Study finds some vegetative patients show awareness, raising ethical questions

"In a study certain to rekindle debate over life-sustaining care for those with grievous brain injuries, researchers report that five patients thought to be in a persistent vegetative state showed brain activity indicating awareness, intent and, in at least one case, a wish to communicate," The Los Angeles Times reports.

"Of 54 unresponsive patients whose brains were scanned at medical centers in England and Belgium, those five appeared able, when prompted by researchers, to imagine themselves playing tennis, and four of them demonstrated the ability to imagine themselves walking through the rooms of their homes." One 22-year-old male patient who had been unresponsive for five years responded "to a series of simple questions with brain activity that clearly indicated yes or no answers, researchers said."

The Times points out that in the United States as many as 37,000 are considered to be in a "persistently vegetative or minimally conscious state. ... Bioethicist Arthur Caplan said the study would complicate decisions about sustaining life in the netherworld between alertness and unresponsiveness" (Healy, 2/4).

The New York Times reports that the study, published by the New England Journal of Medicine, "does not suggest that most apparently unresponsive patients can communicate or are likely to recover. The hidden ability displayed by the young accident victim is rare, the study suggested. Nor does the finding apply to victims of severe oxygen depletion, like Terry Schiavo, the Florida woman who became unresponsive after her heart stopped and who was taken off life support in 2005 during an explosive controversy over patients' rights." Experts also said the new test was not ready for wide use. Still, there was agreement among experts that the study "exposed the limits of the current bedside test for diagnosing mental state" (Carey, 2/3).