Patient in vegetative state says he is not in any pain
A Canadian man believed by doctors to be in a vegetative state for the past ten years has shocked scientists by responding to questions about his care.
Brain damaged
Scott Routley (39) was left severely brain damaged after a major car accident 12 years ago.
Since then, his medical assessments suggested he is unable to communicate and that he is unaware of his surroundings.
But Mr Routely overturned the findings by indicating to researchers that he was not in any pain whilst being questioned during a brain scan using a fMRI machine.
This is the first time an uncommunicative patient thought to be in a vegatative state has responded to questions about his care.
Ground breaking
British neuroscientist Prof Adrian Owen, who led the research team at the University of Western Ontario, said that the ground breaking discovery clearly showed Mr Routely was not in a vegetative state.
He added: “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.
“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”.
Rewritten
Prof Bryan Young at University Hospital, London, who has been Mr Routley's neurologist for ten years, said the findings meant that textbooks would have to be re-written to include Professor Owen’s research.
“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”.
Withdrawal of food & water
BBC health correspondent, Fergus Walsh, said that the findings were significant since current laws permit vegatative patients to die by having their food and hydration withdrawn.
He said: "The case is important because in the past two decades, more than 40 vegetative patients have been allowed to die after High Court judges approved the withdrawal of feeding tubes.
"This followed a landmark case involving the young Hillsborough victim Tony Bland, who was crushed in the stadium disaster in 1989, suffering terrible brain damage which left him in a vegetative state.
"Before any judge decides to sanction the withdrawal of treatment, a thorough behavioural assessment is ordered. But they do not ask for brain scans of the type used by neuroscientists in Cambridge and Ontario to search for hidden awareness.
"It is possible that may eventually change."
Andrea Williams, Chief Executive of Christian Concern said:
“These findings demonstrate that those who are believed to be in a coma or a vegetative state may in fact have awareness and the ability to communicate - even if their doctors think otherwise.
“They should make us wary of writing people off too soon, when in fact there is more going on the inside than meets the eye.
“It’s important that we make sure there continue to be sufficient protections in our legislation for people like Scott Routley”.
Source:
BBC: Vegetative patient Scott Routely says ‘I’m not in pain’
BBC: Finding a voice for the brain injured
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