Friday, February 5, 2010

Study shows some people diagnosed as PVS can communicate

A study published in the New England Journal of Medicine entitled: Willful Modulation of Brain Activity in Disorders of Consciousness showed that 5 people who were diagnosed as persistent vegetative state (PVS) after traumatic brain injury, were capable of communicating while being tested with a MRI brain imaging scanner.

The study used brain scanning called functional MRI on 23 people diagnosed as PVS and 31 people diagnosed as minimally conscious.

The people were asked to imagine two situations. The first was standing on a tennis court, hitting a ball to an instructor with second being walking from room to room in their home. Since the two tasks produced different brain responses, the researchers were able to discover whether the person responded to the question and in one case they were able to communicate with the person by telling the person to image one situation if the answer to a question was yes and imagine the other situation if the answer to the question is no.

In reference to the person that the researchers were able to establish a Yes/No communication with, Dr. Martin Monti, one of the researchers, told the Associated Press:
“We were stunned when this happened. I find it literally amazing. This was a patient who was believed to be vegetative for five years.”

“It just says how much we can learn from looking directly at somebody’s brain.”

Dr. Adrian Owen, a co-author of the report told the Telegraph paper in the UK that the findings have enormous philosophical and ethical implications. He said:
“Not only did these scans tell us that the patient was not in a vegetative state but, more importantly, for the first time in five years it provided the patient with a way of communicating his thoughts to the outside world.”

“We can be pretty confident that he is entirely conscious. He had to understand the instructions, comprehend speech, and then make a decision. Obviously this fits into the issue of when patients to be allowed to die.”

The issue of PVS patients being dehydrated to death became a reality in 1993 when the British Courts approved the withholding of fluids and nutrition from Tony Bland, a man who had suffered a traumatic brain injury. Since that time families and medical teams in the UK have been deciding when it is or is not appropriate to dehydrate a PVS person to death.

Nicolas Schiff, a neurologist from Weill Cornell Medical College in New York, was quoted as saying to Reuters that the findings were a: "game changer" that could "have a profound impact across medicine."

If it can be proven that the person was misdiagnosed as being in PVS then it would be less likely that a decision would be made to allow the person to die by dehydration.

Allan Ropper of Brigham and Women's Hospital in Boston stated to Reuters that:
brain activation was detected in very few patients and only those with a traumatic injury, not in cases where the whole brain had been damaged by oxygen starvation.

In 2005, Terri Schiavo died by dehydration after her husband Michael petitioned the court to withhold all fluids and nutrition from her. She died in 13 days from dehydration in a case that divided many Americans.

Since Terri Schiavo was not otherwise dying, the act of directly and intentionally dehydrating her to death is considered by many, including myself, to be euthanasia by dehydration.

What this study proves is that we need to learn a lot more about people who are diagnosed with PVS. This study should also confirm that it is not our place to judge the quality of life of others, but rather to accept people with all types of disabilities.

Link to the Globe and Mail article:

Link to the Telegraph article:

Link to the article in the National Post:

1 comment:

Anonymous said...

What a shame, that people like Terri Schiavo were denied the opportunity and the basic Right to undergo a Functional MRI. The outcome might have been very different. Her life and the lives of others, are instead left in the hands of the ignorant. That's a Crime !

Gerry T.