Suffering at the Margins: Non-Experiential Suffering and Disorders of Consciousness

Research suggests that caregivers of patients with disorders of consciousness such as minimally conscious states (MCS) believe they suffer in some way. How so, if they cannot experience sensations or feelings? What is the nature of their suffering? This paper explores non-experiential suffering (NES). It argues that concerns about NES are really concerns about harms (e.g., dignity-based harms), but still face problems. Second, it addresses the moral importance of bearing witness to suffering. It explores several possible accounts: epistemic (bearing witness generates important knowledge), consequentialist (witnesses' interests also matter), and deontological (there is a duty to bear witness). It argues that witnessing suffering creates epistemic advantages and disadvantages for determining a patient's interests; that clinicians' interests to not bear witness may have considerable moral weight; and that the obligation to bear witness to NES is unclear.