Chronic Disorders of Consciousness and Homo Sacer

Abstract

The purpose of this chapter is to develop a biopolitical response to certain ethical questions posed by chronic disorders of consciousness (CDoC). This response will draw on Giogio Agamben’s account of homo sacer (Agamben G, Home Sacer: Sovereign Power and Bare Life (trans: Heller-Roazen D). Stanford University Press, Stanford, 1998). ‘Homo sacer’ is a somewhat obscure term, found in Roman law, designating someone who has been expelled from the protection of the law. By addressing Agamben’s own analysis of the ‘overcoma’ and the case of Karen Quinlan, it will be argued that a distinctive normative status can be ascribed to the CDoC patient: the CDoC patient exemplifies the condition of homo sacer, and as such of what Agamben calls ‘bare life’. This argument poses a radical challenge to traditional approaches to bioethics and law. Precisely because homo sacer is placed outside the law, traditional legal or moral conceptions of rights are rendered inapplicable. However, it will also be argued that the Catholic tradition (defending the sanctity of life) or more utilitarian traditions (articulated in terms of quality of life) are rendered equally irrelevant. It will be concluded that the CDoC patient has moral status as a radical experience of bare life – and thus of what it is to be human – albeit one that cannot be expressed or articulated by the patient. The biopolitical challenge posed by CDoC thereby becomes that of facilitating the creative and poetic role of those who bear witness to the patient’s experience. The biopolitics of CDoC thereby rests in the articulation for the patient of a radically different ethical status. The chapter will proceed by firstly offering an overview of the group of conditions classified as chronic disorders of consciousness, before outlining Agamben’s biopolitics, his key terms, zoē, bios and ‘bare life’, and thereby explicating the idea of homo sacer. A series of Agamben’s examples of homo sacer will be rehearsed, including that of the ‘over-comatose’ patient. This will provide the core material necessary for articulating a biopolitics of CDoC, and in particular to explicate the relationship between the patient and their ‘witness’.