Imposed Death - Definitions / Euthanasia / Assisted Suicide / VSED

Vegetative State – Persistent or Reversible?

This is a very brief list of persons who have come forth from lengthy comas, or from persistent vegetative state. Other examples can be found in this website…

“Their inability to satisfy our longing for response does not justify abandonment or imposed death.”          

[“Persistent Vegetative State” Euthanasia: Imposed Death supplement, Human Life Alliance, 2004]

Comment: Eileen Doyle, RN compiled this remarkable list of cases and published this article in the 10/03 New York Nurses for Life newsletter. There are even more cases reported over the years but ignored by the media in the Schiavo case. And note these older cases excerpted from a 1991 American Life League article. There are many more, including the unpublicized ones I and other medical professionals have been seeing for years. [N. Valko, R.N.; http://www.all.org/legislat/guide04.htm]

Background: How Persistent is the “Vegetative State”?
An elderly woman named Carrie Coons stunned the medical world.

The following anecdotal life stories are placed in perspective by the professional study of recovery rates from PVS. 

A study, published in the Archives of Neurology, followed 84 patients with a “firm diagnosis” of PVS.

Of these patients, “41% became conscious by 6 months, 52% regained consciousness by 1 year, and 58% recovered consciousness within the 3-year follow-up interval.”

The researchers were unable to identify “predictors of recovery from the “vegetative state” — that is, there is no established test by which we can tell in advance which PVS patients will ultimately wake up. The data “do not exclude the possibility of vegetative patients regaining consciousness after the second year,” though this “must be regarded as a rare event.” [Levin, Saydjari, Eisenberg et al., “Vegetative State After Closed-Head Injury: A Traumatic Coma Data Bank Report,” 48 Arch. Neurol. 580-585 (June 1991)] Life at Risk, December 1991 (ALL article) Also reported in British Medical Journal, 8/92: 304-305.

Studies show that PVS patients feel pain. Indeed, a University of Michigan neurologist, in one of the most complete studies, concluded that, when food and fluids are withdrawn [to impose death], the patient should be sedated. [Detroit Free Press, 26June90, page 10A]

Eliminate the Pain, Not the Patient

Though unconscious for five-and-half months and diagnosed as being in an irreversible “persistent vegetative state” (PVS), Ms. Coons unexpectedly woke up and began speaking — just a few days after a judge had issued a court order allowing her family to have her feeding tube removed so she could die.

Carrie Coons ultimately died in late November 1991, never having recovered sufficiently to leave the nursing home where she had been cared for while unconscious. But the issues raised by her case live on.

Three events have newly dramatized the uncertainties of medical decision making for incompetent patients:

1. On December 17, Barbara Brashers of Missouri unexpectedly woke up from a “vegetative” state that began in October 1989 after surgery to correct a brain aneurysm. When she first became unconscious a CT scan indicated she had 70 percent brain damage. Reportedly she can now speak in full sentences, recognize and converse with friends and family, and even recall events that took place while she was supposedly unconscious. [J. Spivak, “He never gave up — and she came back,” Kansas City Star, 12/20/91]

2. Nathan Rasmussen, a 17-year-old student in Fairfax, Virginia who fell into a “vegetative state” after receiving head injuries in an auto accident in May, made what his doctor calls a “remarkable recovery” in December and was able to return home for Christmas. Reportedly he can “walk, run, ride a bicycle and carry on a normal conversation” and will soon be able to continue his education. [R. Herman, “Fairfax Teen Goes Home in ‘Remarkable’ Recovery,” Washington Post 12/26/91]

3. Barbara Rozmester of New Jersey was in a coma for 19 days after a blood clot stopped her heart and starved her brain of oxygen on December 5. “The doctors did not offer the family much hope at all,” says a hospital official The 30-year-old woman revived on Christmas Eve and was able to speak, move and open Christmas gifts with her family. [“Comatose woman regains consciousness,” Camden Courier-Post, 12/27/91]

NEW YORK STATE NURSES FOR LIFE, INC. newsletter, October, 2003
(28 Rockville Ave., Rockville Centre, NY 11570)

COMA RECOVERY – A RARE EVENT?

As the health care profession moves rapidly towards a quality of life ethic, many coma patients may be written off as hopeless too soon. Treatment is stopped and feeding tubes pulled consigning the patient to death.

The following are some stories of patients who have recovered from comas.

“Recovery from Coma Is a Reality for Many Patients” is the title of an article by Liz Townsend in National Right to Life News. October 2001. The author reports on the work of Dr. Mihai Dimancescu, chairman of the board of the Coma Recovery Association. He defines coma as “a state of unresponsiveness from which an individual has not yet been aroused.” He asserts that many patients emerge from comas, even after months in that condition. Some patients in a coma are totally unaware while others may be partially or even totally aware of their environment but unable to communicate it to others – called a “locked in state”.

Dr. Dimancescu says that medical science cannot determine why most
comas occur or predict which patients will recover. He says that patients who have been in a coma for seversal weeks do have the potential for recovery: “New connections can be made between brain cells where connections have been lost. Parts of the brain take over
the function of other parts that have been lost.”

But he says that patients have to be given the time to awake from coma and many in the medical commmunity, especially with older patients are too eager to convince the family to stop treatment too soon and discontinue the feeding tube and cause death by dehydration and starvation.

As we reported in our March 2000 Newsletter, a Newsday. 6/26/96 account of Dr. Dimancescu’s “sensory stimulation” program which bombards patients with sounds, noises, smells and touch to stimulate the senses. In a 1993 article Dr. Dimancescu stated his program “produced a 91% arousal rate for prolonged coma patients compared to traditional medicine’s 10% rate of arousal. He has treated 900 to 1000 patients over the years.

Judy’s Story – Judy had been in a coma for 3 months. On medical rounds the professor told his medical students, “She’s in a coma. She’ll never wake up”. When Judy proved his prediction wrong and came
out of the coma she said she “always remembered that darn professor, refusing to stop by her bed, saying she would not wake up!”

Brian Cressler’s Story – Brian was in a coma for I8 months as a result of a car accident in June 1991. His  parents took him home in January 1992. “He couldn’t move or talk, his eyes locked in a blank stare”- ‘a look that went right through you’ said his mother. His parents took care of him with the help of a physiotherapist to prevent muscle atrophy. After a year and a half, “they noticed a change.” His mother said, “You could see a slow awakening. It was like he was talking through his eyes, they just came alive
.” Six mon
ths later he said his
first word, “Mom”. It was ‘pure joy’ said his Mom.

Patricia White Bull’s Story – Patricia had been in a coma for 16 years after giving birth to her son, Mark. On Christmas Eve, 1999, while nurses were fixing her bed, she suddenly said: “Don’t do that!” By January “she was able to speak clearly and visit with her four children.”
Man Awakes from 19 Year Coma – This report is by Alice Stewart, posted on the Internet 7/2/03 (www. kark. com/kark tv/news/story).

Terry Wallis’Story – Terry and his wife were celebrating the birth of their daughter. Amber. Then tragedy struck when he went for a ride with his friend in 1984. The next day their bodies were found under a bridge. His friend died and Terry’s injuries left him a quadriplegic and in a coma that lasted almost 20 years! He was moved to a nursing home and received “round the clock care.” His family came to visit often. All those years the whole family missed out on his company. “Then after 19 years of silence…Terry spoke his first word. He said ‘Mom’.”

The author reports that most of his time was at a rehab center and “his family took him out on weekends and special occasions. The doctor said that’s why he remembers things, we might have kept his
mind going.” The family urges others with a loved one in a coma to “keep the faith and never give up”.

Locked-in State – An article in Psychology Today, Sept/Oct 2002 by Patton Howell and James Hall tells the story of a patient suffering from a “locked-in” state.

James Hall’s Story – James suffered a rare type of stroke in 1991. It seemed he had “no cognitve ability or awareness after the stroke”. But one of James’ friends had learned from a doctor about people who had a “locked-in” syndrome who could live “for years- unfortunately” said the doctor. Fearing that his friend James would be “killed off as medical professionals exerted pressure on the family”, Patton Howell and another of James’ friends were determined to find a way for James to communicate. They were “persistent and creative” and successful and invited the hospital staff to observe the results. They asked James to tell the staff “I want to live” as a clear message.

However the message that James typed was “I DEMAND TO LIVE
A—OLE” as a “direct message to medical professionals in the room who had been expressing the opinion that keeping him alive was pointless.”

Man Awakes from a 7 Year Coma – A Florida Sun Sentinel article by the Associated Press, 9/7/02 reported this account of coma recovery.

Peter Sana’s Story – Twenty seven year old Peter Sana went into a coma as a result of meningitis in March 1995. He has been in a Honolulu nursing home all these years but he began “responding to the commands from his nurse over the last month. The nursing home staff
says regular visits from his family over the years played a large part in his recovery. Sana’s father visited every day.”

A Nurse’s Testimony – In the November 2001 Newsletter Nancy Valko, RN, President of Missouri Nurses told us two stories about some of her patients given up as hopeless.
Katie’s Story – Eighty four year old Katie was in a coma after a massive stroke and doctors recommended to her out-of-town family that she be allowed to die. Nancy met her on the oncology unit where she was working and was told Katie was totally unresponsive. But Nancy had been “an advocate of talking to comatose patients and
many of them unexpectedly ‘woke up’ or improved.”

The nurses spent a lot of time caring for Katie and within a few weeks she started “to respond and even to speak. “One day Nancy gave Katie a doll and as she clutched the doll constantly she became less confused. Then “they began a kind of ‘charm school’ for her having her say ‘please and thank you’. She was no longer confused, recovered her long-term memory and began to feed herself with a spoon. Sadly Katie was tranferred to another unit and began to regress without  the ongoing loving support of Nancy and the other nurses. Nancy ends the story with this conviction: “I have seen the power of labels such as ‘hopeless’ or ‘difficult’ when applied to patients and I have seen the
power of affirmation even save a life.”

Chris’ Story – Nancy tells another life story about a 19 year old girl brain-injured in a car accident 6 months earlier. Eventually Chris came off the ventilator but was considered by the doctors to be in a hopeless vegetative state. The choice was between removing the
feeding tube and letting her die or transfer to a nursing home. Nancy was called by the mother for help. So Nancy worked with Chris for about half an hour once a week. Now Nancy says “Chris is conscious, smiles, cries, moves her legs on command, turns her head to
look at people talking to her and now appears to be trying to vocalize.”

Nancy recommended to the other nurses Jane Hoyt’s pamphlet, “A Gentle Approach Interacting with a Person who Is Semi-conscious or Presumed in a Coma”. (This pamphlet is available from
N.Y. State Nurses for Life on request.)
(A longer version is online at: www1.umn.edu/phrm/pub/hoyt.html
N Valko, R.N.)

Ron’s Story – Nancy’s report on another patient. Ron was brain-injured three years ago and will be going home soon. His Mom has applied for a median nerve stimulator. His improvement has not been as “spectacular as Chris’ but his face crinkled up as if he was ready to cry when his Mom and I were leaving recently. I was amazed,” says Nancy.
(Update on Ron: As I sent in a previous email, Ron’s parents are being prevented by a Missouri Court from being named Ron’s guardians even though Ron’s wife divorced him 1 1/2 years ago and the parents are named as second in line for guardianship. This is because Workman’s Compensation refuses to cover his care in Pennsylvania, where Ron’s parents live. A local TV station is doing an investigative report on Ron’s case which is scheduled to appear soon and I will be sending this out. Ron’s case shows the legal, rehab and insurance bias against people with severe brain injuries even beyond the “right to die” issue. Nancy Valko, RN)

What have we Iearned from these stories of remarkable recoveries of “hopeless” patients? The one common denominator is that they all had families and/or nurses who never gave up hope and stood by them through their long ordeals.

http://www.rgj.com/news/stories/html/2003/11/22/57458.php

[several excerpts from “Persistent Vegetative State” Euthanasia: Imposed Death supplement, Human Life Alliance, 2004]