Last November I wrote that when future generations judge our era, one of the areas where they’ll likely be aghast is our treatment of those who we regard as lacking consciousness. That future may come sooner than I had ever imagined.
A recent study published in the New England Journal of Medicine found that five of fifty-four patients thought to be in a persistent vegetative state showed brain activity indicating awareness, intent and, in at least one case, a wish to communicate.
According to the summary in the L.A Times:
Of 54 unresponsive patients whose brains were scanned at medical centers in England and Belgium, those five appeared able, when prompted by researchers, to imagine themselves playing tennis, and four of them demonstrated the ability to imagine themselves walking through the rooms of their homes.
One of those patients — a 22-year-old man who had been unresponsive for five years after an automobile crash — went on to respond to a series of simple questions with brain activity that clearly indicated yes or no answers, researchers said.
Their work is the first to give physicians and families the prospect of a biological test to determine whether a patient who shows no response to his or her surroundings is conscious and aware of them.
February 4th, 2010 | 9:38 am
I can’t imagine the horror for that one patient. To be conscious but completely and utterly unable to respond or communicate except during MRI sessions. Brrr. Time to make sure my livng will is up to date.
February 4th, 2010 | 10:41 am
I’m all for protecting these people, but let’s remember that millions of conscious people still die from relatively preventable causes like malaria and water-borne diseases these days. I tend to be much more worried about how future generations will justly think about our priorities with regard to so many lives than about how they will perceive our attitudes toward an extremely small number of (admittedly, morally-significant) hospital patients.
February 4th, 2010 | 10:45 am
From the article:
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But some neurologists cautioned that such a new diagnostic technique might further confound families.
In an accompanying editorial, Harvard University neurologist Allan H. Ropper wrote: “It will now be difficult for physicians to tell families confidently that their unresponsive loved ones are not ‘in there somewhere.’ ” Even when a patient has shown purposeful brain response, “we cannot be certain whether we are interacting with a sentient, much less competent, person.”
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What? Doesn’t he mean that “we cannot be certain whether we are interacting with a vegetative remnant.” And yes, they are in there, even if they are less than competent!
No, the turn hasn’t come yet.
February 4th, 2010 | 12:06 pm
This is astonishing! Perhaps this can lead to some cure in the future, since doctors are able to communicate with them. I still think that miracles can still happen. We don’t know what the future holds. But we know who holds the future. Lets give these patients and their families some hope.
February 4th, 2010 | 2:41 pm
“I can’t imagine the horror for that one patient. To be conscious but completely and utterly unable to respond or communicate except during MRI sessions. Brrr. Time to make sure my living will is up to date.”
I had this happen post-surgery years ago. I was literally screaming in my head from fright. This happened because I was put under for surgery even though the doctor knew I would have a reaction to the anesthesia. I will never forget being awake and unable to move a single muscle. I could hear everything but not respond. Still, had I heard folks planning my demise, well, that would have infinitely multiplied the horror.
February 5th, 2010 | 12:55 pm
Steve raises a good point. George Will referred to the medical costs of living longer and that medical care is effective in prolonging life. Thus the US pays an increasing proportion of national income on medical care. Yet, Will says that the country cannot continue this. If the cost to maintain me after a heart attack is X Medicare dollars which could be spent to provide 2000 immunizations to children, what would the Lord want? It is a hard question and not discussed in the national debate—it is like the elephant in the room which no one wants to acknowledge.
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