So-Called “Vegetative” Patient Communicates With Doctors

The battle to protect patients in a so-called vegetative state from euthanasia took a positive turn today with the news that doctors have been able to communicate with one patient.

A Canadian man who was believed to have been in a persistent vegetative state for more than a decade has been able to communicate with scientists that he is not in any pain. It’s the first time an uncommunicative brain-injured patient has been able to communicate.

The news could change the way doctors and society views such patients. From the story:

Scott Routley, 39, was asked questions while having his brain activity scanned in an fMRI machine. His doctor says the discovery means medical textbooks will need rewriting.

Routley suffered a severe brain injury in a car accident 12 years ago.

None of his physical assessments since then have shown any sign of awareness, or ability to communicate.

But the British neuroscientist Prof Adrian Owen – who led the team at the Brain and Mind Institute, University of Western Ontario – said Mr Routley was clearly not vegetative.

“Scott has been able to show he has a conscious, thinking mind. We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is.”

Prof Owen said it was a groundbreaking moment.

“Asking a patient something important to them has been our aim for many years. In future we could ask what we could do to improve their quality of life. It could be simple things like the entertainment we provide or the times of day they are washed and fed.”

Scott Routley’s parents say they always thought he was conscious and could communicate by lifting a thumb or moving his eyes. But this has never been accepted by medical staff.

Prof Bryan Young at University Hospital, London – Mr Routley’s neurologist for a decade – said the scan results overturned all the behavioural assessments that had been made over the years.

“I was impressed and amazed that he was able to show these cognitive responses. He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful.”

Owen, the Canada Excellence Research Chair in Cognitive Neuroscience and Imaging, began his work on the study in London in 2011. The work at the Brain and Mind Institute at Western University mirrored what Owen did in England, work that was published in 2006 by the New England Journal of Medicine that found 18% of patients believed to be in a vegetative state were actually conscious.