Study: Human beings aren't vegetables

And doctors aren't gods:

A growing body of evidence in recent years has indicated that a significant proportion of such patients might have had their conditions misdiagnosed and have more awareness than had been thought.

The study:

One by one, the men and women were placed inside advanced brain scanners as technicians gave them careful instructions: Imagine you are playing tennis. Imagine you are exploring your home, room by room. For most, the scanner showed nothing.

But, shockingly, for one, then another, and another, and yet two more, the scans flashed exactly like any healthy conscious person's would. These patients, the images clearly indicated, were living silently in their bodies, their minds apparently active. One man could even flawlessly answer detailed yes-or-no questions about his life before his trauma by activating different parts of his brain.

"It was incredible," said Adrian M. Owen, a neuroscientist at the Medical Research Council who led the groundbreaking research described in a paper published online Wednesday by the New England Journal of Medicine. "These are patients who are totally unable to perform functions with their bodies -- even blink an eye or move an eyebrow -- but yet are entirely conscious. It's quite distressing, really, to realize this."

That's an understatement. What's more distressing than being in this "locked in" state is being classified as a vegetable and being starved and dehydrated to death.

"I wish this could have been used on my sister to see what could have been done to help her," Schindler said in a telephone interview.

But Owen, Schiff and other experts stressed that the research does not indicate that many patients in vegetative states are necessarily aware or have any hope of recovery. Many, like Schiavo, have suffered much greater danger to their brains for far longer than the patients in the study.

"In some cases, the damage to the brain is so severe that it is simply inconceivable they could produce any responses," Owen said.

Perhaps, in light of this study, physicians shouldn't make themselves the arbiters of hope or the judges of what kinds of lives are worth living. Nor should they have so much confidence in their own omniscience.

An ugly warning:

But some urged caution, saying that the new technique raised a host of thorny questions.

"If a patient wanted to die, if they were asked, 'Do you want to die?,' could they explain themselves adequately?" said Joseph J. Fins, chief of the division of medical ethics at Weill Cornell Medical College. "If they say yes, what does that mean? If this person said yes but meant maybe, or it was 'sort of yes,' we may not be able to understand that sort of nuance. You have to be very careful."

How dreadful that the brain-injured might have their ability to communicate used against them by the hovering vultures. How about asking "How can we help you live?" instead of "Do you want to die?"

*Update: More commentary on this study from The Catholic Medical Student blog:

As a physician, based upon this study, would you be willing to say that an individual who is in persistent vegetative state should have all life support removed? Or what about the young man on the table whose organs are coveted by half a dozen other families? In this study, the individuals who responded were all victims of a traumatic brain injury, which is where many of the organ donations come from.

Read the rest.

I'm sure Wesley Smith will comment on this soon. **Update: Here it is: The Schindlers Were Right to Insist on Tests for Terri:

Indeed, when it was clear that Terri would be lying in bed for a year pending appeals, the family begged Judge Greer to permit sophisticated brain scanning that had never been used on her before. It couldn’t have hurt her, and it might have shown something. But stubbornly, he refused. I will go to my grave believing the judge knew what he didn’t want to know. . . .

The bioethics mainstream has rejected the equality/sanctity of humanlife for the so-called quality of life ethic. It began with the odios advocacy of Joseph Fletcher in the Hasting’s Center Report back in 1972, claiming that the inability to communicate meant that one had lost humanhood (now called personhood). Thus today, not only unconscious but conscious patients are dehydrated to death in all fifty states and it is shrugged off as medical ethics.

. . . thanks to Judge Greer’s intransigence, we will never know what her brain scan would have shown. And don’t bring up the autopsy: The report said her brain was consistent with either a PVS or minimally consciousness, and moreover, that such decisions are clinical, not subject to being decided upon autopsy.

But this is the point. Conscious or unconscious, people should not have to earn the right to receive basic sustenance. What we did to Terri Schiavo was a blight on the legal system and bioethics. Pretending otherwise won’t make that stain go away.

Read the rest.

Many thanks to Michelle Malkin for the link (buzzworthy)

Read the rest.

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