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The already difficult debate over whether to sustain the life of a person with almost no consciousness as the result of a brain injury has grown harder over time, says an American bioethicist visiting Halifax this week. New scientific work has shown that some people who appear to be in a vegetative state, with no prospect of recovery, are in fact minimally conscious, Dr. Joseph Fins, a neurologist and chief of the division of medical ethics at New York’s Weill Cornell Medical College, said Tuesday in an interview. And recent experimental therapies, including deep-brain stimulation and certain drugs, have helped patients in isolated cases regain some consciousness, he said. "We are on the cusp of greater and greater discovery," Dr. Fins said. "In a way, when there was absolutely no hope and no possibility of hope 10 years ago, it was almost easier to sort of deal with it. I think we’re now in a more ambiguous situation where there are glimmers of possibility. If you’re unfortunate enough to have a loved one in this situation and you’re hoping against all odds that there might be something to do, it’s hard to be patient." Dr. Fins will give a free public talk Thursday evening called Lessons From the Injured Brain: Bioethics Meets Neuroscience. Last year in the journal Nature, Dr. Fins described the case of a 38-year old who’d been in a minimally conscious state for five years and regained the ability to eat, speak and make some movements after electrodes were implanted in his brain. But he stressed that experimental techniques like deep-brain stimulation are unproven and cannot be considered treatments. "There’s no treatment for this," he said. The way families of people with minimal consciousness navigate the debate over prolonging life or allowing a loved one to die and their appeals to governments to support research will help accelerate investigations into new treatments, Dr. Fins said. He said more government funding is needed to broaden the experimental approaches to treatment. As it stands, people left with minimal consciousness are largely "neglected" by policy-makers, Dr. Fins said. He and colleagues last year estimated that there are between 100,000 and 200,000 Americans living in a minimally conscious state and about 25,000 who are considered vegetative. But there are no reliable numbers. "If you really care about this population of patients, you have to count them so that you can engage in responsible health policy planning," Dr. Fins said. Periodically, cases like that of Terri Schiavo a severely brain-damaged Florida woman at the centre of a family struggle in 2005, garner a great deal of public attention. Ms. Schiavo died in 2005 after her husband won the right to remove the feeding tube that sustained her for 15 years in a vegetative state. Her parents opposed the move. Dr. Fins said it’s productive to have that public debate on a large scale. He noted that the high-profile case of Karen Ann Quinlan in the late 1970s helped establish the now well-entrenched right of a person to die when there is no hope his or her condition will improve........................
Where hope still glimmers... Bioethicist to speak about sustaining lives of severely brain injured
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OKEECHOBEE (FBW)—Karen Weber, 57, the women at the center of a Terri Schiavo-like dispute, passed away Sept. 17, apparently of “natural causes.”
Joyce Tatro-Manes, of Toledo, Ohio, Karen’s sister, told Florida Baptist Witness that Weber, whose husband Ray Weber recently was awarded temporary guardianship in the case, died at Longwood Regional Hospital in Fort Pierce about 9 p.m. and her funeral was in the Toledo area Sept. 22.
Weber suffered a seizure in November and then a stroke and has been between an Okeechobee nursing home and a hospital. At the center of the dispute between family members was whether she was initially able to make decisions about her own care since her vocal cords were paralyzed when she had the stroke. [See Witness article “Schiavo-like case in Okeechobee garners interest; Stroke victim indicates she doesn’t want to die.”]
Ray Weber, Karen’s husband of 34 years, sought to have her feeding tube removed in March and his wife transferred to hospice. Weber’s mother, who maintained at the time that Karen was alert and responsive. indicated she did not believe Karen would want her feeding tube removed and filed for and received an injunction to prevent Ray Weber from proceeding.
The judge in the case also appointed a committee in March to determine whether Weber at that time was competent to make her own medical decisions.
Since that time Weber’s health problems have become more severe and a judge granted Weber’s husband Ray temporary guardianship of her Sept. 3 reversing an earlier decision granting her mother guardianship of her. The hearing determining her competency was postponed, however.
Despite the guardianship order, an injunction the judge issued in March to prohibit the feeding tube’s removal, remained in place, Tatro-Manes said.
“I wanted to let you know that Karen passed away last night of natural causes,” Tatro-Manes’ said in an email.”
Tatro-Manes said Karen Weber had several infections and her blood pressure had dropped in the past several days. The prognosis has not looked good, she said, and their mother, Martha Tatro, 80, had been at her bedside.
“I consider it a huge victory in that there are some causes you have to champion,” Tatro-Manes told the Witness in an interview. “What we wanted was that Karen not be killed by Ray’s hand, but she was taken by God who took her home.”
The attorney representing Martha Tatro, Joseph Rodowicz Jr., in a news release sent to the Witness, issued the following joint statement on behalf of Karen's family members, including her mother, sister, husband and children:
“Karen Weber’s heavenly father called her home to her eternal reward on the evening of Sept. 17, 2008. Her family knows she is in a better place. We look forward to meeting up with her again someday, but until then, she will be greatly missed as she was dearly loved by all of us.”
Okeechobee woman at center of Shiavo-like case dies of ‘natural causes’
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