Vegetative Patients May Be More Aware Than We Knew(nytimes.com)
nytimes.com
Vegetative Patients May Be More Aware Than We Knew
https://www.nytimes.com/2026/04/09/magazine/vegetative-states-conscious-aware.html
14 comments
I've always been told by my parents that people can still hear and understand even if they appear unconscious or non-responsive, and so I have a personal policy of speaking respectfully toward them just the same as if they were alert and responding and part of the conversation, but it has shocked and amazed me (and saddened me) by what some people say in the presence of a living person who can very possibly hear and understand but may not be able to respond. Be careful not to be cruel to people in that situation!
How arrogant to subvert the "scientific we" to presume to know things that you cannot ever empirically know through the scientific method.
No, "we" never knew how "aware" these patients were. Speaking for myself personally, I never knew; I've never been in a PVS but I do affirm that any person who is in a PVS deserves dignity, the right to life, and the right to ordinary sustenance, such as food and hydration.
I lived through the very traumatic case of Terri Schiavo, whose husband hated her guts and really, really needed her to die ASAP. But I only recently learned of Karen Ann Quinlan, whose parents were quite devout and merciful, and had perceived that the "treatment" (a breathing tube) was causing much discomfort and distress to Karen, yet the medical establishment insisted that removing the tube would be "MURDER" and they engaged in a protracted legal battle against the "MURDEROUS PARENTS" who simply wanted them to withdraw this barbaric medical treatment.
https://en.wikipedia.org/wiki/Karen_Ann_Quinlan
Karen's level of cognizance was fairly obvious to any observer: that she was feeling pain and distress, that she was capable of emotion and rational response to stimuli, and that changing those stimuli resulted in distinct changes in her responses. That much is true.
Karen Ann Quinlan's quality of life improved immensely after the tube was removed. She began breathing on her own. She lived a good life (in a PVS) for a significant period of time and was not, in fact, ever murdered by her loving parents or by her physicians.
No, "we" never knew how "aware" these patients were. Speaking for myself personally, I never knew; I've never been in a PVS but I do affirm that any person who is in a PVS deserves dignity, the right to life, and the right to ordinary sustenance, such as food and hydration.
I lived through the very traumatic case of Terri Schiavo, whose husband hated her guts and really, really needed her to die ASAP. But I only recently learned of Karen Ann Quinlan, whose parents were quite devout and merciful, and had perceived that the "treatment" (a breathing tube) was causing much discomfort and distress to Karen, yet the medical establishment insisted that removing the tube would be "MURDER" and they engaged in a protracted legal battle against the "MURDEROUS PARENTS" who simply wanted them to withdraw this barbaric medical treatment.
https://en.wikipedia.org/wiki/Karen_Ann_Quinlan
Karen's level of cognizance was fairly obvious to any observer: that she was feeling pain and distress, that she was capable of emotion and rational response to stimuli, and that changing those stimuli resulted in distinct changes in her responses. That much is true.
Karen Ann Quinlan's quality of life improved immensely after the tube was removed. She began breathing on her own. She lived a good life (in a PVS) for a significant period of time and was not, in fact, ever murdered by her loving parents or by her physicians.
The right to privacy that Quinlan's parents' case was decided on was derived from the conception of privacy from Roe v. Wade that was reversed in Dobbs, as in the judge explicitly used Roe as framework.
Yes. Indeed.
Ironically, the privacy matter involved with the Quinlan case is that the parents/guardians sought to terminate a medical treatment. The medical establishment regarded this termination as tantamount to murder. That is, without the treatment, Quinlan’s prognosis was death.
While based on the same reasoning in regards to personal privacy and medical treatment decisions, surely we can appreciate the diametrically opposite case of withdrawing an extraordinary, unwanted and ineffective treatment, vs. demanding to undergo one that affects not one life, but two, and again, parental rights over the very life and continued existence of a person who is dependent and reliant on others, and wholly incapable of answering or advocating for themselves.
Ironically, the privacy matter involved with the Quinlan case is that the parents/guardians sought to terminate a medical treatment. The medical establishment regarded this termination as tantamount to murder. That is, without the treatment, Quinlan’s prognosis was death.
While based on the same reasoning in regards to personal privacy and medical treatment decisions, surely we can appreciate the diametrically opposite case of withdrawing an extraordinary, unwanted and ineffective treatment, vs. demanding to undergo one that affects not one life, but two, and again, parental rights over the very life and continued existence of a person who is dependent and reliant on others, and wholly incapable of answering or advocating for themselves.
Analysis of Terri Schiavo's brain revealed that it was mush.
To put it more analytically
"She had developed hydrocephalus ex vacuo, a condition marked by enlarged ventricles filled with cerebrospinal fluid, because of this profound loss of cortical volume"
Half her brain was gone and it was the part we have identified as the seat of identity.
Her brain was so far gone that believing she still existed requires dualism.
To put it more analytically
"She had developed hydrocephalus ex vacuo, a condition marked by enlarged ventricles filled with cerebrospinal fluid, because of this profound loss of cortical volume"
Half her brain was gone and it was the part we have identified as the seat of identity.
Her brain was so far gone that believing she still existed requires dualism.
So what? I mean, why would that even matter?
Are you contending that she was simply medically dead?
Are you asserting that she wasn’t worth feeding, because her “identity” had been lost?
You are saying implicitly that Terri didn’t “exist” in some kind of philosophical framework? That is truly bizarre. What physician, judge, or pastor would claim that this person didn’t exist?
Do you even know what “dualism” is? Apparently not!
What are you really trying to prove with “analysis”?
Are you contending that she was simply medically dead?
Are you asserting that she wasn’t worth feeding, because her “identity” had been lost?
You are saying implicitly that Terri didn’t “exist” in some kind of philosophical framework? That is truly bizarre. What physician, judge, or pastor would claim that this person didn’t exist?
Do you even know what “dualism” is? Apparently not!
What are you really trying to prove with “analysis”?
> Karen Ann Quinlan's quality of life improved immensely after the tube was removed. She began breathing on her own. She lived a good life (in a PVS) for a significant period of time and was not, in fact, ever murdered by her loving parents or by her physicians.
You seem to be guilty of the same thing you accuse the doctors of doing. You have no idea what was going in her mind (or not going). You have no idea if she was still suffering. You have no idea if she wanted to die.
You're the "compassionate killing is wrong, we must preserve life at all cost and quality of life be damned" type of person, and it's simply impossible to have a conversation when your view of the world is so black and white.
You seem to be guilty of the same thing you accuse the doctors of doing. You have no idea what was going in her mind (or not going). You have no idea if she was still suffering. You have no idea if she wanted to die.
You're the "compassionate killing is wrong, we must preserve life at all cost and quality of life be damned" type of person, and it's simply impossible to have a conversation when your view of the world is so black and white.
If you wanted and desired to die immediately, but you had no means of articulating it or indicating those wishes beforehand, would someone grant you that wish? Would that be a licit and legal thing for someone else to take action upon your death-wish?
Karen clearly did not wish to die at all; nor did her parents or physicians wish to deny her a right to life.
Her parents and physicians all agreed (after the fact) that the removal of the machine proved to relieve her immediate suffering and distress, just by judging those outward signs and her struggles against the relentlessly opinionated machine.
There is nothing “compassionate” about killing; it is an oxymoron and a political slogan for eugenicists. You seem to desire that some assassin had stepped up and murdered Karen against everyone’s wishes, and against the law. You and your ilk have a similar mindset to Dr. Mengele, and y’all seem very very proud of that mindset.
Karen clearly did not wish to die at all; nor did her parents or physicians wish to deny her a right to life.
Her parents and physicians all agreed (after the fact) that the removal of the machine proved to relieve her immediate suffering and distress, just by judging those outward signs and her struggles against the relentlessly opinionated machine.
There is nothing “compassionate” about killing; it is an oxymoron and a political slogan for eugenicists. You seem to desire that some assassin had stepped up and murdered Karen against everyone’s wishes, and against the law. You and your ilk have a similar mindset to Dr. Mengele, and y’all seem very very proud of that mindset.
> More than a year after Aaron’s collapse, a year of hospitals and nursing homes, Tabitha still believed that her husband was probably aware and improving, though not a single clinician had raised the possibility that he might be. It made her wonder how doctors could know about a thing, covert consciousness, for 20 years, but still go about their work as if they didn’t. And not explain any of it to patients and their families. “I think they don’t want to give you false hope,” she says. So they try to make sure that you don’t hope at all.
I wouldn't be shocked if many doctors she encountered just weren't up-to-date on the latest findings; even if they were, I can understand why they might not have mentioned it, for all the ethical dilemmas and general uncertainties outlined in this piece. But it really is a heartbreakingly difficult situation all around.
Another story that's stuck with me (although this is about brain death, which is different from a persistent vegetative state but is surprisingly thorny to define--different jurisdictions have different criteria, and some even allow for religious objections to legal death): https://www.newyorker.com/magazine/2018/02/05/what-does-it-m...
I wouldn't be shocked if many doctors she encountered just weren't up-to-date on the latest findings; even if they were, I can understand why they might not have mentioned it, for all the ethical dilemmas and general uncertainties outlined in this piece. But it really is a heartbreakingly difficult situation all around.
Another story that's stuck with me (although this is about brain death, which is different from a persistent vegetative state but is surprisingly thorny to define--different jurisdictions have different criteria, and some even allow for religious objections to legal death): https://www.newyorker.com/magazine/2018/02/05/what-does-it-m...
I’d be shocked if ANY doctor I’ve seen was moderately up to date with current research.
Maybe some in research hospitals stay informed, but I suspect none in private practice…
Maybe some in research hospitals stay informed, but I suspect none in private practice…
Yes. Vast majority of software engineers don’t stay up to date with the latest tools or frameworks either. They often just keep using whatever they learned and occasionally look for a new tool if they get stuck.
I don’t see why doctors have the energy to keep up with the latest research. This is why I think something like ChatGPT and doctor might be the best combo.
I don’t see why doctors have the energy to keep up with the latest research. This is why I think something like ChatGPT and doctor might be the best combo.
please take a look at the video in the article. This man can keep his eyes open and even move his mouth (maybe just randomly behavior). That’s clearly much more responsive than most people who lie in bed with no reaction at all.