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Posted on 11/12/2011 2:04:39 PM PST by wagglebee
Late last night the prestigious British medical journal “The Lancet” published a very important study online that further demonstrated that patients diagnosed to be in a persistent vegetative state have either often been misdiagnosed or are sometimes consciously aware even if they are in a PVS. Several of you wrote back in response to our analysis (www.nationalrighttolifenews.org/news/2011/11/lancet-study-provides-more-evidence-that-patients-in-so-called-%E2%80%9Cpersistent-vegetative-state%E2%80%9D-may-be-consciously-aware) which is one important reason for this follow-up.
I spent about an hour and a half today reading how media outlets covered the conclusions drawn by “Bedside detection of awareness in the vegetative state: a cohort study.” The New York Times’ two lead paragraphs are absolutely brilliant, touching most of the major points succinctly in only 145 words:
“Three severely brain-injured people thought to be in an irreversible ‘vegetative’ state showed signs of full consciousness when tested with a relatively inexpensive and commonly used method of measuring brain waves, doctors reported Wednesday. Experts said the findings, if replicated, would change standards in treating such patients.
“Scientists have seen meaningful, responsive brain activity in such patients before, using a high-tech magnetic resonance imaging scanner. But the new study, posted online Wednesday by the journal The Lancet, is the first to demonstrate that clear signs of conscious awareness can be detected on an electroencephalogram machine by using an innovative strategy. The EEG is a portable, widely available unit that picks up electrical brain activity through electrodes positioned on a person’s head. Clinics and homes treating people with severe brain injuries are far more likely to have access to an EEG than to an M.R.I. scanner.”
Very, very impressive. And note that last sentence: EEG is so much easier to use and, by the way, much gentler with patients who are physically fragile.
As helpful as the study is there is an important caveat. While the Lancet study shows that EEGs could detect signs of consciousness in patients who had been diagnosed as “vegetative,” it does not follow that such patients are definitely unconscious if EEGs do not detect these signs.
As the study itself notes, the fact that the EEG did not pick up these signs of consciousness in 25% of the healthy and aware patients (the “controls”) “shows unequivocally that a null EEG outcome does not necessarily indicate an absence of awareness.”
Burke J. Balch, director of NRLC’s Powell Center for Medical Ethics, commented, “Many patients, probably thousands, have had their food and fluids cut off and died, based on what we now know may well have been mistaken assumptions that they had lost all capacity for consciousness. The Lancet EEG study, together with earlier functional MRI studies, holds out the hope that we may develop ways to communicate with aware patients who have routinely been diagnosed as ‘vegetative,’ much as today eye movements and blinks are used to communicate with some patients with paraplegia.”
Balch added, “Just as what were once generally accepted mental health diagnoses of ‘idiot’ and ‘moron’ have long been dropped from standard medical vocabulary, it is to be hoped that these studies will help lead to abandonment of the dehumanizing and inaccurate term ‘vegetative’ as an acceptable medical diagnostic term.”
This raises and obvious question which the Washington Post’s Rob Stein wrote about today:
“The research inevitably raises questions about patients such asTerri Schiavo, a Florida woman in a persistent vegetative state whose family’s dispute over whether to discontinue her care ignited a national debate over the right-to-die issue and congressional intervention in 2005. Schiavo’s brother, Bobby Schindler, said the new study highlights the limits of medicine in providing an accurate diagnosis.
“’Regrettably, Terri was never afforded these types of exams,’ Schindler wrote in an e-mail to The Washington Post. ‘Such testing could not have hurt Terri but could have helped her.’
“Schindler and others called for a reconsideration of such diagnoses.
“’These findings only reinforce our family’s contention that the PVS diagnosis needs to be eliminated — particularly given the fact that it not only dehumanizes the cognitively disabled, but it is being used in some instances to decide whether or not a person should live or die, as it was used in Terri’s case. None of us deserves to be deprived of food and water,’ he said.”
Two quick concluding points. To be clear the Schindler family adamantly denied that Terri was in a PVS. It was that diagnosis that made intervention to save their sister/daughter almost impossible.
Second, the Schiavo case, properly understood, was NEVER about the “right to die.” There were bogus assurances given by those who wanted her feeding tube removed that she had expressed a wish not to live if ever she was in a situation like that, assurances her family vociferously disputed.
Rather the case was about the duty to treat–to extend to a fellow human being the absolute minimum: food and fluids–and to extend to Terri’s family the right to take Terri home and care for her there.
Exactly and our Republic has NEVER had a greater moral failure.
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It took so long for that person to die. That was YEARS ago, and we're still traumatized by it.
How can someone do it to a family member...then live with themselves thinking they did the right thing???
Then they’re all sad at the funeral......YOU KILLED HIM I scream in my head!!!!
I do know that in two cases I have personal experience with people had their loved one moved to a different hospital after changing physicians and within the couple of weeks it took for all the effects of being constantly sedated wore off were dealing with an entirely different situation. In both cases these folks were not well, but were alert and could carry on a rational conversation. So, convenience it the real issue, whether it's convenient for the hospital to keep treating them or not, particularly when the issue of who is going to pay for it often ends up being, "no one". So, maybe in light of the cost factor, it becomes whether or not it's possible to pay for them to remain hospitalized rather than there being an alternative that someone will or can pay for.
As stunning as it may seem, in one of the two cases I'm describing, the family was upset that the family member was considered well enough for someone to take them home because it would mean one of them taking care of them rather than just visiting them in the hospital now and then. You end up with a situation where a lot of people are willing to go along with classifying someone as a turnip if that's what it takes to keep them from having to deal with the care of a family member who needs more than the occasional glass of water. My sister busted her tail taking care of my parents and at the same time my wife and I were caring for my Mother in Law. It's not easy, but it's possible. It does cost money and it does limit what you can do and how you can use free time you have but it is possible.
They needed to kill Terry because she was inconvenient for her two-timing husband.
it’s cheaper to kill them.
That was a terrible period of time. I was beside myself, totally feeling my own helplessness to do anything to stop this....murder....from taking place. A horrible, gut-grinding pain whenever I thought about Terri and what was being done to her....and it seems that that was ALL I thought about. Although most here on FR understood and felt similarly to me, a number did not. I could never understand that. I stopped coming here for almost a year...felt really disillusioned with people.
sigh.
pattyjo
Very importantly, the very idea of coma is up in the air right now, due to an accidental discovery by a doctor in South Africa. A patient in a “persistent vegetative state” had a “restless arm” that was flopping about, so just on a whim, they gave him the generic form of Ambien, a sleeping pill, to see if it would settle his arm down.
He woke up. So they went around to other coma patients and gave them Ambien, too. It woke up a large number of them.
http://www.guardian.co.uk/science/2006/sep/12/health.healthandwellbeing
While they don’t know for sure why, the current theory is that when the brain is damaged, it secretes extra amounts of a chemical called GABA (gamma-Aminobutyric acid), that shuts down that part of the brain so it can heal. However, in some people, this *sensitizes* them to GABA, so that normal, ordinary amounts produced by the body *keep* the brain shut down. Hence coma.
And Ambien temporarily blocks the production of GABA. But once they wake up, their brain continues to “wake up”, which takes them out of their comatose state for good. From that point, they sleep normally and continue to wake up.
I disagree. I’d say Roe v Wade is a greater moral failure and is an underpinning to the reasoning behind the Schiavo case.
Although we do not get to see it, what goes around comes right beck at you...
we can only hope that the few that wanted this, we can only hope the get the torture of the moment of clarity where they come to the total realization of what they actually did to another human being.
i was born with CP. The drs told my mother to put me in an institution. I was in a vegetative state and would never speak or walk or interact with the world.
I didn’t cry or respond to stimulus for the first three months, but (after that) I developed fast. I was walking at 9 months and speaking by one year. I am clumsy and have the coordination of a drunken monkey, but I’m happily married and have raised two wonderful children into wonderful adults. I can cook meals that will make any man happy and my reading has been clocked at 1500 WPM with 90% retention.
*I* think that I’m perfectly normal. \8-p
I’ve always told my family to not consider me in a PVS until I’ve had at least a full year of intensive therapy and that I’d do the same for them.
it seems to me that most of the time, once the diagnosis happens, the poor people are put in a bed and left to languish. Physical therapy WORKS! (*I’m* here!)
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