New reasons for hope

Look at this story. Ever since Terri Schiavo, the nation has been in a debate over end-of-life issues and the ubiquitous term “persistent vegetative state.” But most people don’t understand that term, much less give any respect to the science of diagnosing and treating it. This story is unusual in that field.

A car crash severely injured the woman’s brain, leaving her in a vegetative state. But British scientists found startling signs of awareness when they peered deeper into her brain: She seemed to hear and follow — mentally — certain commands.

This novel brain-scanning experiment, reported Thursday, is sure to elicit pleas from families desperate to know if loved ones deemed beyond medical help have brain activity that doctors didn’t suspect.

Brain imaging is a new frontier in that science, but it holds hope for people who have been given so little reason to have any, medically speaking.

What an unmet need is out there,” said neuroscientist Joy Hirsch of New York’s Columbia University Medical Center, who is conducting similar research and receives “just heartwrenching” requests to scan patients.

So what brought this about? An interesting test that surprised doctors, to say the least.

First, they checked that she could process speech. Told a sentence such as “there was milk and sugar in the coffee,” the woman’s brain regions that recognize speech reacted just the way healthy volunteers’ brains reacted…

Then came the big test. They told the woman to perform a mental task — to imagine herself playing tennis.

The motor-control regions of her brain lit up, again just like they did in the healthy people Owen compared.

“There is no other explanation for this than that she has intentionally decided to involve herself in the study and do what we asked when we asked,” he said in an interview.

In the minefield of bioethics, it’s great to see some good news that can help save the lives of the disabled. And great to see some honesty.

Columbia’s Hirsch said the woman is not conscious. But, “it tells me that this patient’s brain is operating the essential elements for consciousness. The machinery is there and operating,” she explained.

This kind of research is difficult — there’s little funding for it, among other barriers — but Thursday’s report demands that more be done, Hirsch added.

“It raises the tension about how we treat these patients,” she said. “In some sense, one could interpret this as saying it’s ethically unconscionable not to address.”

This is good news. Biomedicine needs more honest and hopeful reporting like this.