Slashdot Mirror
"Vegetative State" Patients Can Communicate
Kittenman writes "The BBC is carrying a story about researchers in the UK and Belgium who can detect the thinking processes within a patient previously thought to be in a vegetative state. The researchers ask the patient verbally to think in certain ways to indicate a 'yes', in other ways to indicate a 'no' — and have successfully communicated with 4 out of 23 patients previously thought to be in a coma."
As a life-long vegetarian, I'm horrified with the idea of being able to communicate with my... oh wait.
Us vegetative types have been doing that for years on World of Warcraft.
From TFA:
"Patients in a vegetative state are awake, not in a coma, but have no awareness because of severe brain damage. "
It's official. Most of you are morons.
A vegetative state is by definition where there is no detectable awareness. You could legitimately say that they were "previously thought to be in a vegetative state," but if you detect awareness then they are in a coma.
This is one of those terrible fears. It's great that they have found a way to communicate with someone in this state, but at the same time this type of story makes me ponder how horrific that must be for the person.
I will shred my adversaries. Pull their eyes out just enough to turn them towards their mewing, mutilated faces. Illyria
So all they have to do is live in an MRI machine for the rest of their lives and they can communicate. Problem solved!
I judt got a nre Kinesis keybiartf so please excusr ant egregiou typos.
I'm not a neuroscientist, but it seems to me that 4 out of 23 is a pretty low success rate, especially given the kind of indirection the researchers were resorting to in order to elicit the signals they were looking for. How do we know, for example, that a patient doesn't have some kind of spurious activity in the brain area they're using to signal "A"? For that matter, how can we distinguish between "no answer" and a deliberate "B" in the absence of such activity? How can we assume that the patient, who by definition has brain damage, is capable of understanding the question correctly and answering correctly? I agree, this is better than absolutely no communication, but I'm curious how they intend to control for factors like these.
I'm disabling ads until because I choose not to reward redesigns that are less usable than "view source".
This is not really surprising if you are aware what a real coma is. There is a lot of states between fully consciousness and complete unconsciousness. In movies, and in soaps you switch between those states in a surprise wake-up. In reality this is much more complex.
Anyway, better diagnosis is needed to prevent accidents like Brain scan finds man was not in a coma--23 years later and other possible improvements in brain damage treatment.
> It does raise many ethical issues - for example - it is lawful to allow patients in a permanent vegetative state to die by withdrawing all treatment, but if a patient showed they could respond it would not be, even if they made it clear that was what they wanted.
It seems kinda silly that you're only allowed to die when you're unable to make that decision. To me it seems cruel to keep someone alive in a vegetative state just because they have enough of their conciousness left to want to end it. Yay for legalized euthanasia in the Netherlands.
"Eat me, I'm nutritious."
Not to mention replies to résumés.
Planning to be moderated ± 1: Bad Pun.
5 of 54 patients who underwent this procedure. Showed a possible response.
3 of those 5 it turned out showed awareness to normal stimuli and were either mislabeled by doctors, or their condition changed.
So basically that leaves 2 patients out of 51 seeming to "be able to modulate their brain activity". And only ONE of those was able to "correctly answer 5 of 6 yes/no questions"
This could be legit, but there is also PLENTY of room for statistical chance to have created this "result".
The bottom line is that too much of a big deal is being made out of a tiny kernel of good data in a mountain of null results.
Fry: "BEEP!"
Zap: "'Yes.' Ok. And, are you guilty!?"
Fry: "BEEP! BEEP!"
Zap: "Double 'Yes'!"
Sorry -- too lazy to dig for the exact quote.
If you haven't check out this study publicized in Wired, where they detected human emotion activity in the brain of a salmon. A dead salmon.
Just because the fMRI shows some colors, that doesn't necessarily mean that there's really cognition going on. It could just be false detections from imperfect scanning, or it could be scientists seeing patterns in data that don't really exist, or it could be the result of our imperfect understanding of how the brain works, or a whole slew of other things.
This is made worse by things like the Houben case, which used Facilitated Communication to "prove" that Houben had an intact consciousness. FC hasn't passed any rigorous scientific study (i.e. blind tests to prevent the facilitator's motivations/desires from modifying the results), but stories like Houben cause those with loved ones with sever brain damage in PVS to start clamoring that there may still be hope. James Randi has written about FC, and the Houben case in particular.
If you're only sending out 23 surveys you need to take a remedial statistics course. And actually an almost 25% return rate is very good for any survey. Most folks are lucky to get a 10% return.
What if you only have 23 faculty members?
Damn, you know last night I asked my wife how her day was. What a fool I was. How could I ever get valid results with such a small sample pool.
Out of modpoints but really liked a post? 1BDkF6TtmmeZ3yqXbz9yhdYVqRYnwFoXDj
The book was about a WWI soldier who lost all four limbs, blind, deaf, and mute, yet still awake. The medical people thought his twitching was just instinct. Then someone realizes his head banging is Morse code. The story is from the patient's perspective. It resurfaces as an ant-war book periodically.
Try:
http://www.sciencebasedmedicine.org/?p=3122
for a critical point of view.
(founded 95,000,000 yrs ago, very space opera)
You mean the cereal rapist will spend time in Vegetative State Penitentiary.
Of the 54 patients examined in the study most had suffered either from traumatic brain injury or anoxic brain injury. Anoxic brain injury for the most part means your heart had stopped for a prolonged period of time (although other things such as severe prolonged hypoglycemia or carbon monoxide can do the same thing). Anoxic brain injury is a diffuse process and its course is highly predictable. Depending on the severity of the initial event with anoxia patients will either improve after a relatively short period of time or they never will. Of all of the 'miracle' re-awaking cases that have occurred (extremely rare cases of people waking up to a severely disabled state) none of them have been by someone who has suffered anoxia.
Traumatic brain injury has a less predictable course as some of the parts of the brain are destroyed while other parts can be relatively undamaged. Of the five patients in the study who were found with some brain activity all of them were traumatic brain injury cases.
Schiavo suffered anoxic brain injury due to cardiac arrest. These patients never need fancy brains scan as their external findings accurately reflect what has happened to their entire brain. The current New England Journal of Medicine article actually serves to support that anoxia patients have no cognition.
Yes, living wills, and informing your loved ones to remove you from life support in such cases are very important. But as the Schivo case proved, it doesn't really matter when religious politics become involved. Your living will is only as valid as the willingness of your relatives to honor it.
Schiavo did NOT have a living will, which was the cause of the interminable legal wrangling. Had she clearly designated someone to exercise medical power of attorney, there would have been no controversy. Instead, the Florida default rules it fell to her husband who claimed that she had orally represented to him that she did not want to be kept alive in such a case. Her parents claimed that she would not have, given her religious faith. "Religious politics" had nothing to do with it. Quoting Wikipedia (my emphasis)
Given the lack of a living will, a trial was held during the week of January 24, 2000, to determine what Schiavo's wishes would have been regarding life-prolonging procedures. Testimony from eighteen witnesses regarding her medical condition and her end-of-life wishes was heard. Michael claimed that Schiavo would not want to be kept on a machine where her chance for recovery was minuscule, her parents claimed that Schiavo was a devout Roman Catholic who would not wish to violate the Church's teachings on euthanasia by refusing nutrition and hydration.
Honestly, the case really boils down to that -- who do we believe is best qualified to take an essentially random guess about what a person would want. Ideologues on both sides tried to make it into more than that but it just wasn't. If she was genuinely religious and would have wanted to be kept alive, we should have kept her alive. If she would have wanted to die, we should have let her die. The resolution of this essentially factual question (in the absence of any reliable evidence) neatly solves the entire affair.
To summarize, if we can learn anything from the whole shitfest, please leave notarized documentation of your desires. Not even for yourself (although that should be motivation enough) but so your loved ones can feel confident in your wishes instead of being forced to guess. That is not a burden I would wish on the people that care about me, nor do I think it's fair to give them that responsibility. The document does not have to be complicated or expensive -- it can be as simple as designating a person to chose for you.
Am I missing something here?
Maybe you are missing the part where the expected rate is 0%.
This issue is a bit more complicated than you think.
So you remember everything about your life, especially after having brain trauma? That's pretty fucking impressive.
I'm not saying that it definitely is one way or the other. I'm just looking at probabilities.
They would have had to choose very simple, easy to answer questions, partly because they were questioning a brain-damaged individual, but also partly because they had to choose questions that they also knew the answers to. So, the questions would likely be things like "Is your name Bob?", and "Are you male?" and "Were you born in London?". While it is entirely possible that brain trauma could cause a person to forget what city they were born in, it is also possible for a coin toss to result in 5 out of 6 correctly answered true/false questions. Therefore, the evidence, at least as it's presented in the article, is not exactly convincing.
"You cannot simultaneously prevent and prepare for war." -- Albert Einstein
And that is your choice...
Though what happens when the money runs out?
I ask out of genuine curiosity.
A patriot must always be ready to defend his country against his government. -edward abbey