This entry was posted by Monday, 4 November, 2013
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cartoon about healthcare proxy discussion


Remember the Terri Shiavo case?

Everybody was mad at everybody else.

The scientigentsia (me included) were appalled. Ms Shiavo was in a persistent vegetative state. She had no conscious awareness. Her husband said he loved her but the situation was hopeless and she should be allowed to die. Her parents said they loved her but she was ‘in there” and and no one had the right to make that decision for her.

After a long fight, the courts sided with the husband and Ms Shaivo was taken off of her feeding tube. After a while, she died.

Well the court was right. When the doctors finally got a look at Ms Schaivo’s brain, they could see most of it was gone. Like really gone. There were almost no neurons in the part where thinking occurs. She couldn’t have been aware.

But her story doesn’t apply to everyone in similar states. Maybe some can’t think at all. But some others may be in there.

Dr Srivas Chennu (Medical Research Council Cognition and Brain Sciences Unit) used brain imaging MRI on  21 people who were either “minimally conscious” or in a vegetative state. They had the patients focus on certain things that the researchers recited while the doctors watched for a response. What they found is that one of the patients did well in their tests and three seemed to be aware but were pretty vague (couldn’t filter information). The rest didn’t do much.

What did Chennu prove?

Medically, it doesn’t seem to change the status of these very sick people. Only one out of the 21 showed good activity even by this standard. But a test like this could help get extra resources to the patients who need it most or find  better ways to communicate with them.


The real lesson is that science isn’t politics. No matter how you felt about Terry Shiavo, you need to lose the attitude. Not every patient in a vegetative or minimally conscious state is Terry Shiavo. If you let your ideas about science harden so that they resist new information, you might as well hand in your (metaphorical) white coat.

The study was published in the journal Neuroimage: Clinical.

– – – – – – –

That drawing? I made it.



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