For the first time, scientists have been able to show that patients who have been diagnosed as being in a persistent vegetative state are actually aware of their environment and can communicate.
In Science Magazine, British scientists have reported that advanced brain scanning showed that a 23-year-old woman who had sustained brain damage and serious head injuries in a car accident last July had startling signs of awareness.
Attorneys for the parents of Terri Schindler-Schiavo, the Florida woman who had sustained severe brain damage in 1990 as the result of a mysterious and suspicious incident at her home had sought the identical medical testing for Terri in February 2005, a month before her feeding tube was removed by court order which resulted in her death.
Pinellas County probate court judge George W. Greer had denied the motion and Terri’s estranged husband and guardian Michael Schiavo had refused to allow the testing.
By their denials, both Greer and Schiavo were in essence saying that Terri would not have wanted testing or treatment that could have helped her recover from the brain injuries that she had suffered under mysterious circumstances on Feb. 25, 1990.
Scientists had conducted experiments on the 23-year-old woman in Cambridge, England. The results suggest PVS patients can hear, understand and have a cognitive awareness.
Terri Schiavo had valiantly struggled to say that she wanted to live on the day her feeding tube was removed for the last time, but Felos, Schiavo and others claimed it was impossible.
According to the British study, it was not.
Scientists at the Medical Research Council’s Cognition and Brain Sciences Unit had used a functional MRI scanner to conduct experiments to determine if the woman’s brain had retained any functions. Five months following the accident, the woman had remained unresponsive although she continued normal cycles of sleeping and waking.
Dr. Adrian Owen led the research. While her brain was being scanned, the woman was asked to imagine she was playing tennis or walking around her home. Owen said that when the requests were made, distinct parts of her brain were activated(see above image), the same areas of the brain that were activated when healthy volunteers were asked to imagine the same thing.
Owens said that scientists knew from extensive research that “brain responses of this type do not occur automatically but require the willed, intentional action of the participant”.
Dr. Owens said that the results were startling and that they “confirm that, despite the diagnosis of a vegetative state, this patient retained the ability to understand spoken commands and to respond to them through her brain activity, rather than through speech and movement”.
Owen said that it was important to emphasize that “if we don’t see responses in a patient, it doesn’t necessarily mean they are not aware”.
“Future work will investigate whether the technique can be used more widely in these patients and whether this discovery could lead to a way of communicating with some patients who may be aware, but unable to move or speak”.
Owens cautioned that the results of the experiment are applicable only to the 23-year-old woman and that other PVS patients may not as responsive.
Nicholas D. Schiff, a neurologist at the Weill Cornell Medical College in New York said that the British study was very important and was the “first time we’ve seen something like this. It really is kind of shocking”. He stressed that much more work is needed.
Other scientists downplayed the findings.
Award winning author Wesley J. Smith, a senior fellow at Discovery Institute, a special consultant for the center for Bioethics and Culture and an attorney for the International Task Force on Euthanasia and Assisted Suicide, wrote in his blog, Secondhand Smoke, that “The description of the patient in question is startlingly similar to Terri Schiavo: “Scientists don’t even agree on whether the woman had some real awareness–she seemed to follow, mentally, certain commands–or if her brain was responding more automatically to speech.”
“These were the very kinds of tests that the Schindlers begged Judge Greer to permit to be given to Terri Schiavo, in the hope that a scan that measured function, would demonstrate more activity than tests that had been done measuring brain structure. Even though the tests would have caused her no possible harm, and might have found she had more awareness than most of the experts thought, Greer refused. And Terri was dehydrated to death”.
Smith said that “One apparently aware vegetative patient does not mean that other or all such patients are similarly cognitive. But it seems to me that this case provides a very urgent reason to find out, and find out fast. People are being dehydrated to death as you read these words because they are deemed non-persons due to perceived permanent loss of any awareness. If that isn’t so, if many or most of these people are aware, we had better find out”.
Last year, David Gibbs III, attorney for the Schindler family, said that “any action to end Terri’s life would be totally premature” and said that new medical testing should be done on the basis of the studies last year that indicated the possibility that brain injured people such as Terri, treated as though they are unaware of their environment and labeled in a persistent vegetative state, may in fact hear and understand what goes on around them but be unable to respond”.
The new British study supports Gibbs’ statement made a month prior to the Greer-Michael Schiavo killing of Terri Schindler Schiavo.
James Bernat, professor of neurology at Dartmouth College, had said the study findings last year were relevant to the Schiavo case and that a brain image test such as the one conducted on the British woman could have determined if Terri was in a persistent vegetative state as Greer has labeled her.
“Terri was alert, she was aware”, Terri’s father Bob Schindler Sr. said. “I think the bottom line was that Terri deserved to get these tests. It was unconscionable for Judge Greer or any other judge to order her death without these tests”.
The Schindlers maintained, backed by medical experts, that Terri was not PVS and could have improved with rehabilitation. Michael Schiavo, although being awarded over $1.5 from medical malpractice claims on the representation that he would provide rehabilitation services for his wife, refused to do so shortly after receiving the money and instead used the money earmarked for Terri’s therapy and recovery to be used for legal fees to obtain a court order to end her life. 9-07-06 North Country Gazette