Persistent Vegetative State (PVS)

Relatives of unfortunate victims of accidents so severe that they have been left in what is termed a 'vegetative state' characterized by extended periods of unconsciousness - by an inability to communicate leading to the conclusion that there was no brain function, often - after years of deteriorating physical condition have either requested that life-support be removed, or struggled to convince medical experts that they were certain their loved ones were aware, and defied intentions to remove them from life support.

Mothers, looking into the open, but vacant eyes of their children, could still see a spark of intelligence and awareness when medical experts could not. They would appeal to the humanity of the professionals whose decision it might be to remove life-support to enable the stricken person to die. Now it would appear that there is indeed truth to their belief, that some of those patients given up to die - through the conviction that their life-force had elapsed and extraordinary measures to maintain their bodies were futile - are salvageable.

It wasn't all that long ago, in fact, that a sensitive and discerning neuroscientist made the intuitive leap that what had been taken by others in the profession as a brain-dead patient on life-support was in fact a still-brain-functional, fully aware and intelligent human being trapped in a body that tragedy left incapable of functioning. That neuroscientist worked with the patient until he made contact, firmly establishing that the man could function, with the assistance of modern scientific-health technology.

And now with the use of brain scans, medical professionals unequivocally demonstrated that some victims from whom no outward signs of awareness can be detected, are capable of comprehending and communicating, albeit with great difficulty. The physical trauma they suffered resulting in catastrophic brain damage along with damage to the functioning of their motor muscles left them locked in a seemingly non-communicative state.

One that a team at the Brain Sciences Unit in Cambridge, U.K. found was not entirely unbridgeable. They carried out research which resulted in their understanding that brain scans could reveal much, hitherto unrevealed to them. "Not only did these scans tell us that the patient was not in a vegetative state but, more importantly, for the first time in five years, it provided the patient with a way of communicating his thoughts to the outside world.

"We can be pretty confident he is entirely conscious. He has to understand the instructions, comprehend speech, and then make a decision." That decision being to make use of a codified response to personal questions geared to establish his capability of understanding and response. The patient was instructed to imagine a certain physical movement; one for "yes", another for "no", and then imagine those movements in response to questions.

The thought processes were picked up in spatial areas at the top of the brain, to enable the researchers to transcribe the "navigational tasks" assigned as "yes" and "no" responses and match those responses to the questions asked, establishing the accuracy and veracity of the responses. More than adequately proving by the unerring quality of the responses that the patient who had formerly been given up as lost to life, was still functioning.

The patient in question was 28, brain-damaged as a result of a vehicle crash which left him in a coma leading to persistent vegetative state for fully two years. He appeared awake, occasionally blinking his eyes, but no other sign of awareness was evident. It is now assumed that perhaps one in five PVS patients may be capable of communicating. And this brings the medical community to the conundrum of how and when life-support systems should be removed.

Obviously, only after each and every such patient has undergone use of the functional magnetic resonance scanner measuring their brain response.