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Brain-damaged woman must be given 'wake-up' pill, orders judge
Daily Mail ^ | 11/20/06 | LUCY BALLINGER

Posted on 11/20/2006 1:49:59 PM PST by presidio9

A judge has rejected a family's plea that a 53-year-old woman in a vegetative state should be allowed to die.

He has ordered instead that she should be given a drug that could wake her up.

Theoretically the patient could then spend the rest of her life severely disabled and aware of her condition.

Sir Mark Potter, president of the High Court Family Division, says the woman should be given zolpidem, a common sleeping pill.

It has been used before on victims of severe brain damage who have then regained consciousness.

The woman, who cannot be named, suffered a massive brain haemorrhage on holiday in August 2003 and has been diagnosed as in a persistent vegetative state.

Sir Mark ruled that doctors should try giving her the drug before a final decision has to be made on whether to stop giving her food and water artificially, and let her die.

His decision was supported by the Official Solicitor Laurence Oates who represents PVS patients when their families seek permission to allow them to die.

A spokesman said Mr Oates, who has now retired, thought the woman should be given zolpidem to test if she could 'wake up.'

He said: "It was a very difficult case, but Mr Oates believed that before anyone is allowed to die every test possible should be carried out."

Sir Mark is believed to have also heard evidence from experts who look after severely brain-damaged patients.

It is the first time a ruling has been made to keep a PVS patient alive in order to use the drug. The case follows new Government guidelines, revealed by the Daily Mail on Saturday, which tell doctors they risk being put on trial for assault if they refuse to allow patients who have made 'living wills' to die.

The Lord Chancellor told the medical profession that those who do not follow the wills could face jail or big compensation claims in the court.

In a guide to Labour's Mental Capacity Act, which comes into operation next spring, Lord Falconer said living wills must be enforced. PVS patients are described as 'awake but not aware'. Unlike patients in a coma their eyes are open but they see nothing and are not conscious of their surroundings.

They breathe normally but have no swallowing reflex and have to be kept alive by artificial feeding and hydration.

In 1993 the courts sanctioned the withdrawal of feeding from Tony Bland, a 21-year-old brain-damaged survivor of the Hillsborough football ground disaster.

The case went to the House of Lords where law lords ruled it was in his best interests to be allowed to die and said doctors could lawfully stop artificial feeding because they would not be killing him, but withdrawing treatment.

Since then the High Court has sanctioned the withdrawal of food and drink from dozens of PVS patients when doctors, families and the Official Solicitor have agreed that death was in the patient's best interests.

The case of Terri Schiavo, whose husband fought a seven-year battle in Florida before she was allowed to die last year, heightened the debate in the U.S.

--------------------------------------------------------------------------------

THE NEW LEASE OF LIFE DRUG Zolpidem has been used in South Africa with amazing results. One recipient is 32-year-old Miss X, who cannot be named for legal reasons. She suffered four cardiac arrests and hypoxia - a lack of oxygen to the brain - after contracting septicaemia four years ago.

Without the pill, she can barely stand, her arms are in spasm and she cannot speak, although her intelligence has not been affected. But after being given a dose of the drug she can stand up, stretch to her full height and clap her hands.

The left side of her face is no longer drooping and her eyes sparkle. She smiles broadly and can even use a keyboard to communicate with people, telling them how she now hopes to speak again.


TOPICS: Constitution/Conservatism; Extended News; Miscellaneous; United Kingdom
KEYWORDS: ambien; awakenings; moralabsolutes; terrischiavo; zolpidem
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To: ReignOfError

okkkkkkkk


121 posted on 11/21/2006 5:51:50 AM PST by CindyDawg
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To: ichabod1
"I want all possible treatment to save my life if I'm injured."

Make sure that's in your Living Will. You have every right to demand that your family bear the emotional and financial burden of taking care of your severely brain damaged body as long as science allows.

This is about you. Remember that.

122 posted on 11/21/2006 5:52:13 AM PST by robertpaulsen
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To: palmer
"Are you an authority?"

How about that? WIKI confirmed what I said. That makes me look like an authority, now doesn't it?

123 posted on 11/21/2006 5:56:34 AM PST by robertpaulsen
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To: robertpaulsen
No, it says some authorities insist PVS is permanent. Are you one of those authorities?
124 posted on 11/21/2006 5:59:13 AM PST by palmer (Money problems do not come from a lack of money, but from living an excessive, unrealistic lifestyle)
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To: swmobuffalo
"In PVS patients, EEG's show a high level of brain activity."

Not in the consciousness area. That portion of the brain IS dead.

125 posted on 11/21/2006 5:59:40 AM PST by robertpaulsen
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To: robertpaulsen

No


126 posted on 11/21/2006 6:00:50 AM PST by CindyDawg
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To: beezdotcom
"The article talks about zolpidem being administered to people in vegitative states to "wake them up"."

Ah, I see. You think that "vegetative state" and "persistent vegetative state" mean the same thing.

127 posted on 11/21/2006 6:02:01 AM PST by robertpaulsen
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To: beezdotcom
"it may convince people to not so easily allow a misdiagnosis of PVS."

Not that we easily allow a misdiagnosis of any other illness.

128 posted on 11/21/2006 6:04:36 AM PST by robertpaulsen
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To: palmer

I am saying that, by definition, PVS is permanent. If it's not permanent, then it's not PVS. It's something else.


129 posted on 11/21/2006 6:06:50 AM PST by robertpaulsen
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To: robertpaulsen
Permanence in PVS is only by the insistence of some authorities. Obviously others disagree. Are you an authority or do you have some other justification your belief?
130 posted on 11/21/2006 6:09:25 AM PST by palmer (Money problems do not come from a lack of money, but from living an excessive, unrealistic lifestyle)
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To: robertpaulsen
Not that we easily allow a misdiagnosis of any other illness.

I'm sure that you know this happens all the time, with both major and minor illnesses. Otherwise, who would ever bother with "a second opinion"?

PVS (and yes, I *DO* know the difference with and without the 'P') is just one of those conditions where the patient has little inclination or ability to question a possible misdiagnosis. Therefore, it's up to the family to assume that role; some families are just better equipped than others to do this.
131 posted on 11/21/2006 6:13:07 AM PST by beezdotcom
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To: robertpaulsen
I am saying that, by definition, PVS is permanent. If it's not permanent, then it's not PVS. It's something else.

Yes, it's MPVS...a condition that seems to be on the rise, but the increasing numbers probably just reflects less willingness on the part of people to accept the original diagnosis of PVS...
132 posted on 11/21/2006 6:17:55 AM PST by beezdotcom
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To: M. Dodge Thomas

I simply fear that the euthanazia mindset inevitably proceeds from right-to-die, to duty-to-die, and I don't think that's right. You make good points though. And I went through this with my mother, that's why it's personal to me.


133 posted on 11/21/2006 7:16:18 AM PST by ichabod1 (Democracy = Anarchy)
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To: presidio9

Interesting post and discussion.

life


134 posted on 11/21/2006 7:16:27 AM PST by PGalt
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To: Dallas59
"One Kilo of Zolpidem coming up.

Will that be regular or drip grind, sir? "

135 posted on 11/21/2006 7:30:04 AM PST by Erasmus (I finally figured out that my life has a purpose--as a cautionary example to others.)
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To: M. Dodge Thomas
One of the things which always strikes me is that you can find individuals and families (and medical professionals) who have gone through these experiences and reached quite different conclusions.

And that sometimes even strongly held opinion changes as result of experience - my MIL, who eventually declined months or years of what seemed to be a reasonable quality of life started the process in a “keep me alive no matter what” frame of mind, and I'm sure there are plenty of examples of people who went the other way.

There's a form I got a while back on the net that’s instructive in this regard, it has a list of mental states “You have been declared brain dead”, “You are conscious but can no longer recognize your loved ones”; and so on across the top, and a list of medical interventions “You have gangrene, and you foot must be amputated or you will die”, “You must be placed on a ventilator or die, but it may be possible to remove it later” across the top.

You check a box at each intersection to elect or decline treatment.

This really helps to remove such questions from the theoretical and place them in a real world context: “If I have dementia and I can no longer recognize my loved ones, and I get pneumonia, do I what aggressive treatment, or just palliative care?

IMO a lot of difficulty – for ourselves, our decision makers, and medical professions - would be avoided if we all had advance directives based on this sort of decision making process.

136 posted on 11/21/2006 8:21:52 AM PST by M. Dodge Thomas
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To: ichabod1
And I went through this with my mother, that's why it's personal to me.

Sorry to hear about you mother - my wife and I have been through three of these, both in-laws and my father, and it's never easy.

See above, posted to myself by mistake.

137 posted on 11/21/2006 8:34:22 AM PST by M. Dodge Thomas
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To: M. Dodge Thomas

"Declining it's continued use, for myself, if the improvement effected was only from a "vegetative state" to a "cognitively severely disabled state", and declining its use entirely if such improvement was then likely to be used as a justification to keep me alive in such a state."

Yup...I agree 100%.


138 posted on 11/21/2006 8:36:18 AM PST by TampaDude (If you're not part of the solution, you're part of the PROBLEM!!!)
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To: robertpaulsen

Robert,

You're trying to use logic and reason. That doesn't work on pro-life fanatics. They use a different rule book.

I agree with you. There is no point in keeping someone's body alive if the "person" inside is gone. Why have an empty shell take up valuable resources that could be used to actually save a life?

With regards to the "Nazi" picture...we're not talking about killing retarded people, we are talking about letting someone who is essentially already dead finish the dying process.


139 posted on 11/21/2006 8:48:22 AM PST by TampaDude (If you're not part of the solution, you're part of the PROBLEM!!!)
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To: robertpaulsen

"That portion of the brain IS dead."

And your authority to state that is?


"A brain-dead individual has no electrical activity and no clinical evidence of brain function on physical examination (no response to pain, absent cranial nerve reflexes (pupillary response (fixed pupils), oculocephalic reflex, corneal reflexes), absent response to the caloric reflex test and no spontaneous respirations). It is important to distinguish between brain death and states that mimic brain death (eg. barbiturate intoxication, alcohol intoxication, sedative overdose, hypothermia, hypoglycemia, coma or chronic vegetative states). Some comatose patients can recover, and some patients with severe irreversible neurologic dysfunction will nonetheless retain some lower brain functions such as spontaneous respiration, loss of both cortex and brainstem function. Thus anencephaly, in which there is no higher brain present, is generally not considered brain death, although it is certainly an irreversible condition in which it may be appropriate to withdraw life support."

http://en.wikipedia.org/wiki/Brain_death


140 posted on 11/21/2006 10:11:47 AM PST by swmobuffalo (The only good terrorist is a dead terrorist.)
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