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Patients diagnosed as persistently unconscious may be the most scorned people on earth. I mean, who else could be called a turnip or carrot with impunity?  It is within the context of this “unrepentent bigotry”  that I analyze a hopeful story about increasing efforts to find the consciousness within the diagnosed unconscious.

We have discussed before how scientists used advanced brain scanning techniques to determine that at least some of these patients are responsive. Now, Nature reports that research is ongoing to develop means that would allow some of these patients to communicate. From, “The Mind Reader” (June 14, 2012, no link):

Now, using an EEG, Owen is planning to study 25 people in a vegetative state every year...One goal is to identify other brain systems, such as smell or taste, that might be intact and usable for communication...

The studies will also explore whether these patients have the capacity for greater intellectual depth. Owen thinks that some people in a vegetative state will eventually be able to express hopes and desires, perhaps like French magazine editor Jean-Dominique Bauby, who dictated his memoirs by repeatedly winking one eye. “I don’t see a reason why they could not have a similar richness of thought, although undoubtedly some will not,” Owen says.

More power to him. But some worry that it might interfere with the dehydration imperative:
Owen’s methods raise more difficult dilemmas. One is whether they should influence a family’s or clinician’s decision to end a life. If a patient answers questions and demonstrates some form of consciousness, he or she moves from the ‘possibly allowed to die’ category to the ‘not generally allowed to die’ category, says Owens. Nachev says that claiming consciousness for these patients puts families in an awkward position. Some will be given hope and solace that their relative is still ‘in there somewhere’. Others will be burdened by the prospect of keeping them alive on the basis of what might be ambiguous signs of communication.

It’s remarkable how getting these people dead seems so important within some bioethical circles.

Here’s what I worry about: In a world in which such people are denigrated as so many plant products and their bodies coveted as potential organ farms, will it matter?  Or will we decide that we know what we don’t want to know? After all, when people communicate it humanizes them, making it harder to view them as a mere natural resource.


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