To Live or Not to Live? The Effect of Mind Perception and Judgment Strategies on Life-Sustaining Treatment Decisions for Patients in Persistent Vegetative States

Abstract This research explored how perceived severity of condition, mind perception, and judgment strategies influence medical decision-making regarding life-sustaining treatments for patients in persistent vegetative states. Comprising three experiments with a total of 815 non-professional participants, a between-subjects design was employed in which the participants assessed patient scenarios that varied across three distinct levels of perceived severity based on observable behavioral cues (e.g., reflexes, emotional expression). The analysis focuses on the interplay between perceived condition severity, perception of the patient's mind, and three different judgment strategies: substituted judgment, adherence to community norms, and narrative-based reasoning grounded in the patient’s life story. The results indicated that as the perceived severity of the patient’s condition increased, the participants were more inclined to support withdrawal of treatment regardless of judgment strategy, thus highlighting the ethical complexity and diagnostic uncertainty inherent to subjective evaluations. The participants were more inclined to choose to increase treatment in vignettes depicting less severe conditions, whereas decisions to maintain or withdraw treatment were primarily shaped by their perceptions of the patient’s mind in terms of both agency and experiential dimensions. These findings underscore the urgent need for ethical frameworks that guide medical decision-making in ways that are both clinically grounded and sensitive to these patients’ mental states and personal narratives.