I came across a report published last October that sent a chill up my spine. Researchers have confirmed something I had long feared. People in "comas" are sometimes minimally conscious and able to experience pain. They have no way, however, to communicate their suffering to those around them. It's thus quite possible that Terri Schiavo - and others in similar straits - suffered terribly when she was deprived of water and nourishment and essentially starved to death in 2005.
Imagine being aware, if only somewhat, of what is going on around you - imagine being in terrible discomfort - but also being unable to signal your discomfort to anyone or to do anything at all to alleviate it. You would be imprisoned in your body, and your body would be a torture chamber.
The report begins with this:
Do patients who survive a severe brain injury but fail to recover speech or non-verbal communication perceive pain? After their remarkable publication where they showed that a patient in a vegetative state in reality was conscious, scientists at the University of Li�ge (ULg) were able to tackle the very difficult issue of pain perception in coma survivors.
The Coma Science Group of the Cyclotron Research Centre and Neurology Department of the ULg used PET scanning to measure minimally conscious and vegetative patients' brain activation in response to noxious stimulation. After comparing results obtained in the different patient groups with those in healthy volunteers who could communicate it felt painful they concluded that minimally conscious patients must feel pain despite being unable to tell their environment. Hence, these patients should receive pain-killers, the authors concluded.
This study has major ethical and therapeutical consequences also with regard to end-of-life decisions in these challenging but vulnerable patient populations.
This last sentence is, of course, an understatement.
RLC