Unresponsive but Not Unaware

In the article posted in The New York Times on September 7 and October 16, 2006 titled "Vegetative Patient Shows Signs of Awareness, Study Says" By Benedict Carey, readers learn of an unresponsive woman with severe brain damage who showed clear signs of awareness in response to stimulus. When the woman was told to imagine herself playing tennis, the M.R.I. revealed increased blood flow to the premotor area of the brain. In fact, when compared to results of healthy patients undergoing the same commands, the patient's scans are indiscernible from the scans of healthy patients. This leads to the question, "Can unresponsive patients really hear everything going on around them, but are incapable of responding?" I think that depends on the case and the injury each individual has sustained. For instance, patients in a minimally conscious state are probably more aware of their surroundings than a person who has been in a comatose state for years. Unfortunately, I am afraid that the findings of this one case, may raise hope in families of comatose patients who have been unresponsive for years or even decades. This case also brings up the serious issue of the ethics behind the situation. When is it okay to pull the plug on someone? Is it ever okay to pull the plug on someone? I suppose it is up to the family members of the individual, but it makes me wonder how many people have pulled the plug on someone who was aware but unable to communicate. It is a scary thought and luckily I haven't had to make a decision like that in my lifetime. However, my future in medicine is likely to lead me to instances where I may have to make a decision that treads on the boundaries of my own personal ethics and morals. I hope that reading and understanding cases such as this help me to make the best decision.