Friday, September 08, 2006

Oops! My Bad. New info on vegetative state.

Scientists who assured us of the ethics of making life and death judgments on patients in a vegetative state are now not quite so sure.

AP starts out:

Advanced brain scanning uncovered startling signs of awareness in a woman in a vegetative state, British scientists reported Thursday - a finding that complicates one of medicine's ethical minefields.

It's an ethical minefield because lots of people in vegetative states have been treated as subhuman not capable of understanding or of feeling pain.

Slavery was an ethical minefield for those who thought the enslaved (barbarians, blacks, native populations) were not fully human.

Treatment of animals is an ethical minefield for those who believe animals don't feel pain in the same way as humans so it isn't real pain.

It's an ethical minefield for those who sat back and watched Terri Schiavo die of dehydration.

It's the first step towards an "Oops! My Bad." for those who are certain she and others like her are no longer there and feel no pain physically or emotionally.

A new study, using new techniques, has found that a woman in a vegetative state responds like you and me when given a task of imagining doing something.

Owen and colleagues contend their fMRI experiment showed the car-crash victim had some preserved conscious awareness despite her vegetative state.

How could they tell? First, they checked that she could process speech. Upon being told "there was milk and sugar in the coffee," the fMRI showed brain regions reacting the same in the woman and in healthy volunteers.

Then came the big test. Owen told the woman to perform a mental task - to imagine herself playing tennis and walking through her house. Motor-control regions of her brain lit up like they did in the healthy people he compared with her.

"There is no other explanation for this than that she has intentionally decided to involve herself in the study and do what we asked when we asked," Owen said in an interview.

But, until there is irrefutable evidence that all vegetative state patients respond in a similar way, some scientists don't want to give the benefit of the doubt to patients.

Other scientists say that's not clear-cut.

The results are "not totally convincing of consciousness," neuroscientist Lionel Naccache of INSERM, France's national science institute, wrote in a review in Science. He cautioned that the woman's injuries weren't as massive as those of most vegetative-state patients.

One wonders why Mr. Naccache is looking for "totally convincing" evidence. Maybe it's a scientist thing.

But one hopes that doctors, legislators (like our own Sen. Wyden who didn't take seriously the position of handicapped rights groups in the Terri Schiavo case) and judges (maybe even the Supreme Court) will take note. And maybe have the character to at least say, "Oops! My bad." for wrong decisions in the past.

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