Metaphysical accounts of personhood and their ethical implications for the vegetative state: A comparative analysis

This paper investigates how metaphysical theories of personhood carry significant ethical implications regarding attitudes towards patients with disorders of consciousness. After providing conceptual clarifications on key terms such as moral status, vegetative state, metaphysical and moral personhood, and sortals, the paper analyzes five main approaches to theories of personhood: personism, animalism, the disjunctive/hybrid view, the constitution view, and ontological personalism. Related bioethical implications are presented for each theory: the intermittent person (personism, constitution view); personhood as accidental (animalism, disjunctivism); the indefinite substratum (disjunctivism); the dual human-person subject (constitution view); the non-rational person (ontological personalism). Ontological personalism appears preferable in dealing with liminal cases, anchoring criteria for identity in a corporeal entity of a rational nature, while recognizing radical changes in the manifestation of psychological characteristics. From a pragmatic perspective addressing uncertainties of vegetative state diagnoses.