title: Pascal's Wager and the persistent vegetative state.
abstract: I've argued that a version of Pascal's Wager applies to PVS so forcefully that no one who declines continued life without considering it makes a reasoned and informed decision. Thomas Mappes objects that my argument is much more limited than I realize. Of special interest is his appeal to an emerging diagnostic category, the 'minimally conscious state; to argue that there is much to lose in gambling on life. I will defend the Wager. Along the way I maintain that the chance of recovery from long-term PVS is much better than represented (as is the prospect of regaining independence if one recovers consciousness), and that the 1994 Multi-Society Task Force definitions of 'permanent' PVS are confused in ways that make crafting advance directives dangerously difficult. Valid advance directives require informed consent, I argue; the Wager needs to be part of the process. A consequence of my argument is that withdrawing medically-delivered nutrition and hydration from PVS patients is much harder to justify.
authors.affiliation: The University of New ORleans, USA. jstone@uno.edu
authors.forename: Jim
authors.initials: J
authors.lastname: Stone
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D016223:Advance Directives; D000368:Aged; D005260:Female; D006801:Humans; D007258:Informed Consent; D008020:Life Support Care / Q000941:ethics*; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State; D011379:Prognosis