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gigi

Persistent Vegetative States

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gigi   

A 23-year-old woman who has been in a vegetative state since suffering devastating brain damage in a traffic accident has stunned doctors by performing mental tasks for them. Brain scans revealed that the woman, who has shown no outward signs of awareness since the accident in July last year, could understand people talking to her and was able to imagine playing tennis or walking around her home when asked to by doctors.

The discovery has astounded neuroscientists who believe it could have dramatic implications for life and death decisions over other patients diagnosed as being in a persistent vegetative state (PVS)...

Neuroscientists at the Medical Research Council's cognition and brain sciences unit at Cambridge and the University of Liege in Belgium used a brain scanning technique called functional magnetic resonance imaging (fMRI) to detect signs of awareness in the woman, the first time scientists have been able to do so in a PVS patient. The technique is now likely to become a standard way of determining how conscious vegetative patients are.

Check out the story here

The brain is such a crazy thing. Check this out, later in the same article:

The mysterious condition continues to confound scientists. In May, a team of British and South African doctors announced they had given sleeping pills to a PVS patient to help calm restless movements at night. The patient woke up 15 minutes later and was able to speak and even tell jokes.

Doctors have kept the patient on the pills, and believe it works by acting on part of the brain that had been shut down in response to the patient's original trauma.

Edited by gigi

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A 23-year-old woman who has been in a vegetative state since suffering devastating brain damage in a traffic accident has stunned doctors by performing mental tasks for them. Brain scans revealed that the woman, who has shown no outward signs of awareness since the accident in July last year, could understand people talking to her and was able to imagine playing tennis or walking around her home when asked to by doctors.

How do they know she was imaging these thngs? Did they have a screen that showed what she was thinking? I mean if she can talk/communicate (which is about the only way I can imagine them actually KNOWING she was able to imagine these things) how is that a persistent vegetative state?

Edited by Nezpop

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How do they know she was imaging these thngs? Did they have a screen that showed what she was thinking?

The brain-image comparison can be seen alongside this article.

a world of hurt and confusion I would be in now if I had opened that door.

Yes, but remember that there are many folks out there who probably are in a world of hurt right now, having made a difficult decision to end life in similar circumstances. This is not a time to for moralizing or piling on (I'm not saying that's what you're doing, but I suppose someone might feel pained by your statement) -- we simply don't know enough yet to make clear determinations. But it does give one pause.

I admit to feeling a little righteous indignation myself when I read this story this morning.

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Chashab   

Encouraging, yes.

But I'm skeptical of all of these kinds of things after the "experts" went back and forth on the whole Terry Schaivo (sp) thing. In fact, just a few months ago I heard another "expert" giving her two cents, even this long after.

Guess I'm just a skeptic in general some of the time, but things like the Schaivo banter don't help.

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How do they know she was imaging these thngs? Did they have a screen that showed what she was thinking?

The brain-image comparison can be seen alongside this article.

However, that doesn't prove the article's claims. It stated that she was *imagining playing tennis* and *imagining walking around her house*. How do they know that? The pictures show brain activity. That's all. They are making a major leap to declare what the woman was imagining.

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gigi   

I think it's also important to bear in mind that they are cautious that this patient was on the first steps to some sort of recovery.

I posted this more out of the questions that arise from it - I suppose philisophical holes regarding consciousness, etc. - rather than to credit or discredit the scientific rationale.

It actually doesn't particularly surprise me that this happens. The brain is capable of functioning on so many levels that we are simply completely unaware of. It's capacity for making us marvel and question by the very fact of its existence alone is, I believe, unlimited.

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I definitely understand. And I was not trying to shoot this down...but I just thought that was a big claim...I mean, I know I have seen sci-fi stuff where dreams appeared on a big screen...so I thought they were maybe announcing dual breakthroughs. :)

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The implications of this are both staggering and modest.

They are modest because, as has been pointed out already, they have not categorically established that this patient was thinking those particular things, and this does not mean that recovery is round the corner - or even inevitable. However, the evidence is strong. Here is a brain showing no discernible ordered activity. In response to two different verbal suggestions (imagine that you're playing tennis; imagine that you're walking through your house), specific areas of the brain flared into activity. With healthy control subjects, in response to the same two verbal stimuli, the same specific areas of the brain responded in the same overall way (and it's worth noting that the second stimulus invokes some additional areas of the brain - it's not the same response both times). Now we cannot be certain what qualia (experiences within the mind) that translates to - we cannot know how it felt to be the patient at the time - we can at least say that the brain of a patient in a 'vegitative state' is capable of responding in similar ways to those of healthy subjects.

The implications are staggering because it demonstrates that in a brain believed to be incapable of higher-level consciousness, something coherent can still take place. That opens the door to some extremely interesting research which has enormous potential.

It seems to me also that it raises an important question over the position of ethicisit Peter Singer in regard to what constitutes a person and how we ought to be able to act at the beginning and end of life. Singer maintains that what consitutes a person is self-consciousness and rationality - and this definition is more significant than the definition of a human being (for Singer, merely a being which has the genome for homo sapiens). At the beginning of life human beings are born without self-consciousness and rationality - and therefore do not have an automatic right to life. In cases such as the one we are discussing, the assumption has been that self-consciousness and rationality have now gone - the patient is no longer a person and has no automatic right to life. Since the patient is now simply a human organism rather than a person, withdrawing nutrition and water, or administering lethal injections, are ethically justified. What these results demonstrate is that our assumption that self-consciousness and rationality have disappeared is not valid. Now, it still leaves profoundly important and difficult ethical questions - not least because it doesn't do anything to challenge Singer's deeply reductive definition of personhood - but it will mean much more caution over making pronouncements about the 'vegitative' state.

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This is a lengthy excerpt from a longer piece. I've read only the excerpt and can't comment on additional light shed by the full article. But this ... this is amazing. A small sample:

 

In 2009, Laureys's team asked one of the original group of 54 patients that he and Owen had studied — patient 23 — a series of yes-or-no questions. It was the usual drill: Imagine playing tennis for yes, navigating the house for no. The patient, who had been in a vegetative state for five years, was able to answer five of six questions about his earlier life — and all of those were correct. Had he been on holiday to a certain place prior to his injury? Was such-and-such his father's name? It was an exciting moment, said Laureys. "We were stunned," adds Owen, who helped independently score the tests. "By showing us that he was conscious and aware, patient 23 moved himself from the 'do not resuscitate' category to the 'not allowed to die' category. Did we save his life? No. He saved his own life."

 

EDIT: Oh, wow. Pulled up this thread by searching "vegetative" but only realized after posting that the linked article refers, I think, to the earlier story that launched this thread. 

Edited by Christian

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