Traditionally PVS has been described as an eyes-open state of unconsciousness. The patient is not comatose; they are awake but unaware. They can smile, grasp your hand, grunt, cry, but are unable to see or understand speech. These are random, reflexive movements, as their minds are firmly shut off from events around them. They appear to have lost their memories, emotions, and intentions, the qualities that we recognize as making each of us a person.

This traditional description of PVS is now being questioned at least in some cases. Scientists using brain scanners find that some patients may only be trapped inside their bodies, and are still able to think, be aware, and feel to varying extents. Using positron emission tomography (PET) one can highlight different metabolic processes in the brain, such as oxygen and sugar use. Another device known as functional magnetic resonance imaging (FMRI) can reveal active centers in the brain by detecting the tiny surges in blood that takes place as the mind whirls.

Using a series of normal test subjects, the scientists asked them to imagine playing tennis, and then to imagine walking through the rooms in their home. These imagined activities resulted in consistent but two very different brain scan patterns, as different as “yes” and “no.”

When they matched the playing of tennis to the answer “yes” and walking about your home to “no” they found that some patients were able to answer correctly five of six questions about their earlier lives, such as where they went on vacations prior to their injury, and the names of close relatives. This occurred in some who had been in a vegetative state for five years.

Researchers believe that as many as 20–40 percent of patients thought to be vegetative are when examined closely, partially aware.

 

1. Does this introduce a new category of patients? Are these PVS patients misdiagnosed?

 

2. If the patient remained in the closed-off state for the rest of their lives, aware, but unable to communicate outside of brain scans, do you feel this makes it easier or harder for the family? How would the provided health care be different?

 

3. If a PVS patient with a DNR order was tested and found to be minimally aware, should the DNR order be removed?

 

4. Does minimal personal awareness move someone into the personhood category?

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1 37 to 43 of patients deemed to be in a persistent vegetative state can be shown through keen standardized clinical studies relying on the Coma Recovery Scale CRSR to possess minimally preserved cons... View the full answer