Weekend Question 3: Why Are You So Adamant about Keeping Vegetative-State People Alive?
ANSWER: Because there’s someone in there, and there is always a chance they might recover.
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A subscription-only piece in Friday’s Wall Street Journal lays out what “surprises” scientists, even though they happen from time to time:
There May Be More To a Vegetative State Than Science Thought
September 8, 2006; Page B1After a 23-year-old woman sustained a severe brain injury in a car accident in July 2005, she fell into a coma, lying unresponsive in her hospital bed. Even when she eventually opened her eyes and resumed a normal sleep-wake cycle, she didn’t respond to sights or sounds, and never showed as much as a hint of doing anything intentionally. She fit the medical criteria for being in a “vegetative state.”
But the vegetative state isn’t what it used to be. A new study promises, or threatens, to overturn medical dogma about what is happening in the minds and brains of at least some patients in such a state. It also raises new questions about the meaning of consciousness, one of the deepest mysteries in all of science.
Patients in a vegetative state open their eyes and seem to be awake, yet show no sign of being aware of themselves or their surroundings. ….. in a vegetative state, the mind is thought to be AWOL.
In a startling new report in today’s issue of the journal Science, however, scientists describe how the young accident victim in a vegetative state shows brain activity consistent with conscious awareness.
When the scientists spoke to her, advanced imaging showed, her brain registered activity in regions responsible for decoding language, just as the brains of normal volunteers do. When they used sentences with homonyms, which require more complicated semantic processing, the appropriate parts of her brain lit up, again just like healthy brains.
Either response might be dismissed as automatic and therefore unconscious.
….. That’s why simply responding to speech, admits neuroscientist Adrian Owens of the Medical Research Council Cognition and Brain Sciences Unit, Cambridge, who led the new study, is “not unequivocal evidence that [the woman] is consciously aware.”
So they asked her to imagine playing tennis. Remarkably, this made neurons fire in the premotor cortex, a region that hums with activity when you mentally practice sophisticated movement, from a jump shot to a backhand. Then they asked her to imagine walking through each room of her house. This time her parahippocampal gyrus, which generates spatial maps, became active, again just as in healthy volunteers.
“We know from extensive research that brain responses of this type do not occur automatically,” says Prof. Owens, but “require the willed, intentional action of the participant.”
….. Lionel Naccache of the National Institute of Health and Medical Research in Orsay, France, calls the woman’s response to the tennis and home tasks “quite spectacular” and evidence of “a rich mental life.” But he notes that consciousness, according to neuroscience, requires engaging “in intentional actions or interactions” with the outside world. If she is conscious, why does she show no spontaneous intentional behavior, especially since there is no damage to parts of the brain that control moving or speaking?
Although the woman fits the diagnosis of being in a vegetative state, her brain activity raises the intriguing (or disturbing) possibility that there is a fully conscious being locked in that unresponsive body after all.
….. The hints of consciousness in someone so seemingly unaware and unresponsive underline how squishy science’s understanding of consciousness is, starting with how something so sublime can arise in the three pounds of tofu-like glop within our skull. Most scientists believe that consciousness means knowing that you know, even being conscious that you are conscious. Figuring out how to determine that has only just begun.
Earlier this year, there was the story of Terry Wallis:
Nearly two decades after suffering a severe brain injury, Terry Wallis was able to speak out. The incident is being dubbed as nothing short of a miracle by doctors who say that his brain, which was badly damaged when his pickup truck went over a cliff, was able to rewire itself.
There were two important lessons from Wallis’s remarkable recovery. The first was that we simply don’t know all there is to know about what is going on is a minimally-conscious or vegetative-state person. Unfortunately, the second was that there is a euthanasia-oriented mindset, as evidenced in the Associated Press story on Wallis’s recovery, that wishes to limit who can be permitted the opportunity to get better.
The AP’s article pointedly told us that:
Wallis’ sudden recovery happened three years ago at a rehabilitation center in Mountain View, Ark., but doctors said the same cannot be hoped for people in a persistent vegetative state, such as Terri Schiavo, the Florida woman who died last year after a fierce right-to-die court battle. Nor do they know how to make others with less serious damage, like Wallis, recover. (Aside: It wasn’t a “right-to-die†battle at all; it was about someone’s right to continue living. — Ed.)
The news above pointedly shows that there IS hope for people in vegetative states, as those of us who have faith in the Almighty and the eventual ability for science to find a way have always instinctively felt.
As science advances, we will of course learn that someone really IS still in there, and eventually we can begin the painstaking work of getting them back. That work won’t be done if we as a society head further down the road of euthanasia and “futile care,” and simply decide that such work isn’t “worth it.”










