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Drug Found to Aid Vegetative Patients
Oxygen99 writes "BBC News is reporting on some amazing effects of a drug called Zolpidem on patients suffering from persistent vegetative state. Apparently the drug, usually used to treat insomnia, activates dormant areas of the brain that can make patients aware of their surroundings and even hold conversations. This raises several interesting points including the diagnosis of PVS and the attendant ethics of the associated life support, as well as the way the brain responds to injury and damage."
This is great news, and fascinating from a technical standpoint. But I cringe to think of the unfortunate side effect of something like this: think of the countless grieving families who, on the advice of their doctors, pulled the plug. Particularly those who did so recently. Imagine the horror to imagine that this drug could have brought their loved ones back.
I'm not saying that the decision not to perpetuate the incurably brain dead is the wrong one, nor am I placing blame on the medical community in any way. But you can't expect laypeople to understand the difference, really, and the pain of not knowing if the decision was the right one... Of constantly wondering, down where logic doesn't really help, if there was a chance...
No. Terry's cerebral cortex had completely disintegrated. There was nothing to re-activate. No amount of praying or injecting or stimulating her could have changed the fact that her brain was simply no longer capable of higher-level thoughts, as the part responsible for such thought had 'turned to jelly'.
If my brain has been damaged so much that I can only be roused to awareness of my surroundings by a drug that artificially and temporarily activates bits and pieces of my brain, I just want to die quickly and painlessly. As far as I'm concerned, the biggest crime against me would be to keep me alive.
You say that now, but if it were to actually happen to you I very much doubt that you'd rather die than be dependent on that drug.
It's like all the people that say they'd rather die young, and can't stand the thought of growing old. When it actually happens to you and you're faced with the prospect of death you'll change your mind pretty fast.
until it's been replicated and the results published in a peer reviewed neurology journal.
Over the years there have been miraculous cures for diseases that didn't pan out because they couldn't be replicated. Reasons for this might be: the study patients weren't really cured, the study patients improved, but didn't have the disease in question, scientific fraud, simple chance. This is the kind of result that has to be looked at skeptically, because if it were true, it would be true it would mean the bulk of what we think we know about the brain and its function is wrong.
It's possible, of course. Such possibilities are part of what makes science and exciting pursuit. It's also possible that the authors didn't do their study correctly. It's your choice as to what is most likely. If I had to bet, it would be the study population was not selected properly (i.e. they were in a coma, but not a PVS).
I checked out the journal in question. It is peer reviewed, but it is not a neuroscience journal per se. It is an interdisciplinary for various disciplines involved around rehab of brain damage patients. Although it's perfectly erspectable to publish in such a journal, the article would have a lot more initial credibility if it had been published in a journal specializing in basic neuroscience research. It would have to convince reviewers who would be forced by the publication to admit that they hold some significant misconceptions. It's a tough standard of truth, and it slows the spread of Truth (if you will), but it slows the spread of Error more.
If this is a legitimate result, the publication activity will be, to borrow a metaphor from Shaw, like the first pea in a handful of peas thrown at a wall: first one hits, then a couple, then a whole mass of them. Afterwards, the state of science will have changed in a fundamental way.
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
My mother recently died in a similar manner; she was non-responsive, but not brain dead, and I asked that tubes be removed. She had zero chance of short-term meaningful recovery, and the long term was terminal brain cancer (the survival rate 96% of healthy patients her age was 2-6 months. The other 4% were dead in 10 months). She left very specific instructions regarding this possible eventuality (they included the words "Get Dr. Kervorkian"), so there was little debate from the rest of the family (none from the doctors).
I think you'll find that most patients die of pneumonia brought on by the morphine, and not by starvation. I sat by her bed for 10 days, and I can vouch for the level of comfort provided by the physicians...if her body showed any signs of distress, and we're talking elevated heart rate here, they took steps.
It is only a cruel way to die for the people who have to watch.
ad logicam Claiming a proposition is false because it was presented as the conclusion of a fallacious argument.
"Otherwise he could simply have divorced her and moved on with his life."
No, he couldn't.
Terry was legally incompetent to participaet in divorce (or any other) proceedings. Normally, this wouldn't be a big deal - just have her legal guardian represent her. Problem - her legal guardian was Mark. Mark couldn't try to divorce her - he'd be representing her against himself. It only became an "option" when her parents "offered" to take over her guardianship in a quid pro quo - he relinquishes his responsibility to his wife in return for not contresting a divorce.
Mark was Terry's legal guardian because she CHOSE it before she died, by marrying him. Her parents couldn't (and probably still can't) get that through their heads. They went to desperate lengths to override their daughter's wishes, denying her the very autonomy and choice she had made previously. She chose to leave them and put her care into the hands of another. Mark did the same thing - it's called marriage.
Mark discharged his responsibilities to his wife. Why couldn't her parents accept that?
"As God is my witness, I thought turkeys could fly." A. Carlson
> You say that now, but if it were to actually happen to you I very much doubt that you'd rather die than be dependent on that drug.
> It's like all the people that say they'd rather die young, and can't stand the thought of growing old. When it actually happens to you and you're faced with the prospect of death you'll change your mind pretty fast.
That's totally true. Having watched my (young) wife go through stroke, I have to say that living wills make very little sense. You cannot predict while you are perfectly healthy and sitting at the kitchen table what choices you'll want when something happens.
As it was, she refused treatment for a while and changed her mind later. Hard choices came day to day. More than once I believed I had made the hardest decisions my life would contain, only to be wrong the next day.
I think the most useful document is a durable power of attorney document. Find someone you trust, who loves you (more important than the other way around). Talk about things some ahead, but tell them to make the best choices they can.
It may mean a mistake. They might act to save your life when they shouldn't. Or they might act to let you go when they shouldn't. But at least they will be making the decisions with the information available then, when it counts. It's better than you can do in a living will.