Recently, I was invited to speak at an event at London’s Wellcome Institute for the History of Medicine (see http://www.wellcomecollection.org/). The event was entitled ‘Conscious’ and provided the opportunity to share perspectives and stimulate discussion relating to some of the ethical and philosophical issues that arise when consciousness is compromised. Neil Levy from the Oxford Centre for Neuroethics (http:// www.neuroethics.ox.ac.uk/) shared some of the ethical issues that arise from current areas of research in neurology. Roy Hayim shared his personal experience of botulism resulting in his being ‘locked in’, paralysed and totally dependent on hospital staff. My task was to provide an overview of some of the experiences, values and virtues of nurses and other professionals who work with patients who have compromised consciousness. To become more closely acquainted with some of the everyday ethical challenges experienced, I met with nurses who work in a specialist neurodisability hospital. Their sensitivity to the ethical dimensions of their practice was impressive. They articulated clearly some of the dilemmas they experience particularly as they try to reconcile the needs and preferences of patients with those of their families. These ethical challenges seem to fall into three categories: those relating to patient choice and best interests, those relating to family interests and well-being and those relating to professionals’ decision-making processes and potential moral distress. It became clear to me that to work effectively in the field of neurodisability, a wide range of knowledge, skills and values is required. Knowledge and skills are required to conduct complex and prolonged neurological assessment and to plan, implement and evaluate care. Nurses and others who deliver care also require an in-depth understanding of the patient’s ability and disability. Crucially, nurses and other professionals require self-consciousness or skills in critical reflection. In my conversations with nurses, I was struck by reference to areas they are ‘conscious of’, for example, that they work together as a multidisciplinary team, that they need to support colleagues in an area where they have to endure uncertainty, bear loss when patients die, remain hopeful for patients and families and confront unrealistic expectations. Conversations with experienced nurses and with those attending the ‘Conscious?’ event confirmed that in addition to ethical principles that guide professionals to respect choice and dignity, to do good, minimise harm and treat people fairly, virtues are also required. Those that appear necessary, but probably not sufficient, are practical wisdom, compassion, dignity, courage, humility and empathy. Resilience is a quality considered necessary to work effectively with those with compromised consciousness and their families but another is required also. As one nurse said, ‘(you) need to have a passion to work in this area’. A quotation from Lois Shepherd, who has written about the ethical and legal issues that arose in relation to Terri Schiavo, an American woman who was in a vegetative state for 15 years, seems apposite: