To aid neuroscientists in determining the ethical limits of their work and its applications, neuroethical problems need to
be identified, catalogued, and analyzed from the standpoint of an ethical framework. Many hospitals have already established
either autonomy or welfare-centered theories as their adopted ethical framework. Unfortunately, the choice of an ethical framework
resists resolution: each of these two moral theories claims priority at the exclusion of the other, but for patients with
neurological pathologies, concerns about the patient’s welfare are treated as meaningless without consideration of the patient’s
expressed wishes, and vice versa. Ethicists have long fought over whether suffering or autonomy should be our primary concern,
but in neuroethics a resolution of this question is essential to determine the treatment of patients in medical and legal
limbo. I propose a solution to this problem in the form of ethical dualism. This is a conservative measure in that it retains
both sides of the debate: both happiness and autonomy have intrinsic value. However, this move is often met with resistance
because of its more complex nature—it is more difficult to make a decision when there are two parallel sets of values that
must be considered than when there is just one such set. The monist theories, though, do not provide enough explanatory power:
namely, I will present two recently publicized cases where it is clear that neither ethical value on its own (neither welfare
nor autonomy) can fully account for how a vegetative patient should be treated. From the neuroethical cases of Terri Schiavo
and Lauren Richardson, I will argue that a dualist framework is superior to its monist predecessors, and I will describe the
main features of such an account.
Keywords Schiavo - Richardson - Vegetative - Laureys - Autonomy - Utilitarianism - Kantianism - Pluralism
A similar, more established quasi-pluralistic framework could be found in the medical ethics literature under Tom Beauchamp
and James Childress’ Principles of Biomedical Ethics. My paper deviates from this text in many ways, but especially in the inclusion of autonomy and happiness as part of ethical
theories, rather than guiding principles.