may Owen et al. 2006). Adrian Owen and

may still have preserved areas of brain function needed for awareness (Fernández-Espejo and Owen 2013). Advances in neuroimaging have led to the discovery of areas of preserved brain function that may be hidden by motor cortex damage (Owen et al. 2017).  Functional magnetic resonance imaging is used to detect levels of consciousness in vegetative patients by allowing them to respond to  auditory commands ( Owen et al. 2006). Adrian Owen and his team were able to show the same areas of the brain were activated in healthy volunteers when compared to a female vegetative patient who had been asked to imagine playing a tennis match (Owen and Coleman 2008). The research claimed to have confirmed that the patient was aware of her surroundings and herself, thereby challenging the current rhetoric surrounding vegetative patients. Monti et al. (2010) claimed that through the use fMRI research, patients diagnosed VS patients could follow spoken commands by answering simple yes or no questions when asked to think of one type of imagery for yes and another for no. The study examined 16 control subjects and one vegetative patient who underwent functional MRI in which they tried to answer questions by modulating their brain activity. Incredibly the vegetative patient was able to respond correctly to five out of six questions about his life (Monti et al. 2010). The functional MRI approach allowed the patient to establish operational and interactive communication that could not have been determined at his bedside. The accumulation of research throughout the 20 years since Adrian Owen’s  first paper in 2006 has led some to raise the possibility of using neuroimaging to ask patients if they wish to terminate or continue with life-sustaining treatment. Some view this as a worrisome step in the natural progression of neuroscientific advancement as it draws on many moral and ethical considerations that can often be contentious in regular society (Harrington 2013).It is often that heated disputes occur revolving around the legal right to die in patients diagnosed with VS. One of the main arguments against the deliberate decision to end life is the concept of informed consent. To comprehend whether these individuals can decide between life or death, we must consider their ability to be fully informed. Wilkinson, Kahane, Horne & Savulescu (2008) state that the reliability of informed consent should be based on the notion that an individual can demonstrate an understanding of a treatment plan and express justification for acceptance or withdrawal. This insinuates the patient must be competent. Harrington (2013) states that competency is not only the ability to “communicate a choice but also the ability to understand relevant information and to appreciate treatment alternatives and their consequences”. While neuroimaging may be able to aid patients in answering simple yes or no question (Monti et al. 2010 ) it may be argued that the use of brain scans alone cannot display the degree of understanding needed to make a life-altering choice (Harrington 2013). As of now, research regarding whether patients who can communicate via neuroimaging retain the sophisticated cognitive development necessary for reasoning ability is still preliminary. The primary concern when basing awareness on neuroimaging is whether or not current results are reliable enough to meet the criteria for informed consent in DoC patients (Byram et al. 2016). Often the results in one patient cannot be applied to another, and research is in the very early stages. Additionally, it may not be clear whether fMRI changes display an automatic, reflexive response or whether they represent consciousness (Wilkinson, Kahane, Horne & Savulescu, 2009). While there is unanimous agreement that functional neuroimaging has critical clinical implications and many are optimistic, researchers insist we must remain cautious about drawing definite conclusions regarding moral implications (Savulescu and Kahane 2009). Some patients may be able to partake in decision making, but there remain concerns about the reliability of research and ethical burdens that must be overcome (Byram et al. 2016).   The conflicting research and opinions within the field of neurosciences regarding end of life wishes have led to a rise in a  large number of bioethical dilemmas concerning personhood and moral status. The first question that is raised when considering the discovery of covert consciousness is whether these individuals experience consciousness in a manner that defines them as a person. Defining personhood in this select patient group then has a knock-on effect on their moral status as we will come to see. Personhood has technical requirements, and therefore the fulfilment of these requirements infers personhood. Such conditions are “(1) that self-consciousness is sufficient, (2) that the capacity for rational thought is sufficient, (3) that being a moral agent is sufficient, (4) that