Posted on 11/13/2012 11:53:01 PM PST by kathsua
The battle to protect patients in a so-called vegetative state from euthanasia took a positive turn today with the news that doctors have been able to communicate with one patient.
A Canadian man who was believed to have been in a persistent vegetative state for more than a decade has been able to communicate with scientists that he is not in any pain. It’s the first time an uncommunicative brain-injured patient has been able to communicate.
The news could change the way doctors and society views such patients. From the story:
Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine. His doctor says the discovery means medical textbooks will need rewriting.
Routley suffered a severe brain injury in a car accident 12 years ago.
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.”
Prof Owen said it was a groundbreaking moment.
“Asking a patient something important to them has been our aim for many years. In future we could ask what we could do to improve their quality of life. It could be simple things like the entertainment we provide or the times of day they are washed and fed.”
Scott Routley’s parents say they always thought he was conscious and could communicate by lifting a thumb or moving his eyes. But this has never been accepted by medical staff.
Prof Bryan Young at University Hospital, London – Mr Routley’s neurologist for a decade – said the scan results overturned all the behavioural assessments that had been made over the years.
“I was impressed and amazed that he was able to show these cognitive responses. He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful.”
Owen, the Canada Excellence Research Chair in Cognitive Neuroscience and Imaging, began his work on the study in London in 2011. The work at the Brain and Mind Institute at Western University mirrored what Owen did in England, work that was published in 2006 by the New England Journal of Medicine that found 18% of patients believed to be in a vegetative state were actually conscious.
Bioethicist Wesley J. Smith previously commented on the research.
“Patients diagnosed as persistently unconscious may be the most scorned people on earth. I mean, who else could be called a turnip or carrot with impunity?” he asked, saying he was hopeful the research would give them some humanity in the eyes of society.
Last month, a 12-year-old boy, whose doctor claimed he was in a “persistent vegetative state” after suffering a gunshot wound to the head, was talking and receiving physical therapy at a Dallas hospital.
You jest but the organ donation do-gooders hover over these cases and jumping the gun is not outside the realm of possibility especially under socialized medicine where the sheer number of mistakes and ‘officially but not really dead’ cases can only increase.
What stood out to me about this story is that the parents already knew for a long time that their son was “in there” and had the ability to communicate. Doctors didn’t believe them until they used their tests and equipment (that had failed them before) to figure it out. All their previous testing hadn’t revealed this, so they believed their testing over simple evidence that the parents were able to figure out long before.
Way too many doctors (thankfully not all!) have such a god complex, and a view of any non-medical people as being ignorant about anything to do with health and physical well-being. And yet they miss so many things that the supposedly ignorant non-medical people know all along. It frustrates me to no end!
does sound a lot like Terri Schiavo’s parents, doesn’t it?
Terri seemed to have much more awareness than this patient
Lucky for this guy he doesn’t have a spouse who finds his life inconvenient
Yes, like Terri’s parents and probably thousands of other loved ones who were sure of the same thing, but their doctors wouldn’t believe them. It’s horribly sad. Worse than being in this kind of state is being there without anyone believing you are “in there.” What a horrible isolated and abandoned feeling that must be.
It’s high time doctors realized that there are clues to be found “just” by simple (albeit time-consuming) observation, that all their high tech equipment will never find. No, doctors don’t have time to do that, but loved ones do, and if only docs would see them as valuable assets rather than ignorant bystanders!
This story sounds like the U.S. economy under Barack’s leadership.
Detroit?
Close, but not quite. Actually Papua, Indonesia. I, personally, don’t live in the jungle, but it comes up to the back fence.
“Way too many doctors (thankfully not all!) have such a god complex, and a view of any non-medical people as being ignorant about anything to do with health and physical well-being. And yet they miss so many things that the supposedly ignorant non-medical people know all along. It frustrates me to no end!”
About a year and a half ago, my daughter became pregnant. She felt like something was wrong. I didn’t want to distress her, so I said nothing to her; but I did tell my mom, husband and best friend that I agreed with her. There was something ‘off’ about the whole pregnancy.
She went to two different doctors for help. Both of them blew her off as an over-reactive first time mom.
Then she started bleeding. I got her to the ER as fast as I could.
The doctor ordered an ultrasound. Didn’t say anything, just left the room. Two more doctors came in and worked on the ultrasound. They sent for another machine. At one point she had half a dozen doctors quietly looking at the ultrasound. This went on for more than an hour.
Finally one of the doctors had the others clear out. He then explained to us that she wasn’t carrying a baby, but a tumor. A molar pregnancy.
She suffered for three months - begging for help. Trying to convince *someone* that something was wrong. That this wasn’t a normal pregnancy. Educated idiots told her that she didn’t know what she was talking about.
I cannot tell you how many times I’ve dealt with this crap. Instincts count for something.
Your photo is the result of technology, not the absence of it.
Exactly.
Only reason for the plight of the people in that photo, is an artificially high population level, which is the result of technology.
Interesting, but color me somewhat skeptical absent further research.
Basically what this doctor did was hook the patient up to an MRI. Then he spoke to the patient and said “imagine yourself playing tennis” and observed a specific part of the brain light up in the imaging. Then he spoke to the patient and said “imagine yourself walking around the house” and another part of the brain lit up. The doctor then determined that “playing tennis” meant “no” and “walking around the house meant “yes”. Then he asked a series of questions like “is the moon made of cheese?” and the “playing tennis” part of the brain lit up supposedly meaning “no”. Then “is the sky blue?” and the “walking around the house” part of the brain lit up supposedly meaning “yes”. Then he asked “are you in pain?” and the patient supposed answered “no” because the “tennis” area lit up.
But as it is impossible to know for sure whether Scott Routley is in any pain, it is also impossible to know if the “no” answer was correct or if it was just coincidental that the “tennis” area of the brain lit up in the imaging. I can’t help but think of “guided communication” efforts that were proved to be wishful thinking and the unconscious influence of the “guide” rather than communication by the “guided”.
People in a persistent vegetative state are not brain dead and no one argues they are, so it is not surprising that under stimulus, even auditory stimulus, that an MRI would show brain activity. But the bigger question is whether that brain activity is conscious thought and communication or a firing of neurons in the brain, different areas of the brain stimulated by different sound patterns.
Again, I’m not poo-pooing it as it could be a huge leap forward in understand how the brain works and in brain injury. I’m just saying that I wouldn’t count this as definitive in terms of communication until and unless the results can be replicated in numerous patients in persistent vegetative states by other neuroscientists, neurologists, researchers using the same methodology and using a control group.
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