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Groundbreaking Study Finds that Many Patients in a “Vegetative State” are Misdiagnosed

Nov 10, 2011 | 2011 Press Releases

WASHINGTON – A study published today in the British medical journal The Lancet found that “…a population of patients exists who meet all the behavioural criteria for the vegetative state, but nevertheless retain a level of covert awareness that cannot be detected by thorough behavioural assessment.” The study, “Bedside detection of awareness in the vegetative state” raises significant questions about the countless patients who may have been misdiagnosed as being in a so-called “vegetative state.”

“Many patients, probably thousands, have had their food and fluids cut off and died, based on what we now know may well have been mistaken assumptions that they had lost all capacity for consciousness,” said Burke Balch, J.D., director of National Right to Life’s Robert Powell Center for Medical Ethics.  “The Lancet EEG study, together with earlier functional MRI studies, holds out the hope that we may develop ways to communicate with aware patients who have routinely been diagnosed as “vegetative,” much as today eye movements and blinks are used to communicate with some patients with paraplegia.  That would certainly be a positive alternative to starving them to death.”

Using a bedside electroencephalography (EEG) technique to assess patients, researchers studied 16 patients diagnosed as “vegetative” and 12 healthy “controls.” These patients were directed to imagine that they were making a fist and wiggling toes.  A fifth of the patients “could repeatedly and reliably generate appropriate EEG responses” similar to those of the conscious controls.  This finding comes on top of previously published studies using more complex and less readily available fMRI (functional magnetic resonance imaging) technology that demonstrated some patients in a “vegetative” state, when instructed to imagine they were playing tennis, generated brain waves comparable to those of healthy “controls.”

While the Lancet study shows that EEGs could detect signs of consciousness in patients who had been diagnosed as “vegetative,” it does not follow that when EEGs do not detect these signs, such patients are definitely unconscious.  As the study itself notes, the fact that the EEG did not pick up these signs of consciousness in 25% of the healthy and aware controls shows unequivocally that a null EEG outcome does not necessarily indicate an absence of awareness.

Balch added, “Just as what were once generally accepted mental health diagnoses of ‘idiot’ and ‘moron’ have long been dropped from standard medical vocabulary, it is to be hoped that these studies will help lead to abandonment of the dehumanizing and inaccurate term ‘vegetative’ as an acceptable medical diagnostic term.”

Founded in 1968, the National Right to Life Committee (NRLC), the federation of 50 state right-to-life affiliates and more than 3,000 local chapters, is the nation’s oldest and largest grassroots pro-life organization. Recognized as the flagship of the pro-life movement, NRLC works through legislation and education to protect innocent human life from abortion, infanticide, assisted suicide and euthanasia.

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