Thursday, November 15, 2012

Man in Persistent Vegetative State answers questions via fMRI

From BBC:

A Canadian man who was believed to have been in a vegetative state for more than a decade, has been able to tell scientists that he is not in any pain. 
It's the first time an uncommunicative, severely brain-injured patient has been able to give answers clinically relevant to their care. 
Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine. 
His doctor says the discovery means medical textbooks will need rewriting.

There is abundant evidence that many patients in "Persistent Vegetative State" are aware and have complex mental states, despite being unable to communicate.

The diagnosis of PVS needs to be abandoned, because it is unreliable and it consigns a vulnerable group of severely brain-injured patients to neglect, abandonment, and even killing by starvation.

People with severe brain damage are fully human beings and persons, and should be treated with respect and compassion, with the assumption that they are aware of their surroundings and that they have internal mental states.

May we never do to another handicapped person what we did to Terri Schiavo. 


  1. " If I want to kill my relatives, that's my business. Butt out."

    Lizzie Borden was just ahead of her time.

    1. You know I was kidding around with you, right Egnor? I was trying to imitate the style, tone, and bloodthirstyness of the ideological opposition.


    2. @Ben:

      I knew. It was a good imitation.

  2. "People with severe brain damage are fully human beings and persons..."

    This is THE subject that drives atheists mad!

    Believing we are the result of chaos they cannot fanthom that we humans are first and foremost spiritual beings made in the image of God.

    What a sorry sorry bunch!

    (Let's pray for them)

    1. (Let's pray for them [atheists])

      Do you think (assuming, generously, Peepee can think), that your god will change his mind about atheists because you pray to it? What kind of god would pay attention to a miscreant like you?

    2. He isn't praying to change God's mind about atheists. He's praying to change your mind about God and the issue of killing society's unwanted human beings--the elderly, the sick, the unborn.

      God already knows about you. He sees you as his children, even if you don't recognize Him as your father. There's nothing to change there.


    3. Cool story, Pépé. You make absolutely no sense.

    4. He isn't praying to change God's mind about atheists. He's praying to change your mind about God and the issue of killing society's unwanted human beings--the elderly, the sick, the unborn.

      Why would God listen to Peepee? Peepee doesn't know me except for a few exchanges on this blog. If God wants to change my mind, what's stopping it?

      I also wonder why you would equate the elderly, the sick and the unborn with society's unwanted.

  3. Well, he's not in a Persistent Vegetative State. He's in a Locked-in-syndrome, which is a different condition with different treatment.

    Whenever a patient is diagnosed with PVS, the patient should be periodically reviewed and rediagnosed with the best methods available to ensure (as in this case) the horror of the misdiagnosis of a locked-in-syndrome is avoided.

    You've chided me in the past for using the colloquial expression 'brain dead' for PVS. Now you're doing the same thing, confusing two different neurological conditions.

    1. No, bach.

      Locked-in Syndrome is quite distinct from PVS. Locked-in is generally the result of a pontine stroke, and is associated with normal mental state and complete paralysis except for vertical eye motion.

      Evidence for awareness in PVS would lead to a diagnosis of Minimally Conscious State, which has nothing to do with Locked-in State.

      You gotta bone up on your neurology.

    2. Michael,

      Yes, it's a different condition, but one that's quite capable of being misdiagnosed as PVS, as in this patient. His parents had reported seeing him making small movements of a finger. Some patents with locked in syndrome can move their eyes. Some can't.

      It's important that whenever PVS is diagnosed, locked in syndrome is excluded, ideally periodically, with the best technology available.

      Personally, I'd prefer to have PVS than locked in syndrome, which I'd regard as hell on Earth.

      You gotta bone up on your neurology. For a neurosurgeon, you're pretty clueless about neuroscience. Remarkably so.

    3. bach,

      Patients in PVS can move, sometimes quite a lot.

      Locked in patients can't, except for vertical eye movement.

      Neurology 101.

    4. Michael,

      No, it's not Neurology 101. What are the movements that are made in PVS? Patients with locked in syndrome generally can't move at all, or just their eyes. It's dangerous to assume that if the patient can spontaneously make muscle contractions, such as grinding the teeth, that it's PVS, and if not, it's locked in syndrome.

      Patients with PVS should be diagnosed and periodically rediagnosed, to ensure that there's no awareness. And should be treated sympathetically as if there is awareness.

      As an aside, if you could determine that a patient with definite PVS has some awareness (and it's a continuum) and is able to communicate by some scientically objective method, and was able to indicate his desires clearly. If he clearly definitely indicates that he wants to have treatment withdrawn, or even actively killed with sedatives, would that person have the right to do so?

      I know you'll say 'No'. A person in your opinion doesn't have the right to cut short a personally intolerable existence, even if death is inevitable from the person's condition.

    5. No one has a right to kill, including the right to kill himself.

    6. Michael,

      ... And I was right. You don't think anyone is autonomous, able to make personal decisions for him- or herself. Consistent. Not that I'd agree with you.

    7. None of us are autonomous. Laws inherently constrain decisions.

      In my view, it should be illegal to kill any innocent person, even oneself.

      In your view, some innocent persons are killable, notably children in the womb, terminally ill people, and oneself.

  4. If you're a believer in an afterlife, an eternal heaven in the presence of Jesus, the holy spirit, your ancestors, your dead family and friends, the 42 virgins, surely you must also believe that someone in PVS would be better off dead. Right?

    1. No.

      They'll die in their own good time. It's not our job to help them get there. That's called murder.


    2. I'm not suggesting that anyone in PVS should be killed, unless that person had actively requested that (in writing, etc etc) before going into that state. No, I'm asking whether you believe that person would be better off dead.

    3. The answer is still no.

      I think you're confusing us with the Muslims. They're the ones with the virgins waiting for them in heaven.

      Killing people who requested it is still killing and it's still wrong.


  5. Michael Egnor: "No one has a right to kill [the correct term here is 'murder'], including the right to kill himself."

    bachfiend: "... And I was right. You don't think anyone is autonomous, able to make personal decisions for him- or herself. Consistent. Not that I'd agree with you."

    These God-denialist fools are something else, aren't they?

    They assert a worldview that, were it actually the truth about the nature of reality, must necessarily entail that there exists no one at all "able to make personal decisions for him- or herself". Some of them are logically consistent and openly assert that entailment -- at least, when it serves their purposes to be honest. Most of them are logically inconsistent, and deny the entailment -- and then call us Christians liars for consistently pointing out the obviously false consequences of their asserted worldview.

    Moreover, as we see with this fool 'bachfiend', they consistently refuse to understand the distinction between whether one is free to do wickedness and whether one has the right to do wickedness. As Mr Egnor rightly points out, no one has the right to murder any person, including himself.

    1. Ilion,

      Everything you've written is predicated on the assertion that god(s) exist. I argue that there's no evidence that god(s) exist, that there should be and as a result I conclude that god(s) don't exist.

      Hysterical diatribes insisting that mythical beings ban a person from voluntarily ending his or her life when it's no longer tolerable and is going to cause the death of the person soon anyway aren't convincing.

      Denying that there is a god, doesn't make me a 'fool', despite what Psalm 14:1 states.

    2. Looks like you hit a nerve, Ilion.
      The defence of the inconsistency of the reasoning and logic involved?
      A predictable rant about how he does not believe what he cannot see or understand followed by an inference that people have some sort of expiration date.
      Someone needs his ideological diaper changed!

    3. These fools like to boast that they are the Epitome Of Reason; but, in turth, actual reasoning is like kryptonite to them. So, hitting a nerve isn't at all difficult.

  6. A fool, digging himself deeper: "Everything you've written is predicated on the assertion that god(s) exist. ..."

    But, of course, this assertion is false (*). Everything I've written is predicated upon thinking critically about the worldview that the fool, 'bachfiend', asserts. Everything I've written is predicated upon treating this fool's asserted worldview *as though* it were the truth about the nature of reality, and noting some of the obvious absurdities which logically follow from it. And the last step is to recognize the logical necessity that as these absurdities are the logical entailments of the asserted worldview, then the worldview is itself absurd -- and thus, as the God-denialist worldview is logically and inescapably seen to be absurd, it is demonstrated to be false.

    (*) This fool is making the same deliberate error-of-reasoning that God-haters almost always make, as discussed in the last paragraph here: he is "reasoning" that since I arrive at the logical conclusing that God-denial is false, I simply must have started with that as a premise. In other words, he's falsely asserting that I "reason" in the same manner that he does.