- Published: October 31, 2012
Brain damage from traumatic brain injuries can sometimes case people to enter vegetative states, in which he or she is perceived as unconscious but still has periods of wakefulness. For people in a persistent vegetative state, in which there is no hope of recovery, the family must decide if the person should be kept alive. In the early 2000s, the world watched as Terri Shiavo’s husband and parents fought a relentless legal battle over the fate of Terri, who entered a persistent vegetative state after a stroke. Questions in these cases commonly boil down to “is my loved one still inside there?” – if they are, they should be kept alive; if the body is now just a shell of the person, they should be allowed to die.
Upon looking at a person in a vegetative state, you would assume that they were not aware of anything going on in their surroundings. However, new research shows that nearly 20 percent of the people determined to be in a vegetative state may actually be aware of their surroundings and able to communicate through brain signals. When attached to an EEG and asked to move their toes, 3 of 16 people in vegetative states showed increased brain activity in the area associated with toe movement.
This research presents new challenges to the legal system. Persistent vegetative state falls into a legal gray area. While brain death, which occurs when a patient exhibits no brain function, is considered death, vegetative states are not. However, after four weeks of being in a vegetative state, the family is allowed to put in a request to end life support. To end life support, a physician must prove that the patient is highly unlikely to ever have mental function above that of a vegetative state, which means that the patient must not have any cognitive function. With new results from EEGs and fMRIs demonstrating cognitive function even in those who have been in vegetative states for years, these laws will have to be revisited. In this case, does cognition still equal life? I think that if a patient has been in a vegetative state for months, even if he or she has simple cognitive function, the family should still be allowed to make the decision on death instead of the courts.