Mirror of Justice

A blog dedicated to the development of Catholic legal theory.
Affiliated with the Program on Church, State & Society at Notre Dame Law School.

Friday, February 5, 2010

Frontiers of Informed Consent -- Communicating with Patients in PVS

Fascinating new evidence of significant brain activity in patients thought to be in a persistent vegetative state, coming from the University of Liege, reported in the New England Journal of Medicine.  Brain scans of some patients thought to be in that state showed that the patients were, when questioned by the researchers, able to imagine themselves playing tennis, walking through rooms in their own homes, and even answer detailed yes-or-no questions about his life before the accident that put him in that state.  The NYT report of it quotes Dr. Joseph J. Fins, chief of the medical ethics division at Weill Cornell Medical College in NY, discussing new ethical challenges raised by this possibility of communicating with people in this state:  "If you ask a patient whether he or she wants to live or die, and the answer is die, would you be convinced that that that answer is sufficient?"

Another commentator, Dr. Allan Ropper, worries:  "It will now be difficult for physicians to tell families confidently that their unresponsive loved ones are not 'in there somewhere.'"

It seems to me that the Church has been suggesting this very thing all along -- it SHOULD be difficult for physicians to say this confidently to anyone.


Schiltz, Elizabeth | Permalink

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Amen. PVS is becoming an obselete category. And yet it is codified in so many state statutes as a firm category of human beings, for whom death-causing withdrawals of basic care is more acceptable than for other, less disabled human beings.

Posted by: Matt Bowman | Feb 5, 2010 11:01:22 AM

What is happening is a revolution in the diagnosis of PVS. We are learning that what many suspected is true: better diagnostic techniques are showing that some previously thought to be in PVS are not. The recent advances will force us away from taking PVS to be diagnosable via clinical / behavioral criteria. That's a big change that I think is overdue and finally coming. But's it's not a wholesale rejection of PVS as a medically and morally relevant condition.

Posted by: Fritz Warfield | Feb 5, 2010 7:39:09 PM