes our life good in that domain. An interest is what directly and immediately improves life from a certain point of view or within a particular domain, or greatly increases the likelihood of life improvement enabling the subject to realize some good.<ref name=":1" /> That said, sensitivity to reward signals is a fundamental element in the learning process, both consciously and unconsciously.<ref>{{cite journal |title=Henry Adams: The Middle Years. By Ernest Samuels. (Cambridge, Mass.: Belknap Press of Harvard University Press. 1958. Pp. xiv, 514. $7.50.) and Henry Adams: The Major Phase. By Ernest Samuels. (Cambridge, Mass.: Belknap Press of Harvard University Press. 1964. Pp. xv, 687. $10.00.) |journal=The American Historical Review |date=January 1966 |doi=10.1086/ahr/71.2.709 }}</ref> Moreover, the unconscious brain is able to interact with its surroundings in a meaningful way and to produce meaningful information processing of stimuli coming from the external environment, including other people.<ref name=":2">{{cite book |doi=10.4324/9781315723983 |title=Neurotechnology and Direct Brain Communication |date=2016 |isbn=978-1-317-52959-0 |editor-last1=Farisco |editor-last2=Evers |editor-first1=Michele |editor-first2=Kathinka }}{{pn|date=December 2024}}</ref>

According to Hawkins, "1. A life is good if the subject is able to value, or more basically if the subject is able to care. Importantly, Hawkins stresses that caring has no need for cognitive commitment, i.e. for high-level cognitive activities: it requires being able to distinguish something, track it for a while, recognize it over time, and have certain emotional dispositions ''vis-à-vis'' something. 2. A life is good if the subject has the capacity for relationship with others, i.e. for meaningfully interacting with other people."<ref name=":1" /> This suggests that unawareness may (at least partly) fulfill both conditions identified by Hawkins for life to be good for a subject, thus making the unconscious ethically relevant.<ref name=":2" />