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Is Anybody There?

Is Anybody There?

New studies demonstrate how people thought to be in an irreversible “vegetative” state showed signs of full consciousness.

by

Remember Terri Schiavo, the “vegetative” Florida woman who, as a result of her husband’s insistence and a court order (over her parents’ objections), was removed from life support and died in 2005?

“Vegetative” patients – people who, due to disease or accident, are unresponsive to stimuli – are considered by many to be less than truly alive.

Last year, though, a group of European scientists employed something called functional magnetic resonance imaging (fMRI), which shows cellular activity across brain regions, to demonstrate that four patients in a group of 54 diagnosed as vegetative were in fact hearing and thinking – and could actually communicate – answering yes-or-no questions about their lives – through mental effort.

And now, the prestigious medical journal The Lancet has published a study demonstrating that three severely brain-injured people thought to be in an irreversible “vegetative” state showed signs of full consciousness when tested with a relatively inexpensive, widely available method of measuring brain waves. The researchers used a portable electroencephalogram (EEG) machine, which picks up electrical brain activity in the brain’s cortex, or surface layer, through electrodes positioned on a person’s head.

The research team gave 16 “vegetative” people simple instructions, to squeeze their right hands into a fist or wiggle their toes when they heard a beep. The tasks were repeated up to 200 times.

In healthy people processing those instructions, the EEG picked up a clear pattern in the premotor cortex, the area of the brain that plans and prepares movements; the electrical flare associated with the hand was distinct from that associated with the toes.

Although the three supposedly vegetative people could not move their fingers or toes, their brains showed precisely the same electrical patterns.

Related Article: "Virtually Brain Dead"

Of course, even in the absence of evidence of any brain activity detectable by machines we have now no one can know what degree of consciousness persists in a body unable to move. But a diagnosis of “permanent vegetative state” can make it lawful to withdraw assisted nutrition and hydration – in other words, to starve the patient to death.

A different issue is “brain death” – a diagnosis of irreversible cessation of all brain function, which modern medicine and secular law consider sufficient to permit the “harvesting” of organs before removal of life-support. In the eyes of halacha, Jewish law, can such a patient, whose heart is still beating, in fact be considered a warm corpse?

Some rabbis say yes. But many of the most prominent halachic authorities, including Rav Shlomo Zalman Auerbach, zt”l, and Rav Yosef Elyashiv, may he live and be well, disagree. Leading halachic lights in the United States who concur with those halachic decisors, include Rabbi Herschel Schachter and Rabbi J. David Bleich.

Creative use of technology can act as a brake on the “progress” of the commoditization of human life.

(Halacha, to be sure, does not always insist that life be maintained; in some cases of seriously ill patients, even those with full brain function, it even forbids intercessions that will prolong suffering. But Judaism considers life precious, indeed holy, even when its “quality” is severely diminished. And so, halacha does not permit any action that might hasten the demise of a person in extremis. And, needless to say, it forbids removal of vital organs from a patient not deemed by halacha to be deceased.)

Back in 2005, Princeton University Professor of Bioethics Peter Singer was asked by The New York Times what today-taken-for-granted idea or value he thinks may disappear in the next 35 years. He responded: “the traditional view of the sanctity of human life.” It will, he went on to explain, “collapse under pressure from scientific, technological and demographic developments.”

The professor, unfortunately, is likely right about society’s regard for human life – particularly as life-spans increase, insurance costs rise, and demand for transplantable organs intensifies. Human beings run the risk of morphing from holy harborers of souls into… commodities.

Ironically, though, Singer may be wrong about technological developments. As events of late have shown, the creative use of technology can upend our assumptions about things like “vegetative” patients, and act as a brake on the “progress” of the commoditization of human life.

Would an EEG have yielded any sign of consciousness in Terri Schiavo’s unresponsive body? Doctors say it is unlikely, that her brain was likely too deeply damaged.

But of course we’ll never really know.

© 2011 AMI MAGAZINE

Published: December 3, 2011


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Visitor Comments: 19

(10) Heather, March 5, 2013 4:48 AM

response to article

This is a very interesting article & bless those who responded about the value of life. But I had one comment regarding the paragraph mentioning an increase in life-spans. According to the Torah, didn't people used to live alot longer? So haven't they actually decreased over time. Also, didn't they get by without all the advancements that we seem to rely on today? I've been taught that since school it's gotten longer, yet it doesn't really seem so acurate. I had relatives that lived into their 80's & 90's. But recently I have unfortunately seen many of my young friends & loved ones having multiple health issues in their 30's & 40's that weren't as prevalent yrs ago. I don't recall my parents having so many of their friends have cancer when they were young, yet I know many people from school all going through this.

(9) Ellen, December 2, 2012 3:31 PM

/Man in vegetative state communicates using power of thought.

Scientists have succeeded in communicating with a patient in a vegetative state. One of the articles about it: http://www.dailymail.co.uk/health/article-2232064/Man-vegetative-state-communicates-using-power-thought.html Those who are very positive about euthanasia imagine themselves in such a state, and it seems unbearable. But they do not know what it really means to the patient. Do they still feel bodily sensations? Have they been limited to pure thinking, or to a kind of lucid dream? It is at least as likely their experiences are positive or neutral, as negative. Just imagine living in a pleasant dream and hearing people plot to kill you - intending to spare you suffering you do not have - without being able to communicate with them and tell them to stop? Quite a nightmare, and who knows how often this has already happened?

Rachel22, January 1, 2013 12:21 PM

Terrible

This is an nightmare.. when this happend, and we know this is happend all the time..

(8) Dayna, December 27, 2011 9:36 PM

enjoyed the artical. Iwas in a coma and I remember yelling as loud as I could because it was dark and I wanted out of a terrible murder being played out, but i was in a vegetaative state and I was notgetting better.

(7) peter rogol, December 12, 2011 1:26 AM

Terri Schiavo's brain culd not have been conscious based on autopsy studies.

The point that I would emphasize is that persistent vegetative studies can occur in a variety of brain injuries and prognosis depends not only on there being a vegetative state, but also on the type of injury and the severity of the injure. Terri Schiavo's autopsy findings have been published and her brain was almost completely destroyed by liquefactive necrosis. Competent neurological evaluation determined that she did not have meaningful cognitive function. Whether the feeding tube should have been removed is a separate question. To claim that she was not assessed properly in terms of here neurologic function is not accurate. It is also misleading to claim that a small number of missed diagnoses invalidates all the correct ones. The means to be correct are available, as you pointed out, and should be used in the appropriate setting.

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