There is some evidence that not all vegetative states are the same:
http://news.sciencemag.org/brain-behavior/2014/09/man-apparent-vegetative-state-responds-hitchcock-clip
There definitely needs to be follow up studies like this to research patients in vegetative states. The fact that the brain responses were similar to a healthy brain during the show is amazing and surprising. I think this is a very resourceful way to test patients in coma like conditions. If there are studies that support this, there will be a need for clear classification procedures for coma patients to ensure that each patient is being protected and getting the best treatment. I think that this information could give the family a little hope to imply that they can consciously follow SOME visual stimuli. However, it makes it even more complicated about removing the ventilator or analyzing the chance of making a full recovery.
Brent, I definitely agree with your last remark on how this could complicate such ethical and medical questions. This could definitely make for some difficult decisions for the family, but overall is a good concept and idea so better-informed decisions can be made.
Brent, I too feel like you bring up some interesting points, especially about further research. This definitely would make it the decision to remove a ventilator or feeding tube more complicated if it was determined that a person in a coma or vegetative state is actually still functioning at the higher brain level. The medical ethics and moral implications involved with this could be dizzying to say the least. I am really interested to see where this research ends up!
This is a very interesting article and approach to determining whether a comatose patient is actually aware or not. I agree with some of the limitations listed towards the end, however, like some patients having injuries that prevent them from seeing or focusing their eyes. But, I still think that the basic concept is very exciting and could be adapted to be able to be used in more situations of potentially-vegetative patients to ascertain whether they are unaware or aware and possibly to enrich their life and environment in the latter case.
This article brings up the fact that we still don't know all that much about the brain. While lots of progress has been made over the last one hundred years, there is still so much we don't know about how the brain works. This study seems like a great precedent to determining a good system when determining where the line should be drawn in determining whether a patient is brain dead or not.
This article was so interesting and so on point to what my questions are as to patients in comas. In our first paper that we turned in to Dr. Cate, I discussed the difficulty that people in comas add to the mix in defining the definition of death. I also posted to the blog about wanting to ask our visiting ministers about this, but time did not permit. I personally hold to the high brain definition of death, but if people are being misdiagnosed as vegetative when, in fact, they have higher brain activity (like the man in the article) then allowing death to happen to them might be premature. Maybe they should be allowed to continue in end-of-life care. But for how long? Even if they are kept alive due to higher brain activity and awareness, does that necessarily mean they may snap out of it? This article now adds so many more questions to those I had before regarding this issue.
There definitely needs to be follow up studies like this to research patients in vegetative states. The fact that the brain responses were similar to a healthy brain during the show is amazing and surprising. I think this is a very resourceful way to test patients in coma like conditions. If there are studies that support this, there will be a need for clear classification procedures for coma patients to ensure that each patient is being protected and getting the best treatment. I think that this information could give the family a little hope to imply that they can consciously follow SOME visual stimuli. However, it makes it even more complicated about removing the ventilator or analyzing the chance of making a full recovery.
ReplyDeleteBrent, I definitely agree with your last remark on how this could complicate such ethical and medical questions. This could definitely make for some difficult decisions for the family, but overall is a good concept and idea so better-informed decisions can be made.
DeleteBrent, I too feel like you bring up some interesting points, especially about further research. This definitely would make it the decision to remove a ventilator or feeding tube more complicated if it was determined that a person in a coma or vegetative state is actually still functioning at the higher brain level. The medical ethics and moral implications involved with this could be dizzying to say the least. I am really interested to see where this research ends up!
DeleteThis is a very interesting article and approach to determining whether a comatose patient is actually aware or not. I agree with some of the limitations listed towards the end, however, like some patients having injuries that prevent them from seeing or focusing their eyes. But, I still think that the basic concept is very exciting and could be adapted to be able to be used in more situations of potentially-vegetative patients to ascertain whether they are unaware or aware and possibly to enrich their life and environment in the latter case.
ReplyDeleteThis article brings up the fact that we still don't know all that much about the brain. While lots of progress has been made over the last one hundred years, there is still so much we don't know about how the brain works. This study seems like a great precedent to determining a good system when determining where the line should be drawn in determining whether a patient is brain dead or not.
DeleteThis article was so interesting and so on point to what my questions are as to patients in comas. In our first paper that we turned in to Dr. Cate, I discussed the difficulty that people in comas add to the mix in defining the definition of death. I also posted to the blog about wanting to ask our visiting ministers about this, but time did not permit. I personally hold to the high brain definition of death, but if people are being misdiagnosed as vegetative when, in fact, they have higher brain activity (like the man in the article) then allowing death to happen to them might be premature. Maybe they should be allowed to continue in end-of-life care. But for how long? Even if they are kept alive due to higher brain activity and awareness, does that necessarily mean they may snap out of it? This article now adds so many more questions to those I had before regarding this issue.
ReplyDelete