Wednesday, November 14, 2012

Man In 'Vegetative State' Communicates With Doctors

Advances in Science

Scott Routley, a man who has been in a vegetative state for more than 10 years has communicated, through a technique of measuring functional brain images (fMRI), the answers to simple yes and no questions that Canadian doctors posed to him, says a Canadian Press article published in the National Post. This is a remarkable scientific breakthrough, marking the first time that this has ever been achieved. Linda Nguyen writes:
But now, for the first time, doctors caring for the 39-year-old London, Ont., man say they know he’s not in pain. And they learned it from Routley himself, by analyzing his brain waves when they asked him. “This was a landmark moment for us because for the first time, a patient can actually tell us information, important information about how they’re feeling and their current situation,” said lead researcher Dr. Adrian Owen on Tuesday.
The medical breakthrough, believed to be the only time a severely brain injured patient has been able to relay clinically relevant information to their doctors, is being touted as a new way to possibly improve their quality of care. Owen, who is the head of the Brain and Mind Institute at the University of Western Ontario, says research published online last year in The Lancet shows that one in five of these patients are conscious, but essentially trapped in their bodies because they’re unable to communicate verbally or physically.
His team has been working for the past year trying to determine whether Routley, who became vegetative following a car crash 12 years ago, had any “residual brain activity” and how much he was able to understand them. Last June, the doctors employed a functional magnetic resonance imaging machine (fMRI) to see if they would be able to analyze his brain patterns. They told Routley that they wanted him to imagine that he was playing tennis if he wasn’t in pain or imagine that he was walking around his house if he was in pain.
The thought process involved in playing a complex sport like tennis triggers the part of the brain that controls motor skills, while thinking about walking around your house triggers visual associations — contained in a separate area of the brain. With the fMRI, doctors were able to measure the activity in Routley’s brain and conclude he was trying to tell them he was free of pain.
The article adds that the family always believed that Scott Routley had an awareness of what was happening around him; this scientific findings proves that their feelings and intuitions were indeed correct. It is important to note that the vegetative state is a wakeful unconscious state; it is not the same as a coma (where the individual lacks awareness and wakefulness), but rather individuals in a vegetative state can open their eyelids and demonstrate sleep-wake cycles; they lack cognitive functions—at least in the traditional or conventional  sense.

This finding by Canadian doctors will likely now raise further legal and ethical questions on the viability of life and what standards ought to be used to define individual autonomy and to delineate the professional obligations of the medical establishment. Physicians and hospital ethics boards now have been given more information and knowledge on which to make their difficult life and death decisions. It now seems that life extends beyond the realm of what was previously considered as normative.

You can read the rest of the article at [National Post]