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PVS Patients Communicate: BBC Report

A BBC Panorama Report to be broadcast later tonight, follows several patients in persistent vegetative state. It highlights the cases of two Canadian patients, Scott Routley and Steven Graham, who, whilst appearing to be in  persistent vegetative state (PVS)  have been able to answer questions, and even to show that they have laid down new memories.   Using fMRI scanners, Prof Adrian Owen and his team analyse the patients’ brain activity and say:

 “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.”

According to the BBC, Prof Bryan Young, Mr Routley’s neurologist said  “the scan results overturned all the behavioural assessments“:

“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.

Clinical criteria for PVS will clearly need to be revised in the light of this information. However, this research does not answer deep ethical questions about what should be done. These patients have profound brain injuries and their lives are extremely restricted. How will we evaluate their desires? What should we do if they wish to die? We will still need to do the ethical work to evaluate the implications of what they want, particularly whether they wish to live or die.

This is one step towards an answer to te question of how we should care for people with severe brain injuries, but it is not the solution. Not only do we need to know what they want, we also need to know how limited medical resources should be fairly distributed and what constitutes a rational desire to die.


Further Reading

  1. Savulescu, J. (2012), ‘Just Dying: The Futility of Futility’. Journal of Medical Ethics
  2. Wilkinson, D. and Savulescu, J. (2011) ‘Knowing when to stop: futility in the ICU’.  Current Opinion in Anaesthesiology April 2011 Vol: 24 (2) pp 160-165
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2 Comment on this post

  1. This makes even more urgent the ethical debate that some of us have been asking for for the past 10 years or more. Please see:

    Shame these people are using fMRI, instead of EEG or MEG, to read thoughts, as was published to be possible in 1975. Using EEG or MEG should enable him to say a great deal more than just “yes” and “no”, and without using a huge, expensive machine.

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