Vegetative state or consciousness?
February 6, 2010 1 Comment
The brain is a funny thing
Brains are funny things, and neuroscientists are learning more and more every day about the unpredictability of the human brain. While a decade ago, experts might have insisted, based on their standard bedside tests, that a person in a persistent vegetative state could not understand anything being said around them, two recent reports have signaled a shift in the dogmatic wind. The first was the celebrated discovery that a Belgian man, who’d been considered PVS for 23 years after a car accident, emerged from his state and reported having been conscious the entire time. The second, just released, indicates that a small percentage of patients in a persistent vegetative state may not only be conscious but also be able to process questions and answer them accurately. In this latter study (available in full text here), investigators used a technique called functional MRI, which provides an image of the blood flow that occurs to areas of the brain that have become active.
A question of ethics?
These findings raise a number of ethical questions. Some issues of concern center on whether or not these patients might be able to express a wish to live or die, and if so, what the response should be. On a more potentially positive note, doctors suggest that they might be able to ask some presumed PVS patients if they’re experiencing pain and take steps to alleviate it if the answer is yes. Some people may remember the Terry Schiavo case, which raised a number of ethical questions about such conditions and end-of-life issues. In her case, her condition arose from oxygen deprivation. Researchers in the most recent study report that only patients who had experienced traumatic brain injury–rather than oxygen deprivation or blood deprivation–were in the group of patients who seemed able to respond to questions.