Altered perceptions? Minimally conscious patients may have a greater capacity to feel pain than do those in a vegetative state (such as Terri Schiavo, above).
Credit: Reuters
Posted on 10/09/2008 9:49:45 PM PDT by neverdem
Altered perceptions? Minimally conscious patients may have a greater capacity to feel pain than do those in a vegetative state (such as Terri Schiavo, above).
Credit: Reuters
Most of the time, doctors have a simple way to determine if a patient needs pain medication: They ask. But when a brain injury renders someone unable to respond to questions, the right course of action becomes murkier. Now a study finds that the brains of some patients with brain injuries respond to an unpleasant electrical shock much as do the brains of healthy people, suggesting that these patients may feel pain even though they're unable to show it.
Little is known about pain perception in unconscious patients, says Steven Laureys, a neurologist at the University of Liège in Belgium and the senior author of the new study. As a result, whether to provide drugs is up to individual doctors. Some doctors withhold medications, Laureys says, assuming that these patients are unable to feel pain. Other doctors give drugs more liberally but in turn risk sedating patients and missing flickering signs of consciousness.
In the new study, Laureys and colleagues used positron emission tomography (PET) to measure activity in the brains of 15 healthy volunteers; 15 patients in a "vegetative state," a condition famously exemplified by Terri Schiavo, who showed signs of wakefulness but was unresponsive and unaware of her surroundings; and five patients in a somewhat better condition known as a "minimally conscious state," characterized by limited and sporadic responsiveness and awareness. Whereas minimally conscious patients may occasionally look toward someone who calls their name, for example, vegetative patients cannot respond.
In healthy subjects, a zap to the wrist elicited activity in brain regions that rev up in response to pain, including the thalamus, insula, somatosensory cortex, and anterior cingulate cortex. In patients who were in a vegetative state, activity in these regions was reduced, and the timing of firing across different regions was abnormal. But the minimally conscious patients exhibited levels and timing of brain activity that were very similar to those in healthy people, the researchers report online this week in The Lancet Neurology. Although PET scans and other neuroimaging tools won't ever reveal what people actually feel, Laureys says the new findings suggest that minimally conscious patients may have a greater capacity to register pain compared with those in a vegetative state--and a greater need for drugs to treat it. The capacity to feel pain may be another factor for patients' families to consider when weighing end-of-life decisions, he adds.
The findings are an important contribution to an understudied area, says Nicholas Schiff, a neurologist at New York-Presbyterian Hospital/Weill Cornell Medical College in New York City. Minimally conscious patients can't talk or even wince to let doctors know they're in pain, Schiff notes: "There's nothing to guide you without this kind of data." Even so, Schiff says, researchers need to study a larger sample of patients before making specific guidelines for pain medications.
Perception of pain in the minimally conscious state with PET activation: an observational study
Nothing in that photo of Terry demonstrates that she was in a “vegetative state” (dead).
Terri Schindler was NOT in a vegetative state.... Terri Schindler was not in a vegetative state....Terri Schindler was not in a vegetative state. This is a lie that appears will NEVER be undone!
Indeed, she looks like she was happy to see the person that was visiting her. From what limited photos and videos I saw of her, I had a hard time believing that she was not conscious and aware at least some of the time.
It will be undone in the end.
Facing the truth is sometimes too much for our corruptible souls to handle. For some the problem is worse than others.
But always, God knows the truth. And all lies ought to, and eventually will be undone. And God have mercy on us all when that happens.
btt
Thanks Andy. I meant in this world. Yes, I agree. God ultimately undoes all lies and at some point after death, the TRUTH of all things will be revealed.
Several years ago, I had a shattered wrist. It was healing up when I went to a new doctor. He said my wrist had been set wrong and needed to be reset. He gave me some kind of drug, grabbed my arm, and broke it again. My wife said I came off the table I was on and started screaming. She was very angry about that. The Doctor told her to relax and that I wouldn’t remember it. He was right. I do believe I experienced that pain.
Interesting story. Although it makes me wonder if your your situation was more about memory then it is about the relation between experience and consciousness.
Presuming you were conscious of the pain at the time, then I would agree you experienced the pain. Forgetting an experience does not mean an experience did not happen.
However, if your body went through the experience by itself, without you being consciously aware of it at the time, then I would have to say you were spared the experience.
The fact that you were screaming, inclines me to think the first is more likely.
I am still inclined to think that having one's body (including the brain) react to pain (or anything else for that matter), is not always the same as one experiencing pain. The crucial difference being conscious awareness.
Our body can have experiences that we do not notice. In such cases, we might notice the after effects, but we don't have the experience itself. Although this seems obvious, a naturalistic discipline such as neurology is by nature blind to this distinction. Not trying to knock neurology, but its just part of the oversimplification of reality necessary for the natural sciences to operate.
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