Some people have been saying this along, but now there's solid evidence to back it up. Not everyone who is in a coma is completely unaware of what's happening to them. More significantly, some who are diagnosed as comatose are able to feel pain but unable to communicate that fact. New Scientist has the story. Here's part of it:
If there's one thing worse than being in a coma, it's people thinking you are in one when you aren't. Yet a new comparison of methods for detecting consciousness suggests that around 40 per cent of people diagnosed as being in a vegetative state are in fact "minimally conscious".
In the worst case scenario, such misdiagnoses could influence the decision to allow a patient to die, even though they have some vestiges of consciousness. But crucially it may deprive patients of treatments to make them more comfortable, more likely to recover, or to allow them to communicate with family, say researchers.
In a vegetative state (VS), reflexes are intact and the patient can breathe unaided, but there is no awareness. A minimally conscious state (MCS) is a sort of twilight zone, only recently recognised, in which people may feel some physical pain, experience some emotion, and communicate to some extent. However, because consciousness is intermittent and incomplete in MCS, it can be sometimes very difficult to tell the difference between the two.
Of the 44 patients diagnosed as being in a vegetative state by the clinicians, the researchers diagnosed 18, or 41 per cent, as being in a MCS according to the CRS-R.
"We may have become much too comfortable about our ability to detect consciousness," concludes Joseph Giacino who did the study at the JFK Rehabilitation Institute in New Jersey. "I think it's appropriate for there to be some level of alarm about this."
I think that's a considerable understatement. Remember the smug confidence bordering on arrogance of those who argued that Terry Schiavo could be starved and dehydrated to death without experiencing pain? I wonder what they're saying now.
RLC
