"Don’t worry, she can’t hear you.” Though at times, we’ve been warned, she might open her eyes and stare straight ahead for a moment. “It’s nice of you to be gentle, but he can’t feel anything.” Cleanliness and a steady hand are still required for removing the stitches, because an infection or significant local trauma would be contraindicated. But the standard way of initiating an encounter—introducing oneself and one’s role and announcing to the patient what will be done before making any physical contact—that is demoted from an expectation of professionalism to a harmless flourish. A personality quirk maybe. “If it makes you feel more comfortable, you can do it, but the patient won’t be able to tell.”
These types of scenarios are relatively common in medicine. They suggest an implicit elevation of sensory perception as somehow essential to determining the ethical nature or act, or perhaps even personhood itself. Is there a person there to be greeted or harmed if they cannot experience a sensation from our actions? Assuming, of course, that we are correct that no sensation is being generated or perceived within a patient who is comatose, “brain dead”, or otherwise noncommunicative by traditional means. But we may be engaging in a sort of argument from silence: the absence of currently documented external evidence of an internal, subjective phenomenon. It doesn’t take much digging to find cases in which an individual has resumed communicating with the outside world and reported perceiving a surprising (and at times horrifying) amount of their surrounding environment. The examples of locked-in syndrome and spinal muscular atrophy have demonstrated the perceptional awareness and rich internal world that a person can still experience, despite the failure of their muscles to convey this information without an unexpected recovery or assistive technology.
In this paper, an initial foundation will be attempted for considering the “non-sensory patient” in the context of Christian theology and philosophy. Briefly, the historic development of influential perspectives on the meaning of sensation and perception will be traced. And alongside this, an examination of Christian beliefs on how and whether the imago Dei relates to traits and faculties. With these perspectives in mind, an argument will be made for treating all patients as if they can sense what is being done with or around them, resting on three main themes. First, the instructive examples of people “waking up” from noncommunicative states and reporting their experiences. Second, an eschatological expectation of justice and reunion between resurrected persons, in which acts that were presumably not perceived by an earthly body can later be addressed. And thirdly, the understanding that our actions change ourselves regardless of what effects they have on others, and that our actions and inactions can influence our peers and society.