Vegetative Patients May Be More Aware Than We Knew

I've always been told by my parents that people can still hear and understand even if they appear unconscious or non-responsive, and so I have a personal policy of speaking respectfully toward them just the same as if they were alert and responding and part of the conversation, but it has shocked and amazed me (and saddened me) by what some people say in the presence of a living person who can very possibly hear and understand but may not be able to respond. Be careful not to be cruel to people in that situation!

That actually doesn't sound like a good thing. If I became a vegetative patient, I'd rather be completely unconscious and consider it a prolonged deep sleep than be aware and perceive but unable to move. Often just slipping away into that long sleep is the better option — the trauma that causes someone to become vegetative is usually rapid and without pain.

> More than a year after Aaron’s collapse, a year of hospitals and nursing homes, Tabitha still believed that her husband was probably aware and improving, though not a single clinician had raised the possibility that he might be. It made her wonder how doctors could know about a thing, covert consciousness, for 20 years, but still go about their work as if they didn’t. And not explain any of it to patients and their families. “I think they don’t want to give you false hope,” she says. So they try to make sure that you don’t hope at all.

I wouldn't be shocked if many doctors she encountered just weren't up-to-date on the latest findings; even if they were, I can understand why they might not have mentioned it, for all the ethical dilemmas and general uncertainties outlined in this piece. But it really is a heartbreakingly difficult situation all around.

Another story that's stuck with me (although this is about brain death, which is different from a persistent vegetative state but is surprisingly thorny to define--different jurisdictions have different criteria, and some even allow for religious objections to legal death): https://www.newyorker.com/magazine/2018/02/05/what-does-it-m...

How arrogant to subvert the "scientific we" to presume to know things that you cannot ever empirically know through the scientific method.

No, "we" never knew how "aware" these patients were. Speaking for myself personally, I never knew; I've never been in a PVS but I do affirm that any person who is in a PVS deserves dignity, the right to life, and the right to ordinary sustenance, such as food and hydration.

I lived through the very traumatic case of Terri Schiavo, whose husband hated her guts and really, really needed her to die ASAP. But I only recently learned of Karen Ann Quinlan, whose parents were quite devout and merciful, and had perceived that the "treatment" (a breathing tube) was causing much discomfort and distress to Karen, yet the medical establishment insisted that removing the tube would be "MURDER" and they engaged in a protracted legal battle against the "MURDEROUS PARENTS" who simply wanted them to withdraw this barbaric medical treatment.

https://en.wikipedia.org/wiki/Karen_Ann_Quinlan

Karen's level of cognizance was fairly obvious to any observer: that she was feeling pain and distress, that she was capable of emotion and rational response to stimuli, and that changing those stimuli resulted in distinct changes in her responses. That much is true.

Karen Ann Quinlan's quality of life improved immensely after the tube was removed. She began breathing on her own. She lived a good life (in a PVS) for a significant period of time and was not, in fact, ever murdered by her loving parents or by her physicians.

please take a look at the video in the article. This man can keep his eyes open and even move his mouth (maybe just randomly behavior). That’s clearly much more responsive than most people who lie in bed with no reaction at all.