Man thought to be in a vegetative state able to communicate with doctors

ECM sent me this article from the BBC that may cause you to re-think your beliefs about people in “vegetative” states.

Excerpt:

A Canadian man who was believed to have been in a vegetative state for more than a decade, has been able to tell scientists that he is not in any pain.

It’s the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care.

Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine.

His doctor says the discovery means medical textbooks will need rewriting.

[...]Mr Routley suffered a severe brain injury in a car accident 12 years ago.

None of his physical assessments since then have shown any sign of awareness, or ability to communicate.

But the British neuroscientist Prof Adrian Owen – who led the team at the Brain and Mind Institute, University of Western Ontario – said Mr Routley was clearly not vegetative.

“Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is.”

[...]Scott Routley’s parents say they always thought he was conscious and could communicate by lifting a thumb or moving his eyes. But this has never been accepted by medical staff.

Prof Bryan Young at University Hospital, London – Mr Routley’s neurologist for a decade – said the scan results overturned all the behavioural assessments that had been made over the years.

[...]“I was impressed and amazed that he was able to show these cognitive responses. He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful.”

It seems to me that an increasing number of people in society are turning away from the idea that human life is sacred because it is made in the image of God, and towards the idea that human life has value so long as powerful people think it has value. You can see it easily in the abortion debate where an entire category of humans are deemed “subhuman” because they impost obligations on a stronger group of people. Basically, the right to happiness of the strong trumps the right to life of the weak. I don’t think that life is about feeling happy thought.  I think that life is about doing the right thing.

Filed under: News, Brain, Health-care, Medicine, Mind, Persistent Vegetative State, PVS, Science, Terri Shiavo, Vegetative State

EEG device detects consciousness in persons in persistent vegetative state

Here’s an interesting article from the New Scientist.

Excerpt:

Signs of consciousness have been detected in three people previously thought to be in a vegetative state, with the help of a cheap, portable device that can be used at the bedside.

“There’s a man here who technically meets all the internationally agreed criteria for being in a vegetative state, yet he can generate 200 responses [to direct commands] with his brain,” says Adrian Owen of the University of Western Ontario. “Clearly this guy is not in a true vegetative state. He’s probably as conscious as you or I are.”

[Owen's team] devised a test that uses the relatively inexpensive and widely available electroencephalogram (EEG).

An EEG uses electrodes attached to the scalp to record electrical activity in the brain.

Owen and his team used an EEG on 16 people thought to be in a PVS and compared the results with 12 healthy controls while they were asked to imagine performing a series of tasks.

Each person was asked to imagine at least four separate actions – either clenching their right fist or wiggling their toes.

In three of the people with PVS, brain regions known to be associated with those tasks lit up with activity, despite physical unresponsiveness. This suggested to the researchers that the subjects were carrying out a complex set of cognitive functions including hearing the command, understanding language, sustaining attention and tapping into working memory.

“It isn’t the case that just because somebody doesn’t respond they’re not conscious,” Owen says. “There’s a growing body of data now demonstrating that many of these patients aren’t what they appear.”

The rest of the article talks about how the scientists are planning to use their new technique to communicate with patients by asking them to think of specific things which will mean “yes” or “no”. The long-term goal is to get the patients to be able to communicate, perhaps even allow them to move a mouse pointer by triggering reactions in their brains by using their thoughts.

I think this research dovetails nicely with the OCD research I mentioned before. Maybe now would be a good time to talk more about that research.

William Dembski discusses the OCD research of Jeffrey Schwartz.

Excerpt:

Schwartz provides a nonmaterialist interpretation of neuroscience and argues that this interpretation is more compelling than the standard materialist interpretation. He arrived at this position as a psychiatrist specializing in the treatment of obsessive-compulsive disorder (OCD). OCD sufferers recognize obsessive-compulsive thoughts and urges as separate from their intrinsic selves. For instance, after a few washings, the compulsive hand-washer realizes that his hands are clean and yet feels driven to keep washing them. It was reflection on this difference between the obvious truth (the hands are clean) and the irrational doubts (they might still be dirty) that prompted Schwartz to reassess the philosophical underpinnings of neuroscience.

From brain scans, Schwartz found that certain regions in the brain of OCD patients (the caudate nucleus in particular) exhibited abnormal patterns of activity. By itself this finding is consistent with a materialist view of mind (if, as materialism requires, the brain enables the mind, then abnormal patterns of brain activity are likely to be correlated with dysfunctional mental states). Nonetheless, having found abnormal patterns of brain activity, Schwartz then had OCD patients engage in intensive mental effort through what he called relabeling, reattributing, refocusing, and revaluing (the 4 Rs). In the case of compulsive hand-washing, this involved a patient acknowledging that his hands were in fact clean (relabeling); attributing anxieties and doubts about his hands being dirty to a misfunctioning brain (reattributing); directing his thoughts and actions away from handwashing and toward productive ends (refocusing); and, lastly, understanding at a deep level the senselessness of OCD messages (revaluing).

Schwartz documents not only that patients who undertook this therapy experienced considerable relief from OCD symptoms, but also that their brain scans indicated a lasting realignment of brain-activity patterns. Thus, without any intervention directly affecting their brains, OCD patients were able to reorganize their brains by intentionally modifying their thoughts and behaviors. The important point for Schwartz here is not simply that modified thoughts and behaviors permanently altered patterns of brain activity, but that such modifications resulted from, as he calls it, “mindful attention”-conscious and purposive thoughts or actions in which the agent adopts the stance of a detached observer.

It turns out that people can freely choose to exert “mental effort” in order to change what their brains are doing.

By the way, if you like this topic, and want a resource to show your friends, be sure and get a hold of the debate on mind vs. brain between Jeffrey M. Schwartz and Michael Shermer.

Filed under: News, Afterlife, Body, Brain, Consciousness, Denyse O'Leary, Determinism, Dualism, EEG, Evidence, Free Will, Intelligent Design, Jeffrey M. Schwartz, Jeffrey Schwartz, Mario Beauregard, Materialism, Mental, Mental Causation, Mental Effort, Mind, Mindful, Mindful Attention, Mindfulness, Nuns, OCD, Persistent Vegetative State, Physical, Physicalism, PVS, Religious Experience, Research, Soul, Study, Substance Dualism, Treatment

How reliable are persistent vegetative state diagnoses?

Check out this article from The Weekly Standard. (H/T ECM)

Excerpt:

The case of Terri Schiavo–who died five years ago next March, deprived for nearly two weeks of food and water, even the balm of ice chips–continues to prick consciences. That may be one reason the case of Rom Houben, a Belgian man who was misdiagnosed for 23 years as being in a persistent vegetative state, is now receiving international attention.

In 1983, Houben suffered catastrophic head injuries in an automobile accident. He arrived at the hospital unconscious. Doctors eventually concluded that his case was hopeless, and his family was told he would never waken. But the Houben family, like Terri’s parents and siblings, didn’t give up. They diligently sought out every medical advance. This wasn’t delusion or pure wishful thinking. Several studies have shown that about 40 percent of persistent vegetative state diagnoses are wrong.

[...]During the years that Houben was thought unconscious, society changed. Bioethicists nudged medicine away from the Hippocratic model and toward “quality of life” judgmentalism. Today, when a patient is diagnosed as persistently unconscious or minimally aware, doctors, social workers, and bioethicists often recommend that life-sustaining treatment–including sustenance delivered through a tube–be withdrawn, sometimes days or weeks after the injury.

One thing that stands out to me about this story is how the medical profession has accepted the idea that it is OK to kill people who do not have a high enough quality of life. What is behind this view? Well, I think it’s caused by secularism. Secularism has marginalized the Christian worldview that dominated the West. One component of that Christian worldview is that it is morally good to deny yourself happiness to care for the needs of others. And that the right thing is not based on your opinion or the arbitrary views of the majority of people in your culture.

On the secular worldview, though, there is no “right thing” that we “ought to do”. The universe is an accident and there is no design. The only thing to do on an atheistic worldview is to be “happy”. And you can’t be happy if other people need you to take care of them. So, I think that this is what is behind the push by secularists to kill the weak and stop them from using up resources. Secularists look at people who need them, and they want to kill them. There is no objective duty of self-sacrifice for others, on atheism.

Christopher Hitchens is fond of asking people he debates to name one thing that a Christian can do that an atheist can’t do. Here’s one: an atheist can’t rationally ground the decision to sacrifice their own pursuit of happiness to take care of the needs of others. On atheism, self-sacrifice is irrational, unless it makes you happy. You only have one life. There is no way you ought to be. The purpose of life is to be happy. The needs of the weak diminish your happiness. It’s survival of the fittest. That’s what is rational on atheism.

UPDATE: I just got back from breakfast at Denny’s and I was reading Jennifer Roback Morse’s “Love and Economics”. She was talking a lot about the helplessness of babies, and what mothers and fathers do that make children grow up capably. She writes that early on in the baby’s life they scream for everything and the mother has to be there to meet those needs or the child will never learn to trust. Later on, the parents try to encourage the child to be better-behaved and self-sufficient.

All this made me recall this post. If a selfish person believes that it is too much work to care of someone sick who needs extra love, then that person isn’t going to be willing to take care of babies, either. And I guess that’s exactly where we are as a society now, with people having fewer babies, but more abortions and day care. And of course people divorce when they have small children as well, which (usually) deprives the child of a father.

Filed under: Commentary, Bioethics, Coma, Compassion, Conscious, Consciousness, Culture of Death, Dependent, End of Life, Ethics, Euthanasia, Life, Love, Medical Ethics, Morality, Persistent Vegetative State, Pro-Life, PVS, Quality of Life, Right to Life, Rom Houben, Secularism, Terri Schiavo, Vegetative State

Man thought to be in vegetative state was actually conscious the whole time

Story from the UK Daily Mail. (H/T Ace of Spades via ECM)

Excerpt:

A man thought by doctors to be in a vegetative state for 23 years was actually conscious the whole time, it was revealed last night.

Student Rom Houben was misdiagnosed after a car crash left him totally paralysed.

He had no way of letting experts, family or friends know he could hear every word they said.

‘I screamed, but there was nothing to hear,’ said Mr Houben, now 46.

Doctors used a range of coma tests, recognised worldwide, before reluctantly concluding that his consciousness was ‘extinct’.

But three years ago, new hi-tech scans showed his brain was still functioning almost completely normally.

[...]Mr Houben said: ‘I shall never forget the day when they discovered what was truly wrong with me – it was my second birth.

‘I want to read, talk with my friends via the computer and enjoy my life now that people know I am not dead.’

What are we to make of the Terri Schiavo killers now? Is it morally praiseworthy to advocate for getting rid of inconvenient people? Shouldn’t we look on the misfortunes of others as opportunities to act out our love and compassion for our fellow man? Doctors can be wrong in their diagnoses.

Filed under: News, Coma, Compassion, Conscious, Consciousness, Culture of Death, Dependent, Euthanasia, Life, Love, Persistent Vegetative State, Pro-Life, PVS, Right to Life, Rom Houben, Terri Schiavo, Vegetative State

Bobby Schiavo urges caution on persistent vegetative state diagnoses

Story here from TownHall. (H/T Secondhand Smoke via ECM)

Excerpt:

To be clear: there is no indignity more final and brutal than forcing a living person to die the death of dehydration and starvation. Try to imagine the torture my sister endured in the last two weeks of her life. Being unable to defend herself, very likely aware of precisely what was happening and having absolutely no ability to escape it. For nearly two weeks, Terri was denied food and fluids. Not so much as an ice chip was given to her. It was pitiful, it was barbaric and it was clear that she was made to suffer. When my sister expired, she was a shell of her former self.

It is because of the suffering my sister and others endured that I believe the PVS diagnosis must be either reevaluated or completely abolished. With so many medical and neurological professionals admitting that there are inaccuracies and with the diagnosis being a death sentence, it is time to rethink disability and the way we regard it and our fellow human beings.

It is not too much of a burden to provide sick people with food and water.

Filed under: News, Bioethics, Bobby Schiavo, End of Life, Euthanasia, Medical Ethics, Persistent Vegetative State, PVS, Terri Schiavo