Wednesday, November 14, 2012

Vegetative States and Consciousness

There's a fascinating story at the BBC website about new research being done on persons in a "vegetative" state due to severe brain injury that shows that not only are some of them conscious they can even respond to questions:
It's the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care.

Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine.

Vegetative patients emerge from a coma into a condition where they have periods awake, with their eyes open, but have no perception of themselves or the outside world.
Mr. Routley was injured in an automobile accident 12 years ago, and none of his physical assessments since then have shown any sign of awareness, or ability to communicate.
But the British neuroscientist Prof Adrian Owen - who led the team at the Brain and Mind Institute, University of Western Ontario - said Mr Routley was clearly not vegetative.

"Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is."
One of the questions that Owen's patients "answered" was whether they were in pain. Their MRI scans indicated that they were not. Owen was able to get some level of response from one in five severely brain-damaged patients that he tested.
It's hard to imagine what it must be like to be conscious in a body but not be able to make the body function in any way that would allow for communication with the outside world. One would think that such individuals would go insane.

On the other hand, perhaps their level of consciousness is similar to that of someone under an anesthetic like sodium pentathol. They can respond to questions but they're not aware that they're doing it.

In any case, it certainly raises a host of ethical questions about terminating someone's life when they're in a vegetative state. Was Terri Schiavo, for instance, aware of what was being done to her as she was slowly dehydrated and starved to death?

There are more interesting details on this research at the link.