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."

Comments

Great!

[William Robinson]

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.

Great!!! Finally they found medicine for my boss!!

FP, BTW?

Re:Great!

[RsG]

"Great!!! Finally they found medicine for my boss!!"

Nah, at a guess the drug will only work when the vegatable has a still-functional brain :-P After all, there has to be something to repair, right?

Re:Great!

[iminplaya]

And it will create a whole genre of zombie movies. "Attack of the Living Dead"

Gaba stuff

[jimmyhat3939]

It's interesting to me that these things seem to always deal with Gaba. Is Gaba the only thing in our brains?

Most anti-anxiety medications work by fooling around with how Gaba is handled in the brain. I can't remember whether they inhibit it or make it more effective. Now here you have this thing saying that people in vegitative states have something wrong with their Gaba receptors.

Maybe someone who understands a little bit about brain chemistry (if such a person even exists) can shed some light on this. For instance, does this finding imply that you could induce a vegitative state in someone by stopping the action of Gaba in their brains, only to "restart" them once they're needed again?

Re:Gaba stuff

[LiquidCoooled]

I found your hypothosis intruiging, so I went out to try it.

I could not find a simple way to stop the action of the gaba in the brains without physically removing their head (a messy procedure).

I did however find that if you remove the Gaba there is no way to restart the action afterwards.

Re:Gaba stuff

[Mostly a lurker]

does this finding imply that you could induce a vegitative state in someone ... only to "restart" them once they're needed again?

As most wives will tell you, this is eaily achieved by means of a TV remote control.

Re:Gaba stuff

[dirtyhippie]

Neuropsychopharmacology is what you speak of.

GABA is far from the "only thing in our brains". Other neurotransmitters include serotonin (important in depression and hallucinogens), acetylcholine (why people smoke), dopamine (why some drugs are addictive), (nor)?epinephrine, glutamate and aspertate, etc. etc. The descriptions of what these chemicals do, of course, is vastly oversimplified here.

As for what anti-anxiety meds do, they mimic the effect of the naturally occuring GABA neurotransmitter, and have an inhibitory affect on cells with GABA receptors.

You *could* induce a vegitative state in someone by stopping the action of GABA, but it wouldn't exactly be "persistent" - GABA helps control some rather important functions in the brain stem, like breathing and heartbeat - in short, they'd die ;)

Re:Gaba stuff

[Anonymous Coward]

I happen to be a med student but this isn't medical advice. I don't mean to come down on you but you have to be very careful when you analyze the neurological effects of drugs. Your post is mostly correct until the last sentence which is off.

Zolpidem is a potent agonist of GABA A receptors. This means that it causes them to "open" and allow cholride ions in to hyperpolarize the cell membrane. This inhibits the firing of the neuron. Stopping the action of GABA could disrupt the delicate membrane potential balance mediated by a whole host of neurotransmitters.

The intravenous general anesthetic etomidate acts by potentiating GABA(A) receptors although different subunit type than zolpidem. Stopping the action of GABA would not cause someone's brain to shut down in the way the OP is thinking.

Let us doctor types handle the heavy lifting while you guys do your geeky thing. Merely summarizing Wikipedia articles doesn't make you a doctor or pharmD.

Re:Gaba stuff

[Just Some Guy]

glutamate and aspertate

Our brain is umami and sweet at the same time? Maybe zombies are just looking for low-calorie Oriental fare.

Re:Gaba stuff

[dirtyhippie]

> Stopping the action of GABA would not cause someone's brain to shut down in the way the OP is thinking.

I didn't claim it would. Perhaps you missed the part at the end where I said they'd *die* ?

> Let us doctor types handle the heavy lifting while you guys do your geeky thing. Merely summarizing Wikipedia articles doesn't make you a doctor or pharmD.

I hope your healing abilities are better than your psychic abilities (or ability to detect sarcasm).

Re:Gaba stuff

[lbmouse]

A dirtyhippie explaining "why some drugs are addictive". Go figure.

Re:Gaba stuff

[frank_adrian314159]

As for what anti-anxiety meds do, they mimic the effect of the naturally occuring GABA neurotransmitter, and have an inhibitory affect on cells with GABA receptors.

You forgot a few of the more fun receptors like the canabinoid and opioid receptors!

Because GABA is so wide-ranging in neurological function (one of the reasons why many nerve agents impact the GABA receptors as well as the acetylcholinesterase receptors and why many insecticides target the GABA receptors), GABA targeting has always led to drugs with quite a few side effects. Many of the newer anxiolytics target the seratonin receptors or a combo of the seratonin and norepinephrine receptors and, as such, have fewer side effects than older classes of anxiolytics like the benzodiazepines.

Re:Gaba stuff

[RockModeNick]

I have found massive doses of grain alcohol in almost any form to very effectivly moderate my GABA system, and high enough a dose will indeed induce a vegitative state known as "being so freaking drunk I can't think, stand, or walk."

Re:Gaba stuff

[tgibbs]

You *could* induce a vegitative state in someone by stopping the action of GABA, but it wouldn't exactly be "persistent"

No, you have it backwards. Anti-anxiety medications typically enhance the action of GABA, and the effect of stopping the action of GABA is typically seizure. There is currently research into the possibility that blocking particular subtypes of GABA receptors might reverse cognitive impairment. This result is surprising because excess activation of GABA receptors is typically sedative, and zolpidem (trade name Ambien) enhances GABA action a type of GABA receptors that are thought to be particularly involved in sedation, so this result is the opposite of what would be expected from a simple point of view. However, there are a lot of GABA receptors in the brain, and because they are inhibitory you can get some paradoxical effects depending upon how the neurons are hooked up. In particular, you can get "disinhibition," when two GABA neurons are hooked up in series: activating the first neuron releases GABA to inhibit the second neuron, which then releases less GABA--so its targets are less inhibited.

Re:Gaba stuff

[tgibbs]

It's interesting to me that these things seem to always deal with Gaba. Is Gaba the only thing in our brains?

GABA is not the only thing in our brain, but there are a lot of GABA neurons, located in all parts of the brain. It is primarily an inhibitory neurotransmitter, whose function is to "damp out" neural activity. Drugs that enhance the action of GABA are typically anti-anxiety, anti-convulsive, muscle relaxant, and sedative. It has a rich pharmacology reflecting the early discovery of drugs that subtly "tweak" the activity of the receptor rather than overwhelmingly activating or blocking them. There are a lot of subtly different variants of the GABA receptor, and there is considerable interest in developing better drugs that target only specific types of GABA receptors. So when you are concerned with anxiety, convulsions, or sleep, GABA is the major game in town. But drug abuse researchers tend to be particularly interested in dopamine, while learning researchers are interested in glutamate, and people working on depression are very interested in serotonin. And there are lots more, particularly if you include some of the slower-acting transmitters like the peptides.

Re:Gaba stuff

[Kyeo]

GABA is the main inhibitory neurotransmitter. Glutamate is the main excitatory neurotransmitter.

Re:Gaba stuff

[sharky611aol.com]

Just finished my pharmacology class... Here's the 10 second version:

It's best to think of GABA as the big inhibitor of the brain. Anything that increases GABA (alcohol, barbiturates, benzodiazapenes like Valium) slows down just about everything else in the brain. Thus, you get such effects as sedation, loss of inihibtions (people do dumb things when drunk), anti-anxiety, and anti-epileptic effects.

Drugs which decrease GABA, which this drug appears to do, would tend to have an overall excitatory effect, through a phenomenon known as dis-inhibition (inhibiting the inhibitor = excitation). There honestly aren't too many drugs that would do this, as you would have VAST side effects throughout the body, not the least of which would be massive seizures. (I quite frankly can't think of another example of a anti-GABA drug besides the one in TFA. It's much more efficient to target just the neurotransmitter you want to increase).

From what I can tell, the drug in TFA is acting on what's known as the reticular activating system (RAS), the part of our brain responsible for minor details like consciousness, sleep-wake cycles, etc. The neuropharmacology of this area is fairly complicated, but it's know to have fairly extensive GABA-ergic projections to most of the brain. Think of the GABA-ergic projections turning things off, with concommitant norepinephrine projections tending to turn things on. So it makes sense that if you decrease GABA in a person in a persistant vegetative state (who presumably has too much GABA, and thus not enough of everything else), there's a chance they might just wake up.

I'm going to have to do a little searching to find the primary source text, but this seems like pretty fascintating stuff.

Re:Gaba stuff

[Frangible]

Other anxiolytic (anti-anxiety) drugs include beta blockers (antagonistically bind to and block beta adrenoreceptors, which is what norepinephrine and epinephrine(adrenaline) bind to) and SSRIs.

I'm not clear if the anxiolytic mechanism behind SSRIs is directly related to serotonin, or something sigma-receptor or neurogenesis related -- which are rather recent findings about SSRIs.

It is also worth noting that the psychostimulant methylphenidate (ritalin) has been shown to be useful in rehabilitating brain damage and increasing the speed of healing.

Re:Gaba stuff

[ColdWetDog]

Just remember, these are "shotgun" concepts. The neurotransmitters of which you speak (and many others) certainly are implicated in the diseases and conditions mentioned. But when we package them up in pretty little pills and pop them into peoples mouths, they go all over the place - various parts of the brain, the stomach (which has quite a number of neurotransmitter receptors) and various other organs. Our understanding of neuropsychology is pretty rudimentary. So we flood the body with these chemicals and hope the good effects outweigh the bad. Collateral damage is likely. Once we get to the point where we can target specific neurotransmitters at specific sites, then we will be in "interesting times". TFA is exactly what you'd expect when you do this sort of thing - you get a "side effect" of the drug that is potentially more interesting than the desired or planned effect.

Re:Gaba stuff

[Phil Karn]

As I understand it, zolpidem (better known as Ambien) is not actually a GABA A agonist, but a benzodiazepine omega-1 receptor agonist. That is, while it is not chemically a benzodiazepine, zolpidem hits a subset of the receptors (omega-1, -2 and -3) hit by the less selective benzodiazepines (Ativan, Valium, etc).

The benzodiazepine receptors are located on the GABA A receptor complex, but at a distinct site. Activating the benzo receptors doesn't directly open the chloride ion channel. It simply increases the "gain" of the GABA receptor for naturally produced GABA.

Antidepressants have a similar effect on their targets, though by a very different mechanism. They don't directly activate serotonin (or whatever) receptors, but they increase their sensitivity to naturally produced neurotransmitters.

Drugs that directly mimic natural neurotransmitters (instead of enhancing their action) are generally a bad idea. LSD's effects come from being a potent agonist on a very wide range of neurotransmitter receptors.

Re:Gaba stuff

[inKubus]

This result is surprising because excess activation of GABA receptors is typically sedative, and zolpidem (trade name Ambien) enhances GABA action a type of GABA receptors that are thought to be particularly involved in sedation, so this result is the opposite of what would be expected from a simple point of view.

Maybe that's why you get stories of people talking in their sleep, walking in their sleep, or operating heavy machinery in their sleep while on Ambien. Their conscious mind is asleep but their eyes are open, the real control functions of the brain are working, it's just not being "recorded".

Scary scary stuff, specially when you see how many prescriptions of that crap they write, and think about how many people are actually asleep at the wheel on your commute home. The real rise of that drug was right after "9-11" when doctors were prescribing pretty much anything you wanted if you "were having trouble sleeping" or "anxiety". Nice.

Re:Gaba stuff

[oathbreaker]

My Neuropsych is a little rusty, but as I recall, GABA itself is inhibitory, so a drug that inhibits GABA will actually increase firing. And yes, GABA is implicated in a bunch of different processes. I can't answer as to whether you could generate a vegetative state like that, but my guess would be that it would be unlikely, as a medication is likely to change the global level of GABA, rather than the level in the particular areas discussed here.

Re:Gaba stuff

[MysteriousPreacher]

It could be worse, they could be a sociology student.

Re:Gaba stuff

[Richy_T]

the stomach (which has quite a number of neurotransmitter receptors)

More than the brain... My gut tells me that's how our nervous system works.

Rich

Perfect for IT

[s0l3d4d]

A person in a vegetative state will appear to be awake and may have their eyes open, but will show no awareness of their surroundings.

They will not be able to interact with other people, and will show no responses to sounds or things that happen around them.

But they will show signs of movement, and cycles of sleep and may be able to breathe on their own.

So what would happen if they would start to give these drugs to technical support people and system admins? Would they also start to show responses to their environment, and manage to hold a conversation?

Re:Perfect for IT

[bombadillo]

They system admins just need a good night's sleep without the pager going off. No drugs are needed but recreational drugs are welcome!

Re:Perfect for IT

[ajlitt]

IANASA (anymore), but it seems to me that talking smack about sysadmins on /. is right up there with sending child porn to president@whitehouse.gov . Just remember, they can read your email.

Re:Perfect for IT

[CFD339]

Maybe, but I couldn't understand them either way, so what's the point?

Re:Perfect for IT

[Geminii]

No, they only show responses to _intelligent_ input.

Re:Perfect for IT

[Bing Tsher E]

Just remember, they can read your email.

And the janitor can read the stuff that I throw in my office wastebasket.

No, the 'sysadmin' is little more than the file clerk of the future. Sure, the 'filing cabinets' are now cooler than the old steelcase behemoths, but it's essentially the same job.

Important distinction

[fsckr]

PVS is not brain death. The two are completely different and unlike the parent post implied, very few families would consider pulling the switch on a patient's with PVS. Patients with PVS react to pain and other extreme stimuli, so cutting off their nutrient supply is tantamount to starving them to death.

"PVS is also known as cortical death, although it is not the same as coma or brain death."

As opposed to brain death, PVS is not recognized as death in any known legal system.

- wikipedia article

Re:Important distinction

[Oxygen99]

This distinction wasn't considered important in the case of Tony Bland, a PVS patient who was allowed to die in the UK several years ago. Although it isn't recognised as brain death, in this instance doctors allowed the feeding tubes to be removed, effectively, as you say, starving him to death. In the UK at least, it seems the two are usually equated.

Re:Important distinction

[Viol8]

"Her parents desperately fought to keep her alive, because she could make sounds, move her limbs, keep solid eye contact on someone"

So can an ant. It doesn't make them human. If the personality is gone
and theres no sign of intellect all you have left is a base functioning
brain.

"It was downright horrible and state approved MURDER."

In your opinion. Perhaps if you'd been her husband you might have a
different opinion. You sanctamonious types are all mouth. I'd love to see
one of have to see your wife be a vegetable for years or even decades
and see if you still have your arrogant self righteous opinions then.

"Ths drug could have helped her have a normal life, but she did not live long enough to ever have the chance to try it!"

And many people in the middle ages died because they couldn't wait 500
years for anti biotics to be invented. So fscking what?

Re:Important distinction

[Anonymous Coward]

I have a living will which states I want to be shut off after 2 months unless there is good evidence I will recover over time without severe brain damage.
Trolling though you are , it does raise a few good issues. You should have a look into a few medical papers about PVS and higher brain function , may be an interesting read for you.

Re:Important distinction

[FidelCatsro]

Shockingly enough , and this may seem insensitive to say so but it makes a point.
Did anyone ask the patient in question about it.
So if they are brain dead then it is nothing to worry about and simply allowing the family to finally grieve .
If they are not brain dead, then can you imagine being in a PVS , unable to move , do anything for yourself , interact . A veritable life sentence in solitary for the innocent.
To me , letting someone die seems far far less cruel than that.
If there is now medicine which may help some people recover , then that is wonderful but sometimes there is nothing you can do for someone.

Re:Important distinction

[Richard_at_work]

How long should they have kept her alive artificially? Until her parents had died? What then? Who makes the decision after that point? She cant afterall die naturally, the doctors could always keep the body functioning well past a normal lifetime, so when should treatment be withdrawn to allow her to die?

Point is, she was being kept alive artificially, she could not communicate and she showed no signs of intelligence. Her brain patterns were nowhere near normal. In these situations, people will believe out of desperation any little grunt or sniffle is an attempt to communicate.

All of the evidence presented by the postmortem showed that the husbands case was proven - she had no brain function to speak of.

Re:Important distinction

[vandan]

Stop spreading trash. All of your points have been refuted many times. Why not deal with the fact that shit happens and people have to pass on? Why spread these lies and religious self-richeous bullshit, when it had nothing to do with you, and all your arguements have been dimissed by doctors, scientists, and courts alike?

Re:Important distinction

[hackstraw]

And many people in the middle ages died because they couldn't wait 500 years for anti biotics to be invented. So fscking what?

Westerners have an irrational fascination with these new drugs and yes, they do prolong life, but quality of life is most of the time in no way shape or form improved. I've seen family members whose bodies have basically failed, but the doctors have kept them physically alive for another couple of years, for nothing, at the cost of between $10,000-100,000 a piece.

I've been a victim of the FDA approved drug bullshit for almost 20 years, and now that I realize that the drugs made me worse over the years, which has been supported by medical studies, I'm off of the drugs, and at least for now, I'm fine, and I feel healthier than I have in over 20 years since before I started taking these things.

I will give western medicine 4 things. 1) Improved success in living for mothers and children during child birth. 2) Physical repair of broken things like hips and joints. 3) Improved quality and longevity of life because of antibiotics. 4) Immunizations for nasty things.

I'm sure that someone will add to the list, and I did not come up with that list via hard hours of research, its just one I've put together over the past few months of thinking about the stuff.

I was labeled as being mentally ill when I was 18, and have taken between 8-10 different maintenance drugs to help me "manage" my condition. Well, between 6-8 of those drugs are documented for making me worse, which is what I said word for word the last time I saw my doctor. So, he gave me another handful of drugs, that I never took and I threw in the trash. I have altered my diet, and am taking quality (read, not Centrum or anything like that) vitamins, herbs, and supplements, and I'm essentially symptom free, and I have had friends and coworkers comment on how much better I seem.

The drugs that were given to me gave me 1) Chronic diarrhea for over 18 months 2) Headaches 3) Vertigo to the point of almost getting in serious car accidents twice. 4) Depression, anxiety, confusion, and mania (what the drugs were supposed to treat) 5) Obsessive thoughts, usually in the form of a cheesy pop song that I could not get one line out of my head. 5) Daily dry heaves. 6) Paranoia 7) Generally a lower state of cognition and well being.

Oh, and if you think all of those things don't affect your personal and professional life, well, in my case they did.

The trend here is for the pharmaceutical companies to make "maintenance medications", not a cure or something that will drastically increase the speed of recovery and then forgo taking the drug. I strongly recommend that nobody take a drug that is prescribed by a doctor that has no time frame for when you are to stop taking the drug. At least, do plenty of research, and get second and third opinions before taking any maintenance drug.

Another thing to look into, is what you are eating. Most of the food in this country is either void of nutrients or has additives or pollutants in it or comes from unhealthy, uncared for animals. This is for another discussion.

Re:Important distinction

[DarkOx]

You have a good point but we had alread taken steps to keep her alive artifically, and done so knowing she had suffered extensive injury. Maintianing that action constituted inaction, which is always preferable when no pressing need to act exists and its unclear what the results of action might be. Its the cautionary priciple. If you don't understand don't do it. We might have allowed someone who had the hope of recovery to die, when we should have waited and learned more. Treating her for the effects of her injury was already a path we had chosen to go down taking aditional steps to keep her beyond her natrual life would be an entirely new decision process and one where I might be very inclinded to take your view and let her go since she cant chose to be treated.

Re:Important distinction

[Loquax]

onevulcanme-- As a Catholic who agrees with your desire to see all life cherished and preserved, I agree with your sentiment, but as a person who values logic, reason and most importantly, the law, I have to point out a few things. First, Mr. Schivo was given guardianship of Terri by a court of law. You and I may disagree with the judges decision, but we have to respect the law. I prayed daily for that Michael would reverse his stance and hand guardianship over to her parents, but in the end, he exercised his rights under our legal system. If you don't approve of that, cool, but in the end, in this case, it was nobody's decision but his that mattered. Second, as a pro-life Christian who also believes that it is wrong to bear false witness against another, I am embarassed and hurt that people chose to villify Michael Schivo. I understand her parents were not happy with him, I understand that emotions (and not reason) guide any parent's wishes for a terminally ill child, but the rest of us should have taken a step back and realized that none of us had any business judging the man. Have whatever opinion you like, but don't judge a man evil or damned in the eyes of God. We as Christians are forbidden to "judge" (in the sted of God) another, nor are we to slander a man. Michael Schivo was accused way after the point by Christians of beating her to death (way beyond what the scientific proof held), of being a money grubber looking to get his hands on her cash, and of being evil. I saw several interviews with Michael Schivo, and I felt (and still feel) that he was a man plauged by a complicated situation who acted out of love for a woman he made a promise to long ago. God only knows what was truly in his heart, and I hope and pray that it was good intent. The more Christian way to have handled this would have been to leave the man alone with his charge, his wife, and pray for him, and later petition our legislatures to assume a pro-life stance of preserving life in questionable situations such as these. It should be assumed that in absense of a living will or final directive that the person wanted to be preserved. I'm sure it would have been a relief to Michael Schivo to know that the decision was out of his hands in the case of questionable desires from Terri. I personally have written out a living will that directs my wife and thoes I love to take specific actions and filed it with a lawyer. I encourage everyone who feels one way or the other about the sanctity of life and the meaning of death to do the same, but for God's sake (litterally) make up your mind about what life and living mean to you and take a stand.

Re:Important distinction

[SatanicPuppy]

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.

Re:Important distinction

[Gulthek]

Another thing to look into, is what you are eating. Most of the food in this country is either void of nutrients or has additives or pollutants in it or comes from unhealthy, uncared for animals.

Indeed:

A corn diet can also give a cow acidosis. Unlike that in our own highly acidic stomachs, the normal pH of a rumen is neutral. Corn makes it unnaturally acidic, however, causing a kind of bovine heartburn, which in some cases can kill the animal but usually just makes it sick. Acidotic animals go off their feed, pant and salivate excessively, paw at their bellies and eat dirt. The condition can lead to diarrhea, ulcers, bloat, liver disease and a general weakening of the immune system that leaves the animal vulnerable to everything from pneumonia to feedlot polio.

Cows rarely live on feedlot diets for more than six months, which might be about as much as their digestive systems can tolerate. ''I don't know how long you could feed this ration before you'd see problems,'' Metzen said; another vet said that a sustained feedlot diet would eventually ''blow out their livers'' and kill them. As the acids eat away at the rumen wall, bacteria enter the bloodstream and collect in the liver. More than 13 percent of feedlot cattle are found at slaughter to have abscessed livers.

What keeps a feedlot animal healthy -- or healthy enough -- are antibiotics. Rumensin inhibits gas production in the rumen, helping to prevent bloat; tylosin reduces the incidence of liver infection. Most of the antibiotics sold in America end up in animal feed -- a practice that, it is now generally acknowledged, leads directly to the evolution of new antibiotic-resistant ''superbugs.'' In the debate over the use of antibiotics in agriculture, a distinction is usually made between clinical and nonclinical uses. Public-health advocates don't object to treating sick animals with antibiotics; they just don't want to see the drugs lose their efficacy because factory farms are feeding them to healthy animals to promote growth. But the use of antibiotics in feedlot cattle confounds this distinction. Here the drugs are plainly being used to treat sick animals, yet the animals probably wouldn't be sick if not for what we feed them.

-- This Steer's Life

Oh yeah, a mouthfull of meat that would be rife with disease if the steer hadn't been pumped full of antibiotics. That's good eatin'!

Re:Important distinction

[Alidar]

I read slashdot daily and almost never post, but I wanted to let you know that I agree almost 100% with most of your arguments. I am also a Catholic and I argued there were other ways to go about this. The bright red line in the law was that he was her husband, she knew he would be making these decisions, not her parents.

If her parents wanted to argue against him their better and more moral argument, in my opinion, would have been that he was breaking the law by having a common law wife (illegal in Flordia) and therefore no longer her wife. Bottom line though, his wife, his decision. She knew that when she got married and it is not our place to judge.

Re:Important distinction

[localman]

You sanctamonious types are all mouth.

I'd have to agree with this. Members of my own family flipped out over the Terry Schiavo thing, calling it murder. And this was after they had pulled the plug on my grandmother for being in a similar state after a stroke. This was back in '91 and she was in PVS for only a couple weeks. All I had to do was remind them and they shut up. Around me, anyways... they'd still go on preaching to others who didn't know they had made the same decision for their own loved ones.

Cheers.

Re:Important distinction

[plunge]

Tom Delay, of course, before the controversy began and he put himself at the forefront of it, pulled the plug on his own comatose father.

The problem with the extreme pro-life position is that they don't really believe their own rhetoric when it comes to actually applying it to real situations affecting THEM instead of other people they can just rail against. Given the choice between saving a billion zygotes and a single human child, they'd all save the child, and they know it. For all the talk about killing zygotes being murder, or morally equivalent persons no matter what stage of development they are, they don't really believe it. Even the group of brothers who supported the Schiavo parents had basically allowed their own founder to die when they could have kept his body alive just like Schiavo's.

Re:Important distinction

[mdielmann]

I'm currently on what you called a "maintenance drug" for a long-term condition. I'm getting the results expected for the drug, with none of the side-effects (which can be bad). I've had varying qualities of diet and lifestyle over the duration of my condition while I wasn't taking medication and, while my symptoms were lower when my lifestyle was at its best, I've never felt as good as I do now. It's worth noting that my lifestyle is currently at a poorer state, close to the typical North American's.

What I'm getting at is that I agree with you, to a point. Like anything else, take the least invasive approach to solving a problem, so long as the problem is solved. Fortunately for you, that was merely (merely!) an overhaul of your lifestyle. Less fortunately for me, it may be a lifetime of medication. But frankly, if the improvement is as dramatic as it has been, that's a price I'm willing to pay. Not that I'm unwilling to see what difference a lifestyle change can add to (or maybe even replace) it.

Re:Important distinction

[localman]

Yeah, my family revealed themselves on that one, too. After years of being vehemently pro-life, someone in the family had an abortion (not medically necessary) and they all found ways to justify it so they wouldn't have to condemn the person. It's paper-thin morality. And they haven't learned a thing from either experience or fessed up. Don't know what to do with people like that except ignore them. Which is hard when it's your family :)

Cheers.

Re:Important distinction

[Reservoir Penguin]

I wouldntgive it point #1. Approaching child birth as a desease that should be treated at the hospital is wrong and is entirely a Western invention.

Re:Important distinction

[tgibbs]

Unfortunately, there are many conditions where none of the available drugs are entirely satisfactory. In psychiatric illnesses, especially, some people respond to one drug and not another, and some people find the side effects of one drug intolerable while others have no difficulty. Psychiatric illness is still poorly understood, but it's suspected that psychiatric illness can arise from multiple causes, and at present there is no good method other than trial and error to identify the best treatment for a particular individual. Current medications are largely derived from trial-and-error experimentation, because it is difficult to develop good animal models for psychiatric illness. Without a better understanding of how these illnesses arise, true cures, as opposed to palliative medications, are unlikely to arise.

Re:Important distinction

[plunge]

It's worth noting that it was the parents themselves that had to talk Michael into dating again: they not only once approved of him doing so, but encouraged it. And his new partner ultimately even spent more time at the hospice with Terry than Terry's own brother (who only got in on things once the media showed up). So it was doubly cynical and nasty that they would turn around and try to use this against him.

Re:Important distinction

[Alidar]

Excellent points.

Re:Important distinction

[Loquax]

Alidar

I also like your suggestion that they should have tried the bigamy/abandonment angle. At least this has a logical, legal arguement that is based in statute and precident. Common law and bigamy law has been worked out over centuries, and clear fault could be assertained.

Re:Important distinction

[misleb]

Do you also remember after she died they did an autopsy and found that her brain had essentially turned to mush over the years? No drug was going to bring her back. Who knows, maybe if a drug was available when she first entered the vegetative state. But after that many years, the only reasonable thing to do was to "pull the plug."

-matthew

Re:Important distinction

[SatanicPuppy]

I have a living will which says, that if I'm in a persistent vegitative state with no reasonable hope of recovery, I want my loved ones, or the goddamn government, to pull the plug. Because, at that point, I don't call it living.

My mother had the most straightforward approach to dying of anyone I've ever seen. She found out she had a tumor, she went out and got a living will and a medical power of attourney, and she gave them both to me and specifically told me under what circumstances I was allowed to put her on tubes. And by God I did exactly what she asked. She met her death with courage and dignity, and she trusted me to make that possible for her, and not to stick her on those goddamn machines.

And I don't need some filthy little quasi-moralistic cocksucker who has no fucking idea what he's talking about DARING to give me shit about it. I hope to God you end up trapped in a rotting shell of a body by your own goddamn living will that forbids anyone from touching your precious precious tubes.

Re:Important distinction

[19thNervousBreakdown]

5) Obsessive thoughts, usually in the form of a cheesy pop song that I could not get one line out of my head.

Oh, man, I hope you weren't counting on that one going away. Earworms.

Right now for instance, the bridge of Take Her Down to Crippletown is stuck in my head. Of course, this article makes it sound like it's truly bothersome. I usually just enjoy it, even if it's a Prince song stuck in my head you'll see me bobbing to my internal tune with a grin. Sometimes I do a goofy dance too. And if that's crazy, sign me up and pass the lithium, crazy ain't so bad.

Re:Important distinction

[Keebler71]

I was labeled as being mentally ill when I was 18, and have taken between 8-10 different maintenance drugs to help me "manage" my condition. Well, between 6-8 of those drugs are documented for making me worse, which is what I said word for word the last time I saw my doctor. So, he gave me another handful of drugs, that I never took and I threw in the trash. I have altered my diet, and am taking quality (read, not Centrum or anything like that) vitamins, herbs, and supplements, and I'm essentially symptom free, and I have had friends and coworkers comment on how much better I seem.

Quite a rant about the state of pharmaceuticals... have you considered breaking out Occam's razor? Perhaps you're original diagnosis was wrong and you've been fine all this time? That would explain why the meds made you worse and also explain why something as simple as diet modification worked.

Re:Important distinction

[HermanAB]

Interesting - note that it is possible that your condition has been cured, that you really were seriously ill years ago and now isn't anymore. Contrary to common perception, an adult person's brain does grow and heal itself, it is just a much slower process than in muscular tissue for example.

Re:Important distinction

[cellocgw]

Approaching child birth as a desease that should be treated at the hospital is wrong and is entirely a Western invention.

Since I have direct knowledge of cases where women chose to give birth at home, resulting in the death of their child due to simple, easily treated problems like myconium inhalation, I have no misgivings about calling you an uneducated fool.
Childbirth is not considered a "disease," but it is considered a potentially dangerous situation both for mother and infant.
Another case: woman with failure to completely expel the placenta starts a major bleed. Hospital care saves her easily. Try doing that at home.

Re:Important distinction

[alleycat0]

I would definitely add:

5) Anesthesia!

Re:Important distinction

[Crisses]

I am sorry that you know someone who had a bad experience with home birth, but many more are uncomplicated and low risk than those that have problems.

I gave birth twice at home, without problems.

I come from an unbroken line of women who successfully vaginally delivered. Absolutely unbroken. I saw no hereditary reason that I should have any complications. I had a midwife, I had exams, and I was minutes from a hospital if one were needed.

There are risks at the hospital too. Immunizing my newborn for Hep-B being one of them -- a practice that I find patently ridiculous. Carting my kids away to mix them with other babies, give them drugs I don't think are responsible for a newborn's immune system, or cutting off parts of my baby, should it happen to be a boy, that they can't rectify after ignoring the "NO CIRCUMCISION" order on the hospital chart. Or, even worse, if my baby were a hermaphodite and the doctors cart my baby away and decide -- without my knowledge or approval -- to "assign" a gender to my child. I've heard more horror stories, and I didn't want to be one of them. When I was born, the regular practice was NOT to breastfeed and they had a pill to stop the milk from coming in. In spite of my mother's standing order they administered it, and she was unable to breastfeed me. (She was young and clueless for not asking what the pill was.)

Before giving birth at home, I read midwifery books. Signs of meconium inhalation would be apparent at and shortly after birth, after which a wise/educated/responsible/equipped midwife would suction the infant's trachea and recommend transport to a hospital. Risk factors are a late delivery, and complications during labor. The baby's heartbeat would be off in the womb. The amniotic fluid would show signs of meconium taint (if the water breaks and it's green, go to the hospital!), and the baby would have a low APGAR (alertness and reflex testing given immediately after birth). Full-term, on-time, vigorous babies with a high APGAR are at low-to-no risk.

As infant mortality rates go, the rate in the US is FAR from perfect...in spite of so-called medical advances. Hospital deliveries have a high rate of "you're here, so we might as well interfere" -- unneeded procedures like cutting the perineum, epidurals that affect a baby's awareness upon birth, etc. I firmly opt out.

Re:Important distinction

[hackstraw]

Oh, man, I hope you weren't counting on that one going away.

It already did. All of the bad side affects have gone away that I listed.

The drug in question was Zyprexa, an "atypical" anti-psychotic/mood stabilizer. Sure, it knocked me out at night, but the next day I looked like a good psych patient with dark, zombified eyes, and the obsessive song repeating was more focused in the mornings. It completely went away after I stopped taking the drug. Thanks doc! Another side affect is that it causes weight gain, and I've heard of one guy that had the problem of being schizophrenic, took this to help him out, and the bonus points came when the poor guy developed breasts!

I've seen decent looking girls that were amateur models go from cute to nasty, fat, zit-filled, zombies from this drug.

Oh, FWIW, the song that got me the most was that silly No Doubt, "Underneath it all" song. In fact, it was only two lines from the chorus "You're really lovely, Underneath it all", which I just learned what it says. I thought it was "You really love me, underneath it all". Those two lines would repeat over and over again in Gwen's voice. I mean, over and over again. Its an OK song, but over and over again. You get the point?

Let me tell you, these doctors are more psychotic than any of their patients.

Re:Important distinction

[hackstraw]

Quite a rant about the state of pharmaceuticals... have you considered breaking out Occam's razor? Perhaps you're original diagnosis was wrong and you've been fine all this time? That would explain why the meds made you worse and also explain why something as simple as diet modification worked.

The original diagnosis was/is accurate for what I had. Bipolar disorder or manic depression. According to the literature on the disorder, there are stages of both the mania and depression. I have gone into what is called "manic psychosis" which is about 11 on a 1-10 scale of mania.

I have been prone to depression since I was a child. Now I take a variety of natural things that have almost instantly gotten rid of my symptoms, and I am much healthier than I have been in over 20 years. I can't say that this change will last, but from what I've read, the odds are very good. The _ONLY_ people I have read that have been cured of their conditions like mine have done what I have done. I'm talking about people that were up to taking 8 meds at one time to zero in 4 months, with no remission.

Personally, I blame our poor food for my early onset of the disorder, and the prevalence of "mental illness" in the US. I simply do not believe that with such a diverse gene pool here in the US, that genetics are failing and making people ill. Sure there are some societal aspects of it, but I believe its primarily food. I could be wrong, I just started researching about food. Never thought I needed to do such a thing.

Another anecdotal piece of change in my life, is that I have acquired more "friends" here on slashdot, and my posts get moderated higher than normal. Shit, I actually want to live again.

Re:Important distinction

[Marxist Hacker 42]

Leave the real wishes in writing with a disinterested party. It's the only way to be sure.

Re:Important distinction

[lgw]

It's paper-thin morality.

That's a great expression!

Re:Important distinction

[Smurf]

If you were going to kill her by starvation why not just do it? A drug to stop the heart, a plastic bag, a string? Why let her slowly starve to death?

Because in some legal systems letting the patient die by starvation or other "natural" cause won't get the doctors/relatives prosecuted, while doing something actively (e.g., supplying a drug to stop the heart) will. So in the end the laws that supposedly protect the patient end up having far more cruel consequences. (Of course "cruel" is a debatable term in this context).

Re:Important distinction

[Hentai]

Except that you CAN'T ignore them, because there's far more of them than there are rational, non-hypocritical people, and they tend to vote more.

These jerks are the ones running the country, and they KNOW they're full of shit. Sometimes I think they just like the power trip.

Re:Important distinction

[Beryllium Sphere(tm)]

In fact the SSRI antidepressants *grow new brain cells*.

Re:Important distinction

[Beryllium Sphere(tm)]

I know you've found ways to handle the grief, and I know you were spared the horror of having to *guess* what your mother's wishes were. But your situation was still one of the things I would not wish on my worst enemy.

Re:Important distinction

[Beryllium Sphere(tm)]

>I'm really afraid of people like you.

[Eliza]Why do people who honor the explicit wishes of their next of kin make you really afraid?[/Eliza]

Re:Important distinction

[SatanicPuppy]

It is interesting. Obviously, I got a lot of time to think about it. In my mother's case it was pretty clear-cut...She had surgery, which came back with the diagnosis of a Type IV Astrocytoma (Glioblastoma Multiforme), which is pretty much the worst thing you can have in your head. the survival curve looks like the flight path of a 747 with no wings, and the x-axis of the graph is measured in months. So right there you're looking at a bad situation.

In the end it didn't matter, because she ended up having multiple bleeds as after effects of the (otherwise successful) surgery, which left her a tiny step above vegetable.

The combination of factors meant that the idea of long term prognosis was a joke. She couldn't go through the sort of treatment that would slow the tumor down at all. She was going to die. End of story.

Hmmmm...this is interesting. At the time I'd have wholeheartedly supported a lethal dose of morphine or something similar, but in retrospect I find I can't make an argument in support of the idea. I don't know. In my mother's case there really wasn't any pain anyway, so mercy is not a factor. In a situation with another terminal cancer of a painful sort (bone cancer, for example), it seems like the better part of mercy to spare the terminal patient pain.

I think in the end, it's just such a can of worms, it's better to let things take their course semi-naturally with medication to relieve pain, than to go in and muck with things. I can only imagine the lawsuits that would arise if the average person was allowed to decide in a medical setting, how long the terminal patient should live. These days, with medical costs being what they are, there is too much potential for scary expediency.

Re:Important distinction

[deuterium]

I hear your points, but I'm not ready to chuck drug regimens just because of indefinate duration of therapy. If there is a problem in the system, it's one of knowledge, both with the practitioners and the research community. Most antidepressants are prescribed by general practitioners, who seem to have very little knowledge of both the drugs and of diagnosing psychiatric conditions. I've suffered with depression and derealization (both of which raged in my drug/alcohol-virgin body for years) and went to several GPs who all gave me the mildest SSRIs they felt comfortable with, none of which helped. I tried numerous diet/supplement regimens which did nothing. I was ready to crawl into a hole when I finally went to a proper psychiatrist who had me feeling normal again within a week. The guy knew his psychiatry and pharmacology. The drugs he prescribed were generics, and cost me very little.
Now, on the other hand I'm quite sure that there are people who aren't experiencing debilitating mental problems who are prescribed psychotropic drugs anyway. They were still able to function, and the severity of their problem didn't warrant drug intervention. These are the people who should follow your advice.
Mental illness reminds me a great deal of diabetes in this regard. Mild cases can be probably be managed with diet and lifestyle changes. More severe cases will benefit from drugs. It's up to a competent doctor to make the call.
Also, as I mentioned, the medical research on mental illness is pretty primitive. Both the causes of the disorders and the action of the drugs involved are pretty simplified. To assume that something like depression is a single disorder, and is governed by a handful of neurotransmitters is silly. Moreover, to treat mental disorders as something above other organic disorders is plain wrong. Most of the currently approved antidepressants are equally effective analgesics, and many anti-inflammatory drugs are effective antidepressants. Just becase someone feels sad along with all of their other physical discomforts doesn't make it different.

Re:Important distinction

[Lord Ender]

You were on meds because you are crazy. Modern western medicine is tested scientifically. The fact that you had bad side effects from some drugs is NOT scientific at all. The fact that you think careful vitamin use cured all your ills is NOT scientific. If it did cure you, you were probably malnourished, and the only person you have to blame for that is yourself (not "society" or whatever). Our society requires nutrition info to be labeled on food. Nice, eh?

You are right that psychology is one of the most difficult parts of medicine. It is hardest to study scientifically, and hardest to diagnose.

Most "western" medicine is FAR more precise than psychology. I take some very expensive maintenance medicine, and if I took your advice, my life would be MUCH worse. Without western medicine, I would be crippled by allergies, I would be bald, and I would have life-changing digestive problems. No herbs would change that. You show your insanity for suggesting so. Taking pills every day is much better than the alternative.

Re:Important distinction

[dgatwood]

Wouldn't it be a heck of a lot easier to just sprinkle baking soda on the corn?

Re:Important distinction

[SatanicPuppy]

I don't know. I think one of the reasons that she picked me as the legal authority in her medical care, should she become incapacitated, was because she trusted me to be compassionate and concerned...and also to be a righteous bastard should it be necesarry.

She and I disagreed on a lot of things in life, but never on stuff like that. Living is about a lot more than just having a pulse.

Re:Important distinction

[TheRaven64]

One side effect of this is that the patient's organs are unlikely to be in a fit state for transplant surgery after they have starved to death, often aided by large doses of morphine. This means unscrupulous doctors are less likely to suggest killing a patient in a PVS for their organs, but it also may mean people have died who could have been saved if PVS patients had been euthanised in other ways.

Re:Important distinction

[octopus72]

I think noone really wants to actually die in the last conscious moment of his/her life, not even suiciders, When you are about to cease from existance, it must be terrifying. But for someone in coma life can be a prolongation of agony. People let their dogs be killed to avoid suffering, why not apply the same rule to humans.

Only 'issue' with eutanasia is that many of those watchdogs (poking nose into what isn't their business) are in fact merely worried about what will eventually happen to them when it's their turn to die. (But religious fanatics are also force to reckon with in this case)

Re:Important distinction

[Alsee]

I'm really afraid of people like you.

You're afraid of someone who went through the pain and suffering of faithfully following their loved one's last wishes?

I'm afraid that when time comes they will lie ... and expressed wisshes opposite to my real ones.

That's pretty pathetic if you can't find a single trusted loved one to home to give power of attorney for such cases. I sure as hell hope you're not married.

-

Re:Important distinction

[octopus72]

Well it's in pretty expensive. "Feeding" a vegetative person means keeping a body alive, cleaning it, taking care that it doesn't develop skin ilnesses from inactivity and taking care about "byproducts". It costs, and if person doesn't have a chance to wake up, why not use those resources to improve care for other ill people (with a chance to survive)?

Re:Important distinction

[TClevenger]

Exactly. When most of your brain has turned to spinal fluid, no drug is going to fix things.

Re:Important distinction

[Alidar]

I also liked the fact that it didn't require a congressional act for one case. I've always preferred working for the rule and not the exception.

Re:Important distinction

[dan_bethe]

Unfortunately, the meds can do nothing for your severe case of arrogance. I'm afraid you'll have it for the rest of your life.

Sign me up!

[kjart]

activates dormant areas of the brain that can make patients aware of their surroundings and even hold conversations

Sounds like something every slashdot reader needs! Now if only there was a drug to make you move out of your parent's basement........

I've always found that...

[Anonymous Coward]

Salad dressing always seems to bring my vegetables to life.

*cue cricket cheeps*

What?

Re:Oblig. Terri Schiavo comment.

[smcavoy]

the autopsy showed she was a vegetable and not just in a vegetative state.
She died years ago.

Re:Oblig. Terri Schiavo comment.

[pedantic bore]

Pull the plug too early? Her husband would say "we" waited many years too long...

According to the autopsy, this drug would have had to have done a lot more than described here. Maybe if they'd given it to her when she first fell into a coma (we'll never know) but by the time she died, her brain was irreperable.

Re:Oblig. Terri Schiavo comment.

[RsG]

I seem to recall that her autopsy found what was essentially mush where her neocortex would be. I would tend to guess that that kind of damage really is irreparable - but IANANeurologist, so I don't know for sure.

Assuming we could fully repair braindeath (ie, restore the brain when higher functions have been lost), what would remain of the original person? Would we have an adult with infantile brain capabilities, a blank slate? How much of a person's identity is hardcoded? And what are the ethics of the situation - do we revive someone knowing that we'd be making them start over from scratch (and maybe not even that - most of early learning is made possible by infantile brain "plasticity", which an adult brain lacks).

It's not an easy question...

just kill me

[m874t232]

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.

Re:just kill me

[aadvancedGIR]

I really agree, beside dignity issues, there truly are states worse than death. Too bad most doctors consider one more day of agony a great victory.

Re:just kill me

[Itchy Rich]

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.

Re:just kill me

[FlopEJoe]

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...

Eh? Sounds like my morning coffee after a night too much cheer! (not to make light of folks with real mental distress)

Re:just kill me

[MBGMorden]

That's nice to know. Be sure to tell them that on your first awakening so that they can carry our your wishes afterwards.

That fact bears nothing on the usefulness of this drug though, as it's the lone opinion of yourself. Others may (and probably do) share that viewpoint, while still others will not. There are plenty of people who very much would like this, and as such it's a worthy pursuit.

Re:just kill me

[ChrisMaple]

Your opinion is self-contradictory. The drug would allow you to control yourself for a brief period, probably even commit suicide if that's what you wanted. You would have an improved chance to reach a state where the drug would not be required. Without the drug, you would be at the mercy of those taking care of you, with nothing but your "living will" document to protect you.

Re:just kill me

[Neurotoxic666]

Yeah. But what if the drug actually shows you were misdiagnosed PVS? And what if we develop an improved drug that has a longer effect? And what if we end up with some sort of a cure, in the end?

It's always easy to say "I'd be better off dead". But you wouldn't be aware of your condition anyway. So hey, why not wait a few more years and risk being "revived"?

Re:just kill me

[valkoinen]

Ah, hangover. First you are afraid that you will die. Then you are afraid that you won't.

Re:just kill me

[ultranova]

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.

If your brain is so badly damaged that you aren't aware, why do you care what happens to you afterwards ? After all, you won't be aware of it.

Me, if I have to choose between depending on some chemical to stay alive or die... Well, I keep on drawing in oxygen, don't I ?

Re:just kill me

[Mayhem178]

That is an incredibly selfish point of view. I agree with the grandparent. If I'm out of it and my chances aren't looking good, then I want it over, not just for my own sake, but for my loved ones as well. Every day I go on living would be another day of misery for them, not to mention hellacious hospital bills. Do you know how much a single day of intensive care costs? Try spreading that out over several years.

The drug would allow you to control yourself for a brief period, probably even commit suicide if that's what you wanted.

You do realize that the drug in question functions by altering your brain chemistry, and that any testimony or request made (such as the decision to commit suicide) while under the influence of this drug is wide open to attack by the legal system. And that's completely disregarding your previous non-responsive state. At least your "living will" can be protected and honored by virtue of being written while you were in a sane state of mind.

Re:just kill me

[linuxcoder]

But there is no money in letting a person die. The medical industry would want no part in that.

Re:just kill me

[RockModeNick]

The real question is if a patient could build towords an active concious state with this drug therapy... getting brief responsiveness occasionally is something, but if it could eventually lead to enough brain activity for possible recovery is the most important prospect of this development.

Re:just kill me

[RonBurk]

> 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.

You want to die if we run out of coffee? Geez.

Re:just kill me

[sheldon]

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.

Who are you to decide?

My God, are we all going to have to get tatoos which say 'Do Not Resuscitate' to keep you busy bodies out of our lives?

Re:just kill me

[vertinox]

So hey, why not wait a few more years and risk being "revived"?

Judge: "All in favor of waiting a few years of being alive say "Aye""

Doctors, Nurses, Lawyers, and Culture of Lifers at the bedside: "Aye!"

Judge: "All those opposed... Say "Nay!""

Patient: "..."

Judge: "The "Ayes" have it!"

Re:just kill me

[Itchy Rich]

Who are you to decide?

I'm not deciding on anyone's behalf. I'm just suggesting that m874t232's claim that it's a crime to keep people alive might be missing a little perspective... notably the perspective of the patient, who may wish to live if only for one hour a week.

Re:just kill me

[955301]

No, I'm pretty certain that all of the I's that m874t232 used in his post meant he was talking about himself.

Re:just kill me

[YoungHack]

> 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.

Re:just kill me

[Itchy Rich]

No, I'm pretty certain that all of the I's that m874t232 used in his post meant he was talking about himself.

...and I don't think he knows himself as well as he thinks he does. You can prove me wrong by offering him a choice between death or life-long drug dependence and showing that he chooses death.

Re:just kill me

[Itchy Rich]

Sorry to hear that mate.

Re:just kill me

[sheldon]

You can prove me wrong by offering him a choice between death or life-long drug dependence and showing that he chooses death.

That's what he said he choose. Your claiming that you think you know better than him.

Christ, what is it with you people? Why can't you just mind your own fucking business, and let the rest of us well enough alone.

Re:just kill me

[thePowerOfGrayskull]

Probably because knee-jerk responses like, "Oh, just kill me now" or some variation thereof sound childish and immature to anybody with a little perspective. However, nobody is stopping him -- or you -- from offing yourselves at the first hint of infirmity. Party on, dude.

Re:just kill me

[955301]

Well, I'm not going to personally fault someone for wanting to let go according to their bodies condition instead of hanging on according to the state of the art in medicine.

My father had a stroke in 1999. He went from an athletic headstrong 55 year old machine to a half-paralyzed forgetful dependent. With the hemmorage in his brain applying pressure to the rest and killing things in the surrounding area, the doctors brought up the chance that he would be have to remain on life support to breath or swallow. He said he was not interested in do ing that. He repeated that point after we got him home and described the whole ordeal to him, since he was out for most of it.

Having witnessed the situation you guys are hypothesizing about, I am confident telling you that the inherent desire to live is directly tied to the desire to thrive. If no prospects of thriving exist the desire to live suffers as well.

For another real live test case, I'd bet that Ariel Sharon would not want to be kept alive in his current state.

http://en.wikipedia.org/wiki/Ariel_Sharon

I'd also bet that if you gave him meds to regain minimal consciousness it would not change his mind.

Re:just kill me

[sheldon]

Probably because knee-jerk responses like, "Oh, just kill me now" or some variation thereof sound childish and immature to anybody with a little perspective. However, nobody is stopping him -- or you -- from offing yourselves at the first hint of infirmity. Party on, dude.

When you've got the Republican Party going around these days declaring their ought to be Constutional Amendments to ensure people are kept alive, protecting your rights to minding your own business is no longer a joke.

Re:just kill me

[m874t232]

as it's the lone opinion of yourself.

No, it's not. It's the opinion of a sizeable fraction of the population, maybe the majority.

There are plenty of people who very much would like this, and as such it's a worthy pursuit.

It's a cruel and inhuman experiment in my opinion. If it weren't for ridiculous medical interventions, these people would have died long ago already.

Re:just kill me

[m874t232]

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 not a question of "dependence"--these people are never going to leave the hospital or even have a clear thought again in their life.

And I have watched enough relatives face choices that involved far less disability and seen them choose not to go on. If you're at peace with yourself and your life, it's not such a hard choice to make.

Re:just kill me

[m874t232]

Or maybe I know better than you do, because I've actually had to come to terms with this issue personally and watched a number of relatives (both old and young) face these questions.

Here is a medical perspective on such questions.

Re:just kill me

[Itchy Rich]

Your claiming that you think you know better than him.

Funny, I thought I just said that.

Re:just kill me

[Itchy Rich]

Or maybe I know better than you do, because I've actually had to come to terms with this issue personally and watched a number of relatives (both old and young) face these questions.

I'm sorry for any suffering your family may have faced, but I refuse to believe that you know how you will react until you're in that situation yourself... particularly when the alternative to death is only a drug dependency. Get some perspective mate, before you top yourself when faced with a twisted ankle.

Re:just kill me

[MBGMorden]

If it weren't for "ridiculous medical interventions", a very large portion of the population alive today wouldn't be. You're not a "faith healer" type are you?

Re:just kill me

[StikyPad]

I'd say the lack of complaints on behalf of people removed from life support speaks highly to their satisfaction with the decision.

That's a joke, in poor taste, but I honestly believe the people who suffer most in these situations are not the people laying in the hospital beds, but the loved ones who must struggle with deciding their fate.

The reason I would never want extraordinary measures used to save my life has nothing to do with my survival instinct or lack thereof, but rather because as it stands now, when I can look at the hypothetical situation objectively, I can say that I would not want to risk being an enormous burden on my loved ones. The small chance that I might have a full recovery is not worth putting them through the stress of waiting to find out, or the years of taking care of what-used-to-be-me. Furthermore, I wouldn't trust anyone to objectively make such a decision in regards to my life, because they would make their decision the same way I have -- based not on their own best interest, but rather what they would think best for me. But it's my life, and I'd rather take responsibility for what happens to me; if for no other reason than to alleviate any potential guilt. Of course I'd never tell my family that, because that would defeat the purpose. As far as they know, it's just what I want.

And really, even if I changed my mind in the actual situation but couldn't communicate it, I'm pretty sure I wouldn't care once I was gone.

That's just my position, and I respect anyone else's position or decision as well. I think people should be free to make whatever arrangements they desire, and government should keep well out of it.

Re:just kill me

[m874t232]

until you're in that situation yourself

I guess I haven't been clear enough: I have been in the situation of having to make that choice. I decided I do not want to live with severe physical disability or brain damage, and I left clear instructions that I do not want to be resuscitated (fortunately, things worked out OK that time).

particularly when the alternative to death is only a drug dependency.

You are so terribly naive. This isn't "only a drug dependency" or a "twisted ankle", these people have severe brain damage and that's not going to get fixed, ever; they can look forward (albeit dimly) to a future of bedsores, abusive nurses, and watching soap operas as if they were lectures on particle physics in Japanese.

Re:just kill me

[Itchy Rich]

You are so terribly naive.

Now now... don't scratch.

I guess I haven't been clear enough: I have been in the situation of having to make that choice. I decided I do not want to live with severe physical disability or brain damage...

You're still not being clear enough. Am I now speaking to a corpse?

Re:just kill me

[m874t232]

You're still not being clear enough. Am I now speaking to a corpse?

The time to make a living will is when you face serious medical issues and risky procedures, not afterwards. In particular, the people in the article simply can't choose anymore: they have severe brain damage, and no matter what they say now, their choices will not be respected.

Go find out a bit about life and death before you presume to lecture other people on whether they know what their own preferences are. You're evidently the person here who doesn't know what he's talking about and you're the person who has no idea how he would choose once he'd face that issue.

Re:just kill me

[Itchy Rich]

The time to make a living will...

You don't seem to have understood my point. I don't think people are capable of predicting how they will feel in the actual event of serious illness. Given the vast variation in ways you can become ill, even to lump them together is ludicrous, let alone try to predict how you'll feel in those situations.

For example, what if you realise you're quite happy in whatever situation you end up in? Reduced mental capacity is hardly enough to warrant death, take Down Syndrome kids as an example... they're sweet, lovely people who would not want to die just for being the way they are.

Go find out a bit about life and death...

You have no idea what my experiences are. You should find out before presuming to tell me to go and learn about life.

...you presume to lecture other people on whether they know what their own preferences are.

Preferences change, particularly in adverse circumstances. I hope you don't have to find that out... particularly since you'd then be sentenced to death by your own "living will".

Re:just kill me

[thePowerOfGrayskull]

The link you give is to the opinion of a columnist... to be honest, I'm not quite sure how this equates to the Republic Party wanted to pass amendments.

Re:just kill me

[sheldon]

The website is a PAC run by Alan Keyes, who was a candidate for the nomination back in 2000, and tried to run for the Senate in 2004. It's the Republican base speaking.

Re:just kill me

[Itchy Rich]

What part of "I made my living will before undergoing a risky medical procedure" did you fail to understand?

The part where that's not what you said. Besides, you're still making decisions before you're actually in that condition. The point I've been trying to make is that until you are in that position you will not know how you might feel about it.

That's a risk I'm taking.

Exactly. Living with PVS and these drugs might be the happiest days of your entire life. You are absolutely, uncategorically, not qualified to predict how you might feel under those circumstances. By all means arrange to stop your own life support, that's up to you, but I stand by my point that you're completely in the dark as to how you'll feel about that decision when you're actually in that condition.

You are, unfortunately, an example of the kind of meddling idiot who presumes he can tell other people how they have to run their lives.

Temper temper. At what point have I told you how to do anything? (That's a rhetorical question by the way because I didn't, but if you like I could give you a few pointers on how to conduct a civilised discussion.)

Re:just kill me

[thePowerOfGrayskull]

The website is a PAC run by Alan Keyes, who was a candidate for the nomination back in 2000, and tried to run for the Senate in 2004. It's the Republican base speaking.

I suppose you could look for conspiracy if that's what you choose. In my naivete, I'll just take it at face value -- the foolish rantings of a columnist who is generally only read by people who are already convinced that he's right.

Re:just kill me

[sheldon]

I suppose you could look for conspiracy if that's what you choose. In my naivete, I'll just take it at face value -- the foolish rantings of a columnist who is generally only read by people who are already convinced that he's right.

Really? I'll remember that the next time I hear someone ranting about Michael Moore.

Re:just kill me

[Itchy Rich]

I give up. Your ignorance and stupidity just can't be beat.

Come on mate. I'm trying to have a rational, calm, conversation about a serious topic, and you're just whining about me being "ignorant", "immature", and "stupid" but have totally failed to back any of that up with rational argument. Show me where I've been immature. Explain it like a grown up, without any of your bitching, then I might take you seriously.

Re:just kill me

[thePowerOfGrayskull]

Really? I'll remember that the next time I hear someone ranting about Michael Moore.

Please do -- he's right up the same alley.

Re:just kill me

[MysteriousPreacher]

Wow - that is a really selfish viewpoint in my opinion. What about your family and friends that have to watch, wait and fund these couple of years? Do you realize what kind of a toll having someone in the hospital like that takes on the people around them? I would never want to put my loved ones through that. I would much rather give them closure and allow them to get on with their lives.

Well put.

This raises the key question. Who is benefiting from a 'dead' person being kept alive indefinitely? I suspect it's the friends/relatives who just can't let go of that person rather than the poor sod on the breathing machine. It's like having a dead relative stuffed and placed in your living room so you can still feel close to them.

Re:just kill me

[Richy_T]

Don't listen to Sheldon who is just being argumentative. Surveys have shown that of people who have expressed a desire to be put out of their misery if ever they get in to such-and-such a state have, where it's possible to communicate with them while in that state recanted that view. Even severely brain damaged or physically injured, it's still possible to take great enjoyment from life. One person who was cited expressed that every minute extra he had with his grandchildren was reason enough to stay alive in itself.

Point is, it's easy to be glib about your attitude to severe disability when you're up and healthy but don't be so sure about things. At the very least, we should wait to ask people, or rather, as them again (where possible) when they actually reach that state.

Rich

Re:Oblig. Terri Schiavo comment.

[KiloByte]

You would have to grow that person all the brain parts they're missing first.

But of course, we'll have a lawsuit from Terri Schiavo's parents in no more than a few days.

Re:One Big Problem

[kg4czo]

http://www.rxlist.com/cgi/generic/zolpid.htm
http://www.nlm.nih.gov/medlineplus/druginfo/medmas ter/a693025.html

I don't see any mention of fetal stem cells. What I do see is the non-generic names for the drug: Ambien® and Ambien CR®.

Where's....

[Misch]

Where's Robin Williams and Robert De Niro when you need a movie made?

Re:Where's....

[arivanov]

Unless I am mistaken Awakenings was based on real series of medical cases. In fact there was a documentary preceding the movie.

but...

[Shivetya]

does it work on managers?

Re:Terri Shivo

[Hao Wu]

But it was for 'the greater, common good....'

Cool, but...

[MWoody]

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...

Re:Cool, but...

[RsG]

Well, to point out the obvious, long term PVS leads to degradation of the brain. In the Schiavo case that's being brought up in this thread, what remained of her brain had severly atropied, and much of the higher brain centers had been replaced with spinal fluid.

If someone's family memeber were brain dead, then waiting for a miracle cure might not be an option. After all, if it takes ten years for even a partial cure to become available, then that's ten years in which the afflicted is slipping further and further away. This sort of drug might help someone who gets hit by a car tommorow, but it probably won't do much good for someone who got hit by one years ago and has been dead to the world since.

Re:Cool, but...

[plunge]

As we get more and technologically advanced, these what-if questions will always come up, and it's important to be serious about it.

If we develop the technology do bring a truly dead person back to life: to re-animate a day old corpse, will cremation be murder?

Or take the Schiavo case: it may one day be possible to insert new brain cells into someone like that and have them get up and be a person again. But they may not be the same person: the old brain matter that held their memories and personality may be gone. And yet, since we can do that, should we never pull the plug on a brain dead person?

What makes you, you? And what rights do YOU have in determining whether medical science can essentially keep your body alive, forever, no matter what happens to that "you?"

Re:Cool, but...

[penguin_dance]

I was thinking the same thing. My first thought was, "and it's way too late for Terri Schiavo."

What's really scary is some hospitals are also making the decision--they're telling people they either have to move the relative elsewhere, or pull the plug. Not just people with PVS either!

No one really know what a person with PVS comprehends or not. And some people have come out of a diagnosed PVS state saying they could understand everyone around them, but couldn't respond.

I just suggest everyone (which ever way you feel) to get a living will to at least give a chance of your wishes being followed and at least known.

Re:Cool, but...

[Alzheimers]

That would be a case to consider if, for example, you're in the process of taking over the Enterprise by guilt tripping the Doc.

Re:Cool, but...

[sheldon]

If God decides that a person is to die, but we have the medical technology to prevent that from happening, what is more moral?

Is it moral to undermine the Will of God?

Re:Cool, but...

[Joe Tie.]

But you can't expect laypeople to understand the difference, really

I think you're seriously underestimating the intelligence of the average person on the street. Yes, neurology is a pretty hefty subject. But getting enough of a base in it to at least understand the situtation a loved one is in isn't an impossible task by any means. There's popular science books aplenty that are written by people with actual working experience in the field, who can be counted on to supply quality material to any adult of average intelligence.

Re:Cool, but...

[ObsessiveMathsFreak]

Imagine the horror to imagine that this drug could have brought their loved ones back.

Why image, what TV can provide?

"Not long after... they found a cure. A goddamn cure!"

Re:Cool, but...

[Profane MuthaFucka]

Terry Schaivo had less than half her brain left, so it's not too late for Terry Schaivo. Anything that could have saved her, for example, a brain transplant, still hasn't been invented.

Re:Cool, but...

[c0d3h4x0r]

And what rights do YOU have in determining whether medical science can essentially keep your body alive, forever, no matter what happens to that "you?"

Every human being of sound mind and decision-making ability has, by simply existing, the natural right to do anything they want to their own body, including terminating their own lives. For anyone else to step in and question or deny that natural right is simply unethical and wrong.

It's not anyone else's place to second-guess or challenge the decision of a vegetative person who, before becoming vegetative, decided against being kept alive should such circumstances ever occur.

In cases where no such wish was ever expressed by a person before they became vegetative, it should fall to immediately family/parent/guardian to step in and make the judgment call, since they are of sound mind and can make a decision whereas the vegetative person cannot.

Re:Cool, but...

[plunge]

"Every human being of sound mind and decision-making ability has, by simply existing, the natural right to do anything they want to their own body, including terminating their own lives."

That's not entirely right, because we can legally prevent someone from committing suicide: which the law treats as by definition being indictative of a lack of competance due to mental illness.

But you are right insofar as you mean refusing medical treatments or proceedures that would prolong life.

And I of course agree with and very much support people's rights to make their own medical decisions, including when to stop medical treatment.

Re:Cool, but...

[octopus72]

Take an ecstasy and figure out what others think about your right to do with your body what you want. Human society does and always did favour rules beneficial for the society at the expense of indiviudal rights (in this case prohibiting the use of drugs).

Re:Cool, but...

[MysteriousPreacher]

How you know that a person's death is God's will? Since you can never come to a conclusive answer for this it's probably best to allow mortals to make a decision and then if they are struck by lightning assume that the decision was a bad one.

Re:Cool, but...

[Richy_T]

If "God" decides that a person is to die but we are able to stop it through medical technology, did God reallu decide that that person was to die?

Rich

Re:Cool, but...

[Richy_T]

Heh, I was thinking of just that reference.

Rich

Exciting... but unproven.

[Puls4r]

Aside from the obvious issues here of a very minimal sample size, it sounds like some doubts have been raised as to the accuracy of the original diagnosis of persistent vegetative state (PVS).

We understand very little of what causes a person to shutdown and go into PVS. As such, it is EXTREMELY hard to truly diagnosis and pinpoint what is going on. Normally, we wait. If they wake up, it wasn't PVS.

This is like a myriad of other diseases like SIDS that are vaguely defined. Many more incidents are attributed to the issue than are actually caused because we simply don't understand it.

Hyperactivity disorders in children are another perfect example of a rather subjective diagnosis leading to over-prescription and misunderstanding. All that said, hopefully another set of trials over a wider base of patients proves some hope. (insert the obligatory Robin Williams "awakenings" quote here).

Re:Terri Shivo

[vandan]

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'.

birth school work death

[digitaldc]

...that can make patients aware of their surroundings and even hold conversations

It could be argued that this could not only help those in a vegetative state, but our society in general. ;)

It's not news yet

[hey!]

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.

Re:It's not news yet

[ChrisMaple]

News is precisely what this is. By the time it's become an established fact or established medical practice, it's long since stopped being news. Even by the time it's been replicated and published in the appropriate journal, it's fading from the news scene, although each new publication is a separate news item. The root of the word "news" is "new".

Re:It's not news yet

[hey!]

I don't agree with your definition of "news"; somebody claiming that the moon is made out of chocolate pudding isn't news, even if it is "new". It's just the same old malarkey. And one out of twenty times a well designed study will yield a statistically significant result contrary to established fact, jus tby chance.

But if you insist, we can say "newsworthy". As in worthy of forming an opinion about matters of public import over.

The problem is that the claims here are so uncredible that they hardly bear paying much attention to until they've been replicated and peer reviewed by a different committee with a different makeup. It's not that they're necessarily untrue, but a few more peas (not the whole bunch as you say, but more than one) have to hit the wall before it's worth taking into consideration as "newsworthy". If you sit up and pay attention to every published claim that the current body of scientific knowledge has got it all wrong, then you're life will be a constant attempt to pick sense out of nonsense -- the few sensible and revolutionary discoveries that do occur notwithstanding.

Re:It's not news yet

[Richy_T]

I don't agree with your definition of "news";

Pfft, if they can put sports results and articles in the "news", I'm ready to accept anyone's definition of news.

Rich

Re:Oblig. Terri Schiavo comment.

[clickclickdrone]

For those that didn't bother to read the medical reports and instead relied on the newspapers/media, Terri's brain had totally atrophied away, it was gone. Her skull contained the brain stem, a bit of shrivelled brain and an awful lot of fluid. There really was no hope, she was long gone.

What simple questions?

[suparjerk]

It'd be cool to know exactly what "simple questions" were asked and what their responses were. My definition of a "simple question" might differ from theirs. Even if they had asked /complex/ questions, that doesn't necessarily mean the answer was correct or even intelligible.

Researcher: Hi there, can you see me? Patient: FFOOOOOOOOOMDE!

Sure, they interacted with the researcher and they answered a simple question. Their response could even arguably be considered a word, perhaps poorly pronounced, but... I fear the article leads this discovery to sound more amazing than it actually might be.

Re:What simple questions?

[Tx]

I was wondering the same thing. Like did "catch a basketball" mean a basketball thrown from across the room with the patient standing up, or dropped into his arms from a couple of inches with him sitting down. It's the usual frustrating lack of detail we get with mainstream media reporting of science issues. I understand they want to keep it simple, but make it too simple, and the report becomes almost meaningless.

Re:What simple questions?

[KarmaMB84]

It's probably more like
Researcher: Hi there, can you see me? Patient: BRAAAAAAIIIIINNNZZZZZZZZ

Re:What simple questions?

[F_Scentura]

"Sure, they interacted with the researcher and they answered a simple question."

Ah, just like Schiavo, I'm sure.

Re:What simple questions?

[inKubus]

Well, gathering from the article and a few other posts:

There are two sides of the brain, the conscious and the subconscious, with a sort of database in the middle. The conscious mind is associated with meaning, emotion, deep thoughts. The subconscious is associated with motor skills, communication, and logical thoughts.

There's a collection layer that handles getting data from your senses (eyes, ears, nose, etc.). The conscious mind is what you use for memories. It handles tagging data with meaning before it's inserted into the database. If there is no meaning, it cannot be retrieved from the database. More on this in a second.

The subconscious is the section that's responsible for acting on things. You know how sometimes you just "get that feeling"? That's when you are sort of aware of your subconsious working. Your subconscious has read access to the database, so it can draw on all the stuff in there to run your body, even if you are no longer learning (conscious tagging and assigning meaning to sense data).

Ambien turns off the conscious mind and actually stimulates the other sections. So you hear stories of people on Ambien running tractors or cooking breakfast in their sleep and then having no recollection of it. Their subconsious mind is easily capable of performing these tasks, it can just refer back to the thousands of other times you've walked or driven or cooked eggs.

So, in people who's brain is damaged in such a way that their subconscious faculties are still working somewhat, if you stimulate what is still working, you can get a reasonable facsimile of a healthy person's behavior, as far as logical tasks are concerned.

But all this really does is explain why Ambien is a really really bad choice for a sleeping medication. I mean, it activates your mind and body but turns off it's ability to record. You are, in essence, a zombie.

Re:What simple questions?

[jamstar7]

What, he was talking to the President?

Re:I have plenty of Karma

[Random Destruction]

You're right. Won't the BBC please think of the Americans?

Re:I have plenty of Karma

[The Ape With No Name]

Slashdot article, Mr $uid > 500000.

Starving...

[electrosoccertux]

If she was dead, why not use a faster means of death? Like lethal injection or something. We wouldn't cruelly starve an animal to death. I think that would have been too quick; would have looked too much like murder (as if starving her were any better). It's odd that the painful of treatements was the more socially acceptable.

Re:Starving...

[RsG]

Sociey doesn't prevent you from killing yourself - it only treats you the same way it treats anyone else found ODing or bleeding to death, or whatever. It's just that medical proffesionals aren't instruced by law or common practice to treat possible suicide cases any differently. Technically suicide is legal in most places, though assisted suicide is another matter.

As for refusing medical treatment, that depends on the circumstances. You'll note that, for example, people in mental hospitals can't refuse to take their meds. If you're bleeding on the sidewalk, I don't think the paramedics are going to listen to you if you tell them to stop trying to treat your wounds.

I'm not disagreeing with you, but I think you misunderstand why we as a society try and save people from suicide attempts, and allow people to refuse things like chemo.

Re:Starving...

[Doc Ruby]

Because the same groups of theocrats trying to pray Mrs Schiavo's brain back from the dead have actually succeeded in thwarting America's euthanasia movement. Even people who face an horrible, immediate terminal condition ("certain agonizing death") with determination to spare themselves and their family the fear, pain and expense with dignity can't get help to kill themselves quickly and painlessly. Because America's Christaliban has already got more political power in shaping the laws.

Instead, "Compassionate Conservatism" demands people get tortured medically as long as pharmacos have a legal patient. When Republicans need political lifesupport, they'll move heaven and Earth to invade people's privacy even to interfere with what little protection we have for letting a dead person's body join them after a decade of medical and legal consensus.

Re:Starving...

[ultranova]

If she was dead, why not use a faster means of death? Like lethal injection or something. We wouldn't cruelly starve an animal to death. I think that would have been too quick; would have looked too much like murder (as if starving her were any better). It's odd that the painful of treatements was the more socially acceptable.

If she was dead, she was also unable to feel pain, and consequently it made no difference to her how she was killed (or even if she was). So why not pick a method that's easiest for those left behind ?

It's the same as graves: the dead don't care if you bring them flowers or if there's a fancy headstone, it's all for the benefit of the living. Bring me flowers and say nice words when I'm alive to hear them, don't worship my corpse when I'm dead, it's no use to me then...

Re:Starving...

[KarmaMB84]

Because eventually another family member with something to gain ($$$) from their death will gain the power to make medical decisions and argue they have the right to have them euthanized. I'm an atheist and I think the prospect of having people euthanize other people is horrendous. Abuse would be inevitable and you can't trust the courts not to throw out any provisions to stop the abuses.

Re:Starving...

[Doc Ruby]

What do you think of the thousands of people dying in agony across America right now who can't be euthanized? Either by someone else who's got the power after the dying person can no longer directly exercise it, or by the dying person themself?

Re:Oblig. Terri Schiavo comment.

[pe1rxq]

Bullshit....

The autopsy was watched closely by a lot of people who would have jumped at any chance to discredit it. They failed. She had no brain worth mentioning left.

Re:This could be an amazing discovery!

[Just Some Guy]

There is also obviously the danger that some people might want to take this drug for cognitive boosting effects which would not be a good thing if it was not highly tested before hand.

Especially since it's "usually used to treat insomnia" (summary). There's not much use for an IQ of 180 if you're asleep.

Re:Oblig. Terri Schiavo comment.

[RsG]

Yes, well I did specify that we'd need to be able to reverse braindeath (something this new drug doesn't do). That would mean something like cloning technology or medically created regeneration.

But I was thinking more specifically of the Schiavo case the OP brings up. Assuming we could have restored the parts of her brain that had liquified, would we have done her any good to do so? After all, instead of death, what you're instead giving the person is a sort of brain wipe.

Do we consider a person dead if the human aspect (the conscious mind) is gone? And is giving the braindead a new mind actually healing them, or merely condeming them to an existance of perpetual infancy? Because in the case of Terri Schiavo, even with miracle technology that we don't have yet, those are the only forseeable options.

You cannot expect to restore software when the hard drive has not only crashed and died, but has actually melted, no matter what kind of data recovery you have... and the information kept on a hard drive is more recoverable than the information stored in a human brain. Like I said, the ethics are complicated.

Re:Terri Shivo

[Welsh Dwarf]

This is the second thread on this, give it a break ok?

Mr Shiavo had already spent years keeping her alive, and paying for her treatement, when he could have just 'divorced and moved on' as you say. Also, the autopsy was performed by several doctors (not just one), and was overseen by people on both sides of the agenda, the point is that there was no brain left, and hadn't been for years.

Troll, please do not feed

[ianscot]

We've modded that "insightful"? A post that shows no signs of knowing thing one about the Schiavo case?

Re:Of Brains and Religion

[jamesh]

I think you might be a bit confused. It's the Scientologists that don't want your mental state improved with medication. They want you nice and stupid and gullible.

The Catholics are the ones that don't want you preventing pregnancy (be it masturbation, contraception, or abortion). Queue the Monty Python 'Sperm Song' :)

I don't see they could be angered by a drug which may (if the research is correct) result in less cases of pulling the plug on someone.

But maybe I missed your point...

Re:Terri Shivo

[jonnythan]

No, according to the autopsy.

The brain itself weighed 615 g, only half the weight expected for a female of her age, height, and weight. Microscopic examination revealed extensive damage to nearly all brain regions, including the cerebral cortex, the thalami, the basal ganglia, the hippocampus, the cerebellum, and the midbrain. The neuropathologic changes in her brain were precisely of the type seen in patients who enter a PVS following cardiac arrest. Throughout the cerebral cortex, the large pyramidal neurons that comprise some 70 percent of cortical cells--critical to the functioning of the cortex--were completely lost.

The damage was, in the words of Thogmartin, "irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons."

Re:I have plenty of Karma

[tehcyder]

Left-wing Americans

I think you miss-spelled "slightly-less-right-wing".

Re:Oblig. Terri Schiavo comment.

[demonlapin]

Do we consider a person dead if the human aspect (the conscious mind) is gone?

A private service by me to all of Slashdot who doesn't understand:

Brain death is defined legally as cessation of all brain activity, with the caveat that it is not due to a reversible cause. Brain dead people are, simply, legally dead. While we generally leave someone on ventilators and the like for a short period of time after brain death, because families often feel like death is when the heart stops (and they want to be there), there is no legal requirement to do so. Once a diagnosis of brain death is made, I can fill out a death certificate and turn off all the machines.

PVS is not the same; PVS patients have some brainstem activity but no evident higher function.

So, to answer your question, no, we don't. But you probably wouldn't want to live like that.

Re:Oblig. Terri Schiavo comment.

[Lord Kano]

Assuming we could fully repair braindeath (ie, restore the brain when higher functions have been lost), what would remain of the original person? Would we have an adult with infantile brain capabilities, a blank slate? How much of a person's identity is hardcoded?

Starting over with a blank slate is better than starving to death.

Another question is would this enable a person to feel pain that they wouldn't have otherwise.

LK

Re:Oblig. Terri Schiavo comment.

[RsG]

I don't know whether that plasticity would return or not. Actually, if we could restore a braindead person, then giving them back all the mental maeliability they had as an infant would probably be trivial. The real pain would be rehab; imagine trying to re-teach everything - absolutely everything - a person learns in their childhood all over again.

As for the pruning thing, that is a very interesting question. I guess we could probably do it if we could pull off all the other miracles we're talking about in getting a braindead person healthy. The problem might be testing it - this is not the sort of thing you can easily test on animals, and the ethical problems with human trials would be a big hurdle.

The funny thing actually is that if we had the techology to cause neurological plasticity and neuron pruning, we'd probably ban it, fear it, or at least put heavy restrictions on it, given the abuses that could come out of it. Can you imagine what a totalitarian government would do with a way "reeducate" dissidents? We've already got people up in arms over GM tech, stem cells and human cloning, and those are all relatively minor by comparison.

Re:NOOOO!!!! TERRYYYYYYYYYY!!!!!!!!!!

[narcolepticjim]

It's unlikely anything would have helped her. The sheer amount of brain tissue that died as the result of her cardiac arrest probably precluded any treatment for her.

Re:Oblig. Terri Schiavo comment.

[RsG]

Depends on your outlook. I would view the loss of my mind and identity the same way I'd view my death. Which I guess is why I wonder if we'd be doing someone a favour by "saving" them, when it won't really be the same person who comes out the other side.

Re:Terri Shivo

[R2.0]

"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?

Re:Oblig. Terri Schiavo comment.

[pla]

Did we pull the plug too early?

For better questions:

Who funded this study?
How did they define a PVS?
Did multiple doctors concur on the diagnosis?
How do they define "aware of their surroundings", and "conversation"?


All of those, pushing them just a little too far in one direction, could mean the difference between "zolpidem makes people in a coma twitchy" and "zolpidem cures living death, malaria, snake-bite, and anal warts".


I would love for this to turn out a meaningful discovery, but it just seems too far from the realm of credibility. Keep in mind that you can make a dead and removed frog's leg twitch by applying electricity... Does this amount to a chemical version of that same experiment?

Re:Oblig. Terri Schiavo comment.

[Mr. Slippery]

Starting over with a blank slate is better than starving to death.

"Starting over with a blank slate" is just a quick death, followed by the creation of a new person who happens to look like the old one.

Indeed, if this "mindwipe" were painful, versus a well-anaethetised starvation, starving to death might be preferable.

Bah

[dumdeedum]

Drugs to aid vegetative patients is ridiculous when you can simply cure them by feeding them meat.

Re:Bah

[EZLeeAmused]

No, you're thinking of persistent vegetarian patients, a much worse condition.

As a side note, the "confirm you're not a script" word when I posted this was "barbecue"

What is the matter with me...?

[dkf]

I read that article title and immediately wondered if the researchers were using BabyBio or MiracleGro...

Re:Oblig. Terri Schiavo comment.

[Ihlosi]

"Starting over with a blank slate" is just a quick death, followed by the creation of a new person who happens to look like the old one.

And what if the new person happens to like his/her existence ?

Re:This could be an amazing discovery!

[wolff000]

Are you f@$%ing kidding me? have you ever meet someone who has woken up from a long term coma? I have and they are completely screwed up the muscles atrophied and if they can talk it seems that have a head full of jello. there is no way I would want that crap. If I end up in a coma pull the damn plug! I don't want to wake up months later and not be able to move and most likely have major brain damage. For short term coma pateints this would be great but long term ones need a serious evaluation before we try to wake them up. as far as not using drugs did you have coffee or soda there is a drug in there, had any chocolate lately one in there too. Smoke cigarettes? Cause that has drugs in it too. America's war on drugs is ridiculous. It's been going on for way too long and gogin no where. In fact more people use drugs today then when it started which means we are losing and the people on drugs are winning. What does that tell you about drug use?

This might help my daughter - more info?

[dzogchen]

My eldest child has an undiagnosed condition that has left her unable to walk, talk, move, eat etc. The condition developed gradually and doctors say that the problem seems to be in the brain stem. I gather that GABA affects the working of the brain stem.

Does anyone have a link to the actual paper, or more info on this? I hesitate to grind up an Ambien and put it in her G-tube, but even the thought of something that might help her brings tears to my eyes as I write this. You have no idea what it is like to watch your child essentially disintegrate right before your eyes -- it's been 18 years of torture.

Thanks in advance for any help.

Re:This might help my daughter - more info?

[nbritton]

"Does anyone have a link to the actual paper, or more info on this? I hesitate to grind up an Ambien and put it in her G-tube, but even the thought of something that might help her brings tears to my eyes as I write this. You have no idea what it is like to watch your child essentially disintegrate right before your eyes -- it's been 18 years of torture."

Try it, if you can get your hands on some. Ambien is a fairly mild drug in my book... read up on the prescribing information sheet and try it on yourself first to test for allergic reaction (rare) etc. Ambien CR is supposed to be a longer lasting version of this drug, the half-life for normal ambien is like 2.5 hours... BTW.. I'm not a doctor, but I did stay at a Holiday Inn Express last night :-).

Every time I've taken this drug, for sleep problems, I get amnesia from it. The best example I have for this was when I was in the hospital and was given this drug to help me sleep for the night, the nurses said I was up all night reading magazines when I 'knew' I had fallen asleep... I have also witnessed this side effect in other people, she was able to cook a meal on the stove and have a conversion with me but had absolutely no memory of this event, It's a common side effect for this drug but they like to down play it for sales... This I'm sure has something to do with the topic at hand...

Re:This might help my daughter - more info?

[dzogchen]

My wife has some at home. Before we try anything we will be talking to the doctor regarding any potential interactions - she also gets diazapam and prozac and has an intrathecal baclofen pump in her abdomen ( this hockey - puck sized unit puts 120 mcg of baclofen into her spinal fluid -- bypassing the blood-brain barrier -- if she had to take the stuff orally, to get that amount past the barrier would take about a dump truck full and trash her other organs)

I think the CR must mean controlled release, and as we have to give her meds through a G-tube, we need to either get them in liquid form or grind them, so most time-release stuff doesn't work as planned.

Re:This might help my daughter - more info?

[nbritton]

Yes, checking with her doctor first would be a good idea :-). I wish you luck and here is some more info for you:

Run this search through the PubMed database: 'Clauss zolpidem'.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=P ubMed You should get six hits and the email address for Dr. Ralf Clauss (the guy who did the study) is claussrp at yahoo.com

Google has some more hits: http://www.google.com/search?hl=en&lr=lang_en&safe =off&q=Clauss+zolpidem&btnG=Search

Re:This might help my daughter - more info?

[johansalk]

TALK TO YOUR DOCTOR FIRST before you try anything. You don't know for sure what effect it may have on her breathing and such.

Re:This might help my daughter - more info?

[dzogchen]

Re: TALK TO YOUR DOCTOR FIRST before you try anything.

We have calls in to her regular doctor as well as her neurologist. Hey, we might be desperate, but we aren't crazy.....

Re:Oblig. Terri Schiavo comment.

[plunge]

Better for WHO exactly? If the original person is essentially gone, who's interests are we serving in creating a new person in their old body? Not the old person's. Not even the new person's because they don't exist yet to HAVE interests.

Re:Oblig. Terri Schiavo comment.

[Mr. Slippery]

And what if the new person happens to like his/her existence?

So what? I don't have any ethical obligation to suffer pain in order to create a new person, regardless of how much that new person may happen to like his existence. Given the option of painful death + creation of new person (a person who, being an infantile mind in an adult body, would be a burden on others for many years) versus painless death, I'll take the painless death, thanks.

Oblig. Brain/Computer Analogy

[Kadin2048]

Back when the Schiavo thing was going on, somebody made what I thought was a reasonably apt computer analogy. I'll paraphrase as best I can (and apologies to whoever originally came up with it).

Being comatose is like a computer crashing. It can happen for a variety of reasons, hardware (injury) or software (psychological), and sometimes it's fixed by letting the system reboot itself (persn sits there until they wake up).

PVS is a lower-level issue. It's like having a device get bricked because the firmware gets hosed. Some low-level stuff might work, and the hardware might or might not be okay, but nothing's running on it.

The Schiavo case was like opening up a computer's case, and realizing that somebody's stolen the CPU, RAM, and motherboard, and replaced everything with the contents of the small-electronic-parts drawer at Radio Shack. You can try to reboot or re-flash that thing all you want, but it's never going to come back on.

I'm sure there's probably a bad car analogy in there somewhere, too.

Creepy

[Mab_Mass]

Patient N had been "constantly screaming", but stopped after being given the drug when he started watching TV and responding to his family.

Personally, if I were confined to a hospital bed with little hope of ever leaving, I'd spend some time screaming, too.

Somehow, the switch to watching TV just seems a little, well, brain-dead.

Re:What is death?

[plunge]

Indeed. This is why there is no real "moment" or qualification that the first living on our planet went from not living to living. It's a hazy continuum, not a bright line.

Re:This could be an amazing discovery!

[pwntang]

I don't know, that chick from Kill Bill seemed ok after her coma

Re:NOOOO!!!! TERRYYYYYYYYYY!!!!!!!!!!

[modmans2ndcoming]

the brain was much more intact early on in her condition. atrophy happens over years. (not that I thought she was worth saving at the point the controversy began)

Let's never talk of this again

[spun]

Or anything else that might offend anyone, anywhere. The most important thing is to put on a happy face and never disagree. Just nod and smile, there ya go, uuuhhh, let me wipe that drool off your chin...

Seriously, wtf? Just because an issue is controversial we can't talk about it? What kind of PC thought policing happy-happy joy-joy troll ARE you? Me, I only read the flamebait articles. Sure, there's lots of immature asshats, but the amazing thing is, on any issue with any kind of controversy, you also get plenty of thoughtful and interesting arguments from both sides. Which lets you strengthen your own arguments by responding to criticism from intelligent people. It's a little technique known as dialectic, you may have heard of it.

Re:This could be an amazing discovery!

[tehfenx0r]

Have you ever seen a normal person on ambein thats not sleeping? I have and they generally are talking to things that aren't there and stumbling around or throwing up.

Re:Oblig. Terri Schiavo comment.

[molo]

Couldn't they have done an MRI while she was alive and found this? Or maybe a Functional MRI? I don't understand why this wasn't detected earlier.

-molo

Re:Oblig. Terri Schiavo comment.

[Detritus]

It's a bit more complicated than that.

See http://www.notdeadyet.org/docs/schiavoautopsyPR060 5.html.

Coma

[Joebert]

I understand that breakthroughs in medicine usually happen this way, but I can't help wondering who thought,
"Hey, this person is in an advanced coma, let's see what this sleep medication does to them."

Re:Oblig. Terri Schiavo comment.

[P3NIS_CLEAVER]

this happened to me after a couple years of touring with the Dead.

Wtf are you talking about?

[Viol8]

Care to post a link to this supposed article Mr Coward or are you just
trying out some transparent BSing in the hope of getting me modded down?

Ubik

[nusuth]

Have you read Ubik? It might be useful to be able to return from death briefly.

Re:Oblig. Terri Schiavo comment.

[GnomeChompsky]

If that was the case, wouldn't a CT or MRI scan have revealed that immediately, ending all debate? Why were we subjected to this melodrama on CNN for a month and a half?

Re:What is death?

[MasaMuneCyrus]

When your brain completely shuts down, you're nothing but a lump of flesh that is incapable of doing anything. That, and when your brain shuts down, your body stops renewing itself, and starts decaying. That would be the definitive line for death.

Re:Oblig. Terri Schiavo comment.

[LunaticTippy]

I read the link and don't see how it's complicated.

Some biased non-medical activists disagreed with the autopsy results. What could be more simple?

Re:Terri Shivo

[Qzukk]

Then perhaps the solution should be along these lines: If a person is paying for the care, then that person can keep anything on life support for as long as they are willing/able. If that person is no longer willing or able, then anyone else "interested enough" in maintaining the patient on lifesupport can step forward, even against the first person's wishes. When nobody will step forward, the state will pay for X days of life support. At the end of these X days, if no person comes forward to claim responsibility for the patient's care, then the body will be collected for research and/or organ transplants (the public thus receives benefits for the costs incurred to maintain that life). To prevent people from gaming this system, once the state's X days begin, any person wanting to take responsibility for the patient must place a deposit for the average cost of the patient's daily care * X days.

This procedure would then be followed for all patients where the patient did not make an uncontested "living will" requesting withholding of life support in advance of the situation requiring it. If such a request exists and is contested, then the above procedure will be followed until proper proceedings have determined the validity of the request.

Re:Oblig. Terri Schiavo comment.

[cellocgw]

I would view the loss of my mind and identity the same way I'd view my death. Which I guess is why I wonder if we'd be doing someone a favour by "saving" them, when it won't really be the same person who comes out the other side.
You mean like what happened in Maine once?

Re:Oblig. Terri Schiavo comment.

[brouski]

They did do a CAT scan in '02 that showed severe cerebral atrophy.

Re:Oblig. Terri Schiavo comment.

[Phil-14]

IMHO, you don't know what her brain would have looked like before she went through roughly a decade worth of non-treatment coupled with the occasional court-ordered attempt (and the one that was successful was not the first) to cause her to die of thirst.

I'm reminded of all of those "self-fulfilling prophecies" from the old Greek legends.

All I am going to say

[majortom1981]

I know from real life experiences that some wierd things can go on in regards to comas.

I was in a coma for 5 weeks and woke up like nothing was wrong.

I also was in another one for a week. They had me on life support and everything. They didnt expect me to live.One day i woke up like nothing happened.That night I was complaining that I wanted to go home.

The mind still holds a lot of secrets.

I still have doctors who want to stick me in a hospital and run tests for months.

Re:One Big Problem

[Jah-Wren Ryel]

Damn! It seems no one has a sense of humor.

L-Dopa all over again?

[YesIAmAScript]

Perhaps this news should be held until the results can be studied before. This sounds very similar to the L-Dopa results years ago (see the movie "Awakenings" for the Cliff Notes). The problem was that the results were not permanent. And that may very well be the case this time too.

Re:Oblig. Terri Schiavo comment.

[ObsessiveMathsFreak]

How much of a person's identity is hardcoded?

Seemingly none. Dr Ewan Cameron essentially proved this via human experiments. [Source]

Linda Macdonald, 55 years old, an employment counselor now in Vancouver, is one of those who sued for compensation. "I walked through those doors with a husband on one arm and a guitar on the other and was a healthy person and coherent," she said.

Diagnosed as an acute schizophrenic -- she had gone to Dr. Cameron for treatment -- she spent 86 days in the "sleep room" and was subjected to 109 shock treatments and megadoses of barbiturates and other drugs. Reduced to a Blank Slate

When she got out of the experiment, she could not read or write, had to be toilet-trained and could not remember her husband, her five children or any part of the first 26 years of her life.

Re:Oblig. Terri Schiavo comment.

[RsG]

Ay, but that's part of the problem. The longer a person remains in a PVS, the worse their prognosis is. What are you supposed to do in that kind of situation? Keep them on life support, hoping for a miracle cure to emerge (and knowing that every year in which a cure doesn't emerge, the likelyhood of it working on the patient drops a bit further due to brain degradation), or letting them die with dignity?

Even in an ideal world, where brain damage could be reversed, I suspect there'd be an upper limit on how long the damaged person can afford to wait. And there is the unanswerable question in the Schiavo case of just how much damage was done when her heart failed in the first place - how much, if anything, a wonderdrug or other treatment could bring back. Chemo induced remission could be seen as miraculous - it's something we couldn't have done decades ago - but even then there is no guarantee it'll always work, or that you can get the cancer diagnosed in time.

Yet another reason for prevention

[Beryllium Sphere(tm)]

Avoiding situations like that, if possible, is not just in the interests of the patient. Prevention spares the family and caregivers from a situation in which, as for a slug in a salt mine, all decisions are agonizing.

Another Vegetative Illness:Encephalitis Lethargica

[reporter]

Like Zolpidem, L-DOPA produces a similar effect in patients who are afflicted with encephalitis lethargica. The illness causes its victims to enter a motionless, sleep-like state. Once they receive a dose of L-DOPA, the victims immediately awake and behave normally until the drug wears off.

The movie, "Awakenings", accurately portrayed the sleep-like state that befell the victims of this terrible illness. The movie started Robin Williams and Robert DeNiro.

Picture of Zolpidem

[Un pobre guey]

Search for Zolpidem at In Silico Sstudios

Re:Oblig. Terri Schiavo comment.

[Detritus]

The 39-page autopsy report is a bit more nuanced than "she was a vegetable", which is a debatable and simplistic characterization.

The medical study, and this isn't the only drug

[Frangible]

Effect of zolpidem on brain injury and diaschisis as detected by 99mTc HMPAO brain SPECT in humans.

The study investigates the effect of zolpidem (CAS 82626-48-0) on brain injuries and cerebellar diaschisis. Four patients with varied brain injuries, three of them with cerebellar diaschisis, were imaged by 99mTc HMPAO Brain SPECT before and after application of zolpidem. The baseline SPECT before zolpidem showed poor tracer uptake in brain injury areas and cerebellar diaschisis. After zolpidem, cerebral perfusion through brain injury areas improved substantially in three patients and the cerebellar diaschisis was reversed. Observations point to a GABA based phenomenon that occurs in brain injury and diaschisis that is reversible by zolpidem.

The problem with this study is a small sample group and no control. You can't make many broad conclusions from that data.

Indications, efficacy and tolerance of drug therapy in view of improving recovery of consciousness following a traumatic brain injury

... RESULTS: The synthesis provides evidence about the theoretical actions and efficacy of the available pharmacological agents. The clinical studies are less convincing: indications and therapeutic choices are empirical. Studies report often single cases. Randomised studies are rare, often heterogeneous concerning the aetiology of the brain lesions. The evaluation scales are varied and too wide. In this context, amantadin, amphetamine, methylphenidate and bromocryptin showed some positive effects. ...

All of the drugs described in the above study have dopaminergic function; either indirectly increasing dopamine levels (amantadin, amphetamine, and methylphenidate) or directly agonizing the receptors (bromocriptine). It is interesting that GABA, an inhibitory rather than excitatory neurotransmitter in most cases, shows efficacy here as well.

Good movie

[Pedrito]

I saw the Movie. Robin Williams and Robert DeNiro were great.

All kidding aside, this isn't unlike that case (which was based on a true story). In both cases, the affects of the drug are temporary, which really sucks for the people in the vegetative state. I mean, frankly, if it were me, I'd probably just want to be kept vegetative until you could end it for good. A few hours of being awake but being so weak you can't move and so groggy you can't make any sense of anything, probably wouldn't be very pleasurable. But I guess that's me.

Worst web site this month

[Beryllium Sphere(tm)]

To save you frustration: Volume 21 Number 1/2006, pp. 23-28
Try, with low expectations, http://tinyurl.com/e6wgz or http://tinyurl.com/krr39
There's a "free sample issue" button. Unfortunately it goes to the January 2004 issue. The actual article is at http://tinyurl.com/h6f79, USD20 for online pay-per-view.

Re:Worst web site this month

[dzogchen]

Thanks for the link. I agree with your assessment of the site. I was able to get a little more info thanks to your digging. I'm not at all sure if this will work for my daughter, but when you have no diagnosis and no prognosis you tend to grasp at anything that might offer help.

Re:Oblig. Terri Schiavo comment.

[Frangible]

My conclusion from recent evidence suggests that memories are not stored in the brain, or even in the synapses, but rather accessed through quantum microtubules or neurotubules within the brain. Assuming the regrown brain structures could access the same underlying quantum structure the previous neurotubules were able to, the person's memory should be intact, as the ultimate storage mechanism exists outside the cells of the brain in a quantum field.

Microtubules and memory

Some quantification of the quantum interactions of neurotubules.

Depending on how much of the brain and conciousness is a "quantum computer", rather than a neurological one, in addition to memory the person might lose little. It all depends on how much of our minds resides in neural cells, and how much is in the quantum field that it accesses. Bottomline? We probably don't know.

Bad example

[Beryllium Sphere(tm)]

If this report pans out we're going to have ethical problems that are "interesting", in the sense of the Chinese curse "may you live in interesting times".

Since Ms. Schiavo's brain had turned into soup she would not have been one of the interesting cases.

Re:Oblig. Terri Schiavo comment.

[LunaticTippy]

I'd read an autopsy analysis if you know of a link. My understanding of it is that she had permanent irreversable extensive brain damage and was in a vegetative state.

Childbirth

[Beryllium Sphere(tm)]

Ever noticed how often "his mother died in childbirth" appears in biographies? Used to be one of the leading causes of death for women. Good midwives could have prevented some of those, but I wouldn't try a home birth without prior medical screening, skilled on-site assistance (nurse, midwife, whatever) and a live phone line with E911 capability.

Re:Oblig. Terri Schiavo comment.

[NewbieProgrammerMan]

My conclusion from recent evidence suggests that memories are not stored in the brain, or even in the synapses, but rather accessed through quantum microtubules or neurotubules within the brain.

Er...what? So you're saying the information is not stored in physical structures in the brain, but rather some non-physical "quantum structure?" Somehow I doubt that either of the articles you linked (yes, I read the abstracts) suggests any such thing. However, if you can point out to me what specific evidence can only be explained by a non-physical storage mechanism, I'd be glad to see it - it would probably represent one of the greatest discovies in the history of the world.

Clarify the facts a little

[clonan]

I have to disagree with you when you stated "decades worth of non-treatment."

If you recall she received all potential treatment including at least one experimental treatment. She recieved a large amount of money in a malpractice lawsuit and essentially ALL of it was spent on experimental procedures and hospice care.

The sad truth is that even if there hadn't been a court order to remove her feeding tube, her family wouldn't have been able to continue treatment for more than a few years anyway. Hospice care is very expensive and you will not be able to keep people there indefinetly unless you can pay.

Her husband did everything possible and when no hope was left of recovery he tried to give her a death with dignity which her family, the media and the government denied her. Her death was very sad. Personally I think everything she was actually died over a decade ago. Only the empty shell of her body died recently.

The real tragedy of this whole situation was how the rest of us reacted to their private and painfull situation.

Re:This could be an amazing discovery!

[The Queen]

which means we are losing and the people on drugs are winning. What does that tell you about drug use?

Nice Bill Hicks reference. Boy do I wish we could wake HIM up right about now...but he'd probably rather be dead than know Bush II was in office...

Re:Oblig. Terri Schiavo comment.

[Frangible]

Here's another article which goes into much more depth on the use of quantum computing by the brain; it is not a study but rather a paper.

http://xxx.lanl.gov/abs/hep-ph/9505374

If you wanted a much shorter version focusing on just memory, see:

http://xxx.lanl.gov/abs/quant-ph/9912120

This isn't anything new-- quantum theories to explain memory have been around for quite some time; since the 1980s I think. But it's only been lately that there have been studies that have actually quantified and identified this.

You should be able to find a lot more on Google / PubMed.

Cruel: putting a child clone in an adult's body

[geekotourist]

Or take the Schiavo case: it may one day be possible to insert new brain cells into someone like that and have them get up and be a person again. But they may not be the same person: the old brain matter that held their memories and personality may be gone. And yet, since we can do that, should we never pull the plug on a brain dead person?

If the person's memories and personality are gone, then all you're doing is growing a new person in an older body. You're twinning- cloning- a brain and giving it an instant full body transplant. You're giving a delayed twin both age-shortened telomeres and an age-damaged body.

This is cruel.

The new person is going to have to learn life- they'll be a baby, then a child, then an adult again. All without the protections of actually being a baby or child. All with the expectations that they're going to be the person they immediately resemble (at least a twin/cloned baby will prove their independence as they grow up).

Of course they're likely to be happy and glad to be alive- we have a tenacious ability to make do with what we have. But given that you'd get the same result by twinning/cloning a new brain in a new body- aka making a baby- why make a new person with half an ordinary lifespan? Why not just make an identical twin from the start (assuming that the telomere-length problem and the other problems in cloning are fixed)?

If brain stem cells are used to fix and repair a person's brain- that's only a quantitative change from what happens today, that small sections stop working, and then get working again. Brain damage is repaired by the person learning to reroute abilities across different, undamaged parts of the brain.

Rebuilding or recreating a brain? That'd be homeopathic neurology, the idea that spinal fluid and disconnected neurons can magically retain the memories and personality of the previous person.

Re:Cruel: putting a child clone in an adult's body

[plunge]

No no, homeopathic neurology would be grinding the person up into tiny particles and then diluting them until there is not even a single particle left... and then expecting the resulting fluid to be even MORE like the original person than the person was themselves. :)

What does this quote mean? Ethical problems?

[Beryllium Sphere(tm)]

"For every damaged area of the brain, there is a dormant area, which seems to be a sort of protective mechanism."

IF that's what the researcher meant, and IF he was quoted accurately, that seems to be saying that undamaged brain areas shut down as a safety measure, kind of like shutting off utilities to an earthquake-damaged building.

In which case, is there a risk of further damaged from turning the dormant areas back on?

Re:Oblig. Terri Schiavo comment.

[ImaLamer]

Don't mess with Terri, she's Real Ultimate Power!!!

You better get a life right now!

Re:What is death?

[PenguiN42]

Even after the brain shuts down, your body can still be kept alive through life-support.

Also, it's possible to be permanently "a lump of flesh incapable of doing anything" even before your brain has totally shut down.

The line is blurry.

Zolpidem/Ambien

[nincehelser]

I suppose it depends on the patient's current condition and dosage, but my experience with Zolpidem (Ambien) is that it really messes with your head, particularly your memory. So, if it brings somone out of a vegatative state, will they be able to remember it? It might make them more communicative, but what's the point if you can't retain the memory?

Re:What is death?

[dgatwood]

Also, it's possible to be permanently "a lump of flesh incapable of doing anything" even before your brain has totally shut down.

We call them "Legislators".

Re:Oblig. Terri Schiavo comment.

[Herbmaster]

And for those who missed Dr. Frist's report to the Senate, she was fine.

Frist / DeLay 2008!

Re:Terri Shivo

[R2.0]

You are missing the point - the parents weren't going against the husband's wishes, they were going against their DAUGHTER'S wishes. Terry CHOSE to leave her parents and give her trust to her husband. Terry's parents were, in efect, saying that Terry wasn't competent to make that decision then.

Do you belive that parents should make decisions regarding their children's marriage choices against their children's will? Should Terry's parents have had the ability to file for divorce for Terry prior to her illness as well?

Terry chose her husband to make the decisions he did. She could have stayed unmarried, but she CHOSE!

And her parents shit all over that.

how do you know?

[porky_pig_jr]

did you face the prospect of death?

My take of it: a prospect of sudden death when your quality of life is in general OK is something no one want to face. But suppose you health slowly deteriorates. At some point you simply don't care too much whether you're dead or alive.

GABA drugs go way back

[tgibbs]

Actually, people have been taking GABA-receptor enhancers to get to sleep for decades. Ambien is just the latest. It has good pharmacokinetics, but it is also still under patent, so it is heavily marketed. Before Ambien, it was benzodiazepines like diazepam (Valium), which worked in essentially the same way. All of them have the potential to induce a kind of "hypnotic" state, particularly if you mix them with alcohol. And before the benzodiazepines, it was the barbiturates, which are even more dangerous, because at high doses they can activate the GABA receptor directly, rather than just helping GABA.

The GABA modulators that people take to sleep are probably less dangerous than the ones that they take for anxiety, because normally you don't take a sleeping pill and get into your car (although I know somebody who had a harrowing automotive experience as a result of accidentally taking an Ambien when he thought he was taking his similarly-shaped Lipitor). But people take anxiety-reduction drugs just to get through the day. There's been a lot of work on developing targeted GABA receptor modulators that are less sedating, but it has proved to be a difficult task.

Re:Terri Shivo

[Alsee]

Fine. How about you go lobby to have the law changed such that spouses are no longer the next of kin and that parents rather than spouses get to make mediacal and financial decisions?

But no, I think you're spouting bullshit. I do not believe you'd be any happier and I do not believe you would stand by that argument if the situation were reversed and it were the parents making the legal decision to terminate medical treatment and the husband opposing side.

Go ahead, tell me that you're not lying out your ass. Go ahead and tell me that you are honestly making the argument that parents should have the right to terminate medical treatment over the objection of the spouse.

Sure there are bad marriages and sure there are divorces. However there are also bad parents. There are also good parents who simply do not share a person's values. Parents whom the person simply cannot rely upon to carry out their own wishes.

You do not get to choose your parents. You do choose your spouse. You do not necessarily share your parents' values. You should (and presumably do) choose a spouse who reasonably shares your values. You do not necessarily trust your parents. You should (and presumably do) choose a spouse whom you do trust. You should (and presumably do) choose a spouse who respects you and your wishes. When you get married you are forming a new family and spending your entire day-to-day life with this person. This person presumably should and does get to know you better than your parents. This is the person with whom you have chosen to share all of your life decisions. This is your next of kin.

If you choose marry someone you don't trust then you've got far more fundamental problems.

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Re:Oblig. Terri Schiavo comment.

[Alsee]

If that was the case, wouldn't a CT or MRI scan have revealed that immediately, ending all debate?

The tests WERE done and it WAS revealed, years ago.

Of course it didn't end the debate because one side of the "debate" was a bunch of crusading fanatics who didn't care what any of the medical tests revealed and didn't care what any of the other facts were. People on a Holy Mission to save Terri's life and who didn't care if her brain tissue was two grades too thin to qualify as pudding.

People who Had Faith that Terri was Still In There. People who Had Faith that if they prayed long enough and hard enough, that God would reach down and Make Terri All Better.

To use a Bushism, they were not members of the Reality Based Community.

Why were we subjected to this melodrama on CNN for a month and a half?

Because we had a bunch of clowns putting on a huge circus, and the media just loves to cover a circus. The sad part of it being that half the clowns preforming in this circus were elected officials to whom we entrust the legal stewardship of this country, and that that is often exactly how those clowns get elected/reelected.

Of the three branches of governemnt, I have the most respect for the judiciary. Circuses rarely fly in a courtroom. In this case the courts consistantly ruled to shut this circus down, even after the clowns in congress passed a law (unconstitutionally crafted to uniquely target a specific case BTW) and set up an additional side show freak event at the Federal court level.

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Re:Oblig. Terri Schiavo comment.

[MakyoDetector]

Sir, I find your disingenuous comments repulsive. Don't you realize it's incredibly cruel and murderous to kill a person like that. What they should've done is give her a brain transplant. For Chrissakes, all she needed was a new brain!

Re:This could be an amazing discovery!

[MysteriousPreacher]

So did Steven Seagal in one of his films (the name escapes me). If I remember correctly he was in a coma for a good few years. Of course the only sign of this was a slightly long beard. Within a short while he was up and busting faces again.

Re:Oblig. Terri Schiavo comment.

[sonamchauhan]

"[...] who didn't care if her brain tissue was two grades too thin to qualify as pudding."

If her brain tissue was truly this grade, Terri would be long DEAD!

But her brain wasn't, and she wasn't, dead. She was alive. Until she was starved to death. Thanks to the likes of you. This is reality if you can handle it.

We'll never know if this drug, which is surprising physicians, would have helped her. All you do now is cling to your _faith_ that it wouldn't have mattered.

Re:Oblig. Terri Schiavo comment.

[Alsee]

If her brain tissue was truly this grade, Terri would be long DEAD!

That is exactly my point. Terri was long dead.

The Terri Schiavo circus ringleaders spread a ton of misinformation, so it is quite possible you have simply been missinformed. Either you are unaware of the facts of the case, or you are in psychological denial of reality.

The Terri Schiavo autopsy results:
The brain itself weighed 615 g, only half the weight expected for a female of her age, height, and weight. Microscopic examination revealed extensive damage to nearly all brain regions, including the cerebral cortex, the thalami, the basal ganglia, the hippocampus, the cerebellum, and the midbrain. The neuropathologic changes in her brain were precisely of the type seen in patients who enter a PVS following cardiac arrest. Throughout the cerebral cortex, the large pyramidal neurons that comprise some 70 percent of cortical cells--critical to the functioning of the cortex--were completely lost.

The cortical neurons, the organ that "thinks" and contains the mind, the neurons that make you you, were completely gone. No drug can do anything to reactivate neurons that no longer exist. No drug can reactivate a mind that no longer exists. No drug can revive a person that no longer exists.

The fact that her kidneys and other body tissues were still medically maintained does not mean Terri was alive. Functioning kidneys do not make a live person any more than nonfunctioning kidneys make a dead person. There was a blob of lower brain stem maintaining heartbeat breathing and other primitive reflex responses, however the rest of the brain was nothing but empty support scaffolding - the thinking neurons had all died and disintegrated. The the rest of the brain was nothing but empty goo.

The only organ that meant anything, the brain neurons, all died and disintegrated years ago. That-which-was-Terri disintegrated and returned to dust long ago.

The most that would even be theoretically possible would be some science fiction treatment to cause massive growth of brand new neurons. Some science fiction treatment to manufacture a brand new blank-slate mind, to manufacture a brand new person. Some science fiction abomination to manufacture a brande new blank slate infant mind inside that empty shell of a body.

The entire Terri battle was nothing but a circus put on between politicians and a handfull of nuts who think faith is an excuse to ignore and deny reality. Ignoring and denying physical world facts is not faith - that is a perversion of faith.

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Re:Oblig. Terri Schiavo comment.

[sonamchauhan]

> > If her brain tissue was truly this grade, Terri would be long DEAD!

> That is exactly my point. Terri was long dead.

No, she wasn't dead. She was alive. The judge thought she was alive too. Your attempt at redefining life and death for others, according to your private philosophy is laughable.

> > The cortical neurons, the organ that "thinks" and
> > contains the mind, the neurons that make you you,
> > were completely gone.

(a) you don't know (b) no one has the right to judge someone else worthy of death because x% of 'y' neurons are missing (or worse, like you, judge them already dead) --- when they obviously are NOT brain dead, and respond to the environment about them.

By your logic, mentally handicapped children born in the same state as Terry (say, x% of 'y' neurons) can be killed. Your thinking on this is similar to the Nazi "life unworthy of life" philosophy.
During the Third Reich a minority of medical practitioners and public health officials in positions of authority, following an authorization decreed by Adolf Hitler in August 1939,directly implemented a policy of extermination respecting segments of the population who were diagnosed as suffering from severe mental and/or physical dysfunction.

Without God you are directionless.

Re:Oblig. Terri Schiavo comment.

[Alsee]

x% of 'y' neurons are missing

"x%" here was 100%. There was ZERO functional brain tissue anymore. 100% of the cognitive neurons were gone.

As I said in my last post, you were either missinformed or you were suffering from psychological denial of the facts of reality. I gave you the benefit of the doubt, suggesting that you were likely just missinformed by the activists in this circus. however it is now clear that you are suffering from denial of the facts of reality. As I posted, the autopsy report was that the cortical neurons were COMPLETELY GONE. Yet you persist in ingoring that fact, and simply pretending that a brain still existed... that Terri still existed.

The only organ that matters... the brain.. was dead and gone. All of the cognative neurons had died and disintegrated years ago.

respond to the environment about them

No, there was no longer any mental response to the environment. There was no cognitive brain tissue to provide any such response. As I said, there was nothing remaining but autonmomic reflexes.

Functioning kidneys do not mean a person is a live. Autonomic reflexes do not mean a person is alive.

no one has the right to judge

Does not a person have the right to decline medical procedures? If I decline chemotherapy, or decline dialysis, or decline a feeding tube, are you going to pull out a gun and imprison me and forcibly impose invasive medical proceedures upon me?

And does not the responsibility for carrying out a person's medical wishes fall to the next of kin?

Without God you are directionless.

What a rediculous statement. I do not think God wants us artificially maintaining kidneys and other empty body tissue alive years after the person has returned to dust.

The only organ that mattered - the operational brain tissue - had not only 100% died, it had 100% disintegrated away.

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Re:Oblig. Terri Schiavo comment.

[smcavoy]

"simplistic characterization"
dude, this is slashdot so I'll stick with "she was a vegetable"
and the real point is whether her husband knew her wishes or not.