8,38 Life-sustaining treatments range from antibiotics and artificial nutrition and hydration to mechanical ventilation and dialysis. #KOS 953 randurls[1|1|,|CHEM1|]# Each intervention should be considered separately according to the patient’s condition and prognosis, applying relevant evidence-based medicine. This means that the duty to sustain the lives of PLCC patients does not necessarily entail an obligation to use every available modality in every

case. If we accept as a guiding principle that the fact that the patient is mentally deficient does not make his/her life less worthy, these considerations should be taken into Inhibitors,research,lifescience,medical account just as they are considered for cognitively competent patients. Thus, any suffering entailed in the treatment and its outcomes should be given due weight. Certainly, if the patient is enduring

pain and suffering that Inhibitors,research,lifescience,medical cannot be alleviated, it may be permitted and in certain circumstances even obligatory to refrain from prolonging life. However, in the case of PLCC patients, there is no indication that being in this state as such involves suffering; however notwithstanding, when a PLCC patient seems to be in pain or to be Inhibitors,research,lifescience,medical suffering otherwise, this should be adequately treated.23 Looking further into what might positively serve the well-being of the patient, it would be advisable to use the formula suggested by Jox,1 according to which, life-sustaining treatment should be continued Inhibitors,research,lifescience,medical if the well-being associated with this option

is superior to the well-being associated with allowing the patient to die. Due to the epistemic gap regarding the well-being of PLCC patients, just as the value Inhibitors,research,lifescience,medical of (their) life after death, to which Jox relates in his formula, and since the only known parameter in the formula is that life in itself has a positive ethical value, it turns out that life-sustaining should be presumed to serve better the well-being of these patients. Moreover, compassionate care for such unresponsive patients is an expression of unconditional Entinostat love, which is a great privilege for the caregivers, which might also give the patients an opportunity to experience (if and as much as they can) the feeling of this rare kind of love. The Dignity of the PLCC Patient The dignity of the PLCC patient is a tougher issue, due to both the calls for “death with dignity” and the high value placed by Western society on cognition as an integral aspect of an individual’s dignity (in accordance with the Kantian reading, which sees dignity as based on rationality).35,36 However, dignity has other interpretations, relating to all human lives being created in the image of God, and having a human genome.