January 23, 2020


Latest research on vegetative state calls for new civil rights movement (Charles C. Camosy, 1/22/20, RNS) 

Remember Terri Schiavo? She was a beloved daughter, sister and (new) wife when, in 1990, at the age of 26, she had a heart attack. Though she was revived and breathed on her own, Terri sustained significant brain damage and was deemed to be in a permanent vegetative state.

A big part of the debate that gripped the U.S. in the mid-2000s about whether to take Schiavo off of life support had to do with her Catholic upbringing. While her husband maintained that Schiavo wouldn't have wanted to live with the aid of a feeding tube, her parents and brother said she would have agreed with Pope John Paul II, who weighed in on her case, that food and water are care, not medical treatment, and are basic to respect fundamental human dignity.

But leave those issues aside for a moment. The received view both during and after the debate over Terri's case, especially if you thought that she ought to have her feeding tube removed, was that someone in a vegetative state essentially had the functions of a "vegetable." This turns out to be wrong, but you can be forgiven for thinking so: after all, given the term "vegetative state" that we've all been taught to use.

In the 15 years since Schiavo died -- an eternity in the world of medical research and technology -- much has changed. And what has changed should make us totally rethink fundamental questions about patients thought to be "vegetative."

Even before Terri died, in fact, folks who were forthright about our limited understanding of the brain and consciousness knew that permanent vegetative state, or PVS, was a sloppy and ill-defined category. In 2002, for instance, certain PVS patients were categorized as being in "minimally conscious state." In 2006, a dramatic study found that a PVS patient could be understood to answer yes or no questions by watching the patient's brain activity on a live scan while asking her to think about playing tennis to answer yes and walking in her house to answer no. 

In his 2015 book, "Rights Come to Mind," Joe Fins, an attending physician and chief of medical ethics at New York Presbyterian Hospital and Weill Cornell Medical College, tells deeply researched stories of several patients thought to be vegetative but who ended up in a very different place. 

The insuperable difficulty with the end of life decision is that all the parties to it have a financial interest.

Posted by at January 23, 2020 8:49 AM