"Persistent Vegetative State" Diagnoses Too Often A Rush To Judgement

Political Mavens ^ | August 5, 2007 | The Stiletto

[theothercheek]

A study by the Coma Science Group of the University of Liège, Belgium, finds that up to half of patients in an acute vegetative state regain some level of consciousness.

In the study, which analyzed data collected over a five-year period, researchers assessed and classified comatose patients according to the Coma Recovery Scale. The researchers determined that some 40 percent had been incorrectly diagnosed as being in a persistent vegetative state, when they were in fact in a minimally conscious state. And 10 percent of those diagnosed as being minimally conscious were communicating functionally.

A patient who is minimally conscious shows periodic signs of awareness of himself and his surroundings but is usually cannot communicate with others, whereas a patient who is in a persistent vegetative state is awake but lacks such awareness.

The Coma Science Group’s Dr. Steven Laureys presented the study findings at the European Neurological Society congress in June:

"Our data show that acute vegetative state is certainly not rare among patients admitted to intensive care … What is important to note is that it may be transient and that the prognosis for patients with impaired consciousness depends to a great extent on the nature of the brain damage. … The study underlines the importance of extreme caution in any decision to limit the life chances of patients during the acute phase of a vegetative state." …

Take the case of Jesse Ramirez, who suffered major brain injuries after his car flipped over and he was thrown from the vehicle on May 30^th. Doctors predicted that the 36-year old Arizonan could remain in a permanent vegetative state. Less than two weeks after the accident, his wife, Rebecca, 33, asked doctors to remove his food and water tubes. But Jesse's family challenged her decision in court, and a Maricopa County Superior Court judge ordered the tubes reconnected.

And then, Ramirez regained consciousness. The Arizona Republic reports:

[H]e can hug and kiss, nod his head, answer yes and no questions, give a thumbs-up sign and sit in a chair. …

Jesse is now ready to move from a hospice to a rehabilitation facility.

"We have had a lot of miracles," said Betty Valenzuela, Ramirez's aunt. "He would have been gone."

"All of the family is absolutely thrilled that he has now become conscious and is able to go through rehab," Judge Paul Katz said. …

The Arizona Republic notes that this same Judge Katz had previously scolded the family for not acting in Jesse's best interest.

Meanwhile, groundbreaking new research published in the journal Nature suggests that patients who are in a minimally conscious state are treatable, and can recover some cognitive ability, speech and movement.

With the aid of computer-generated maps and image-guided navigation equipment, researchers implanted a deep brain stimulator to deliver electrical pulses to the brain of a 38-year old man who had been in a coma-like state for six years after being the victim of a brutal mugging, during which he had been repeatedly kicked in the head. The man had been able to respond to commands on occasion, sometimes moving his thumb in response to yes-or-no questions.

Within hours of receiving the implant, the man opened his eyes and tracked the movement of people in his hospital room, reports The New York Times. He has continued to progress for more than a year and can drink from a cup, comb his hair, speak in short sentences and recently he recited the first 16 words of the Pledge of Allegiance, according to researchers at the JFK Johnson Rehabilitation Institute in Edison, NJ.

There are 100,000 to 300,000 minimally conscious patients in the US, and the researchers do not believe that the treatment would benefit all of them. For instance, the implant did not help Terri Schiavo, the FL woman whose husband won a court battle in 2005 to remove her feeding tube after she had been in a persistent vegetative state for 15 years.

The man's mother, who had signed a "do not resuscitate" order for her son told journalists at a press conference that "he can cry and laugh and say 'Mommy' and 'Pop.' I cry every time I see my son, but now it's tears of joy."

[mtbopfuyn]

[H]e can hug and kiss, nod his head, answer yes and no questions, give a thumbs-up sign and sit in a chair.

As could Terri, but her hino, Greer, and the government murdered her.

[Sun]

I saw a video of Terri laughing at her dad’s joke.

[theothercheek]

I hope all this new research redefines some people’s idea of “what’s in the best interest” of the patient - IMO, it’s giving him every chance to recover to the fullest that he can rather than hastening his death prematurely.

[Grammy]

My dad was diagnosed as being in a PVS... and did I “want to feed him?” (meaning, insert a feeding tube). I said yes, but it took about a half hour worth of arguing with the DR to have it done (”he could live like this for 20 years... he will never improve.... terrible life...”)

I finally said “If God wants him to leave, you won’t be able to keep him here. Otherwise, you will do everything you can to help him.”

10 days later, he woke up, fully concious. The following (last) 2 years of his life were the ones where we had the best part of our relationship.

[LaineyDee]

I finally said “If God wants him to leave, you won’t be able to keep him here. Otherwise, you will do everything you can to help him.”

Bless your heart and Right On!! :)

[Fawnn]

For instance, the implant did not help Terri Schiavo,...

This is the first that I've heard that Terri Schiavo had had such an implant. (?)

[Tammy8]

From what I remember from a news article she did have implants of some sort, but was not taken back for follow up care.

[thulldud]

Nothing was done to help TS. HINO did not allow it.