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Can a Comatose Patient Communicate End-Of-Life Wishes?

by Rania Combs

StethescopeA couple of weeks ago, I mentioned an article I read recently about a study that suggested 20 percent of the tens of thousands of  people in a vegetative state are able to communicate, but trapped in a body that does not allow them to do so.

Using a functional magnetic resonance imaging (fMRI) machine, researchers asked patients to imagine playing tennis or walking through the rooms of their house, activities which stimulate different regions of the brain.

They then asked the patients yes or no questions, suggesting that the patients imagine playing tennis to answer in the affirmative, and to imagine walking around the house to answer in the negative.  The fMRI machine detected their answers as different parts of their brain became active when each question was asked.

The research is far from complete, and the technology has its skeptics. However, if the technology is proven to be a reliable means of communicating with patients in vegetative states, it would raise some interesting issues.

On a positive note, the technology would allow comatose patients in conscious states to communicate their feelings so that doctors to tailor treatment to the needs of the patient. If the patient were not able to communicate, it would perhaps reassure family members that there truly was no hope of recovery and allow them to move forward with the inevitable.

But would the technology allow a comatose patient in a conscious state to make an end-of life decision? For example, in my article a couple of weeks ago, I mentioned the story of Edwarda O’Bara, who slipped into a coma at 16 years of age and spent 42 years in a coma before she died. Would this technology have allowed her to communicate desire that life-sustaining treatment be withheld?

Or would the comatose patient’s ability to communicate discourage loved-ones from terminating life support and put families in the awkward position of feeling compelled to extend the patient’s life despite the knowledge that there is very little hope for recovery?

You can read: Do Brain Scans of Comatose Patients Reveal a Conscious State by clicking on the link.


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