According to a study by the Coma Science Group of the University of Liège, Belgium, up to half the patients in an acute vegetative state regain some level of consciousness. Results of the study are also consistent with previous studies showing that at least 40% of patients deemed to be in a persistent vegetative state are misdiagnosed.
“The study showed how very hard it is to disentangle the minimally conscious state from the vegetative state,” says Dr. Steven Laureys. And in cases that health workers diagnosed as minimally conscious, 10% were actually communicating functionally.
Comparing past studies on this issue shows that the level of misdiagnosis has not decreased in the past 15 years. The results “should give great pause to those who advocate not supplying or quickly removing life support for people with traumatic head injury,” writes Wesley J. Smith, an attorney for the International Task Force on Euthanasia and Assisted Suicide.
Moreover “when family members claim that they detect signs of consciousness in their ‘unconscious’ loved ones, doctors should be less quick to assert that they are merely seeing ‘what they want to see.’”
Finally, “people ought to consider this problem when determining in an advance medical directive to have themselves dehydrated to death if they become permanently incapacitated” (North Country Gazette 6/21/07).
Researchers are seeking “markers that tell us whether we should increase our therapeutic efforts.” Patients who pass the initial functional magnetic resonance imaging (fMRI) could be followed up with electroencephalography (EEG) (Nature 2007:446:355).
“Of course, what really needs to be done is to reject the notion that people with severe brain injuries are somehow less ‘human’ or are not ‘persons.’ Unless and until we do that, people in these devastated states will not be safe,” Smith continues. www.wesleyjsmith.com/blog
In Arizona, Jesse Ramirez, Jr., became responsive about a month after a car crash that left him in a coma, and a week after food and water were restored. He had been five days without hydration or nutrition when his wife made the decision to disconnect his feeding tube. His parents and siblings filed a lawsuit to have the tube re-connected, and a guardian appointed by the court.
Ramirez was nearly dehydrated to death without lawful authority. Arizona statute reads that “a surrogate who is not the patient’s agent or guardian shall not make decisions to withdraw the artificial administration of food or fluid.” Ramirez’s wife, with whom he had a “tumultuous” relationship, did not have power of attorney.
Ramirez is now able to answer yes-or-no questions, nod his head, give a thumbs-up sign, and sit in a chair (Arizona Republic 6/27/07).
“Man Regains Speech After 19 Years in a Minimally Conscious State,” AAPS News of the Day 7/7/06.
“More Hope for Patients in Unresponsive States: Three Cases,” AAPS News of the Day 10/18/06.
[Association of American Physicians and Surgeons, Inc. 7/15/2007]