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
(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.
(6) Shoshana, December 11, 2011 9:36 PM
Thou shalt not kill
I was very surprised to read that EEG is not used automatically in every such case. How else do they know if the brain is working or not? It is also surprising to read that so many people think that a person can decide to end a life. You see that R.H. said that she personally knows someone who recovered. What more do you need to hear than that? And a few years ago in Leniardo Hospial (Natanya) a man in a deep dead-like coma for seven months woke up and left the hospital the same day! And there are many other such stories. BUT all this IS IRRELEVENT. And It is not a matter of my opinion or the next guys, or his idea of ethics or someone elses. Nobody had a right to take another life even if he thinks that "this is not called life". G-d gives life and only He can take it away. We are not allowed to kill. Not for an organ, not to make more room in the hospital, not for any reason at all. So even if it seems wrong to keep the person alive, if Hshem says , "Live!" you live and if He says "Die" you die. And what is the purpose of life in this condition? The purpose is the fulfilment of the Devine will of your Creator, Who said Live! and therefore you live. And may we all make it until 120 in good health and happiness. Amen.
(5) Elana, December 5, 2011 4:44 AM
Things to think about...
And imagine...imagine being fully aware and being a prisoner in your own body for days and days at at time. Imagine that you are stuck in the dark and unable to communicate a single sound. Imagine that you have to rely on other people to change you and turn you and position you. Imagine getting bed sores on yourself because no matter how often someone comes to you to change your position, sometimes it happens because you are always in bed. Imagine not being able to scratch yourself if you felt itchy; how about wet? Soiled? This is a life? You would condemn a living breathing person to this? It is worse than prison!! If there is no chance in recovery...free them from their prisons...
Neta, December 6, 2011 3:55 PM
You are not describing a vegetative state
Elana, Although there are different causes of vegetative states, I don't think that any of them would fall into the category you describe, by definition. There are patients who are in that position but are not classified as vegetative. You should also note that for those patients who show signs of "consciousness", it is not what you would consider consciousness. They may have very simple type of awareness which is not continuous. For those people, I don't think they know or feel anything you describe. Thankfully!
Anon, December 7, 2011 2:11 AM
who gave you the right?
Who gave you the right to make this decision on behalf of a life that is not yours to take?
Rachel Ann, December 10, 2011 4:24 PM
What such knowledge calls for
Is better care of patients who are PVS; not only making certain they are physically cared for, but that they receive stimulation in patterns similar to a waking person. Quiet at night, stimulation such as conversation by nurses who come in to care for them, a television or radio program or shiur on during the day, music etc. Eventually it might be possible to connect the brain to various stimuli so the patient can turn them on and off him/herself, eventually perhaps even communicating. Humanity and love is the answer, not mercy killing.
(4) Anonymous, December 5, 2011 3:03 AM
Brilliant article. thank you!
(3) Dr. Harry Hamburger, December 5, 2011 2:53 AM
Value of life
The values that we cling to >reflect the people that we are >look down for diamonds in the dirt >or reach up for a star > >Life full of sorrow and pain >but gives a chance to learn >how to nurture and to grow >so that flame of emuna burns > >But times have changed our thinking >now for those with twisted minds >life has become pursuit of happiness >all material dreams they can find > >It matters not that deformed seed >has in future much to give >is only important what it lacks >so cannot be allowed to live > >For selfish convenience had to go >but memory will not pass away >when "merciful" mothers slay their children >will be shame of our days > >Do not ask me to understand >how people need to be free >I cry for a lost generation >for those who will never be
(2) ruth housman, December 5, 2011 1:49 AM
the grey ethical areas
Where to draw the line is an ongoing question of ethics, with people who weigh in on both sides of he issue. One of the very major reasons for helping someone die, has to do with quality of life, as a near vegetative state in terms of ability to do what we do, could be termed less than living. Certainly it's a decision and a weighty one to pull the plug on someone who cannot tell us their desires. Terrible pain which is intractable seems to be something that does impel those with humanity to consider acts of mercy. It seems we are entering a highly difficult area of ethics with respect to coma. And lately there has come into view a drug that seems to take people out of comas. A recent article in the New York Times Magazine, read in fact, quickly, before coming to this very article and worth perusing. I personally know of a man who was in a coma for one year and he's now quite functional, running his antique business and so it is possible for some to emerge from this state intact or fairly intactt. There are deep questions in the grey area of ethics wherever we turn, and we try, hopefully, to do our best to weight the issues and act in compassionate ways, but we can never truly know... I hope science never loses this concept of soul, of what's spiritual. I also do know we are meant to deal with the angst of very difficult, often seemingly unresolvable ethical issues. We do the best we can in weighting both sides.
(1) False, agenda driven, "science" at Aish again, December 4, 2011 8:16 PM
Deleted comment
This comment has been deleted.
Batsheva, December 5, 2011 9:54 AM
Uncited, unreferenced...
and yet you comment anonymously? Once you read all of this article, it is clear no wild assertion about Terry Schiavo was being made. However, the article's point about the cheapening of life in the absence of "quality of life" is right on target.
Miriam, December 5, 2011 3:42 PM
No, Aish is not agenda driven, the doctors and scientists are
Aish has an open mind, searching for the truth. Doctors and scientists have a definite agenda. Dare to clear your mind of subjectiveness and you will find the truth as well.
Chaya, December 5, 2011 7:07 PM
Last Sentence...
I guess you didn't read the last sentence before you wrote your comment. You just started reading, got upset and posted, the last line said.... "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"
Beverly Kurtin, December 5, 2011 7:21 PM
Terry
You said exactly what I was thinking about writing. She had nothing left; her mother's assertions that she heard Terry speaking was only her mother's wishes, her imagination, if you will. The usual hypocrites came out of the wood work thinking that if they just prayed enough Terry would wake up and walk out of her room. IF a person's brain has not been destroyed, there is always a chance that they could recover, but with no brain matter left, there is no chance whatsoever. I believe this article can be misconstrued to give false hope to people.
Neta, December 8, 2011 1:34 AM
Terry, I think you are missing the point of the article
I doubt that the Rabbi is attempting to provide a medical argument. I am sure that he is quite aware of the difference between persistent and permanent vegetative states, coma, etc. Just so that we are clear, let me also share with you that a Rabbi does have some pretty good logical grounding. Therefore he would be well aware of the argument you are presenting. It is necessary to have a brain to think, but it is not sufficient. So, if the requirement is necessary and sufficient then both must exist in order for something to be true. Thus, if half a brain is necessary for us to think (Schiavo case) and there is no half a brain then we have a problem. But, the Rabbi is quite aware of this argument. Obviously, you are not getting the "sufficient" part of this argument. What else is necessary for you to think? People who are blind from birth and then are given their vision still cannot see. Why? Their eyes are perfect but they cannot see. What is missing? My reading of the text is that as technology progresses the human being is becoming less and less sacred. We are becoming more like machines and we are treated as such. It seems as if we can no longer accept the old definitions of who we are but rather we need to have EEG's to define us before we pull the plug. Already the medical industry is using utilitarian ethics to determine our fate. That means if you are over 65 and the patient next to you is 30 and the two of you have the same problem then guess which one will get the treatment first? As soon as we begin to slander those who open up the debate we lose the forum. Really, whose side are you on? If Rabbi is arguing for life then whose side are you on?