Human Exceptionalism

Der Spiegel: Rom Houben Not Really Communicating

I reported earlier on the Rom Houben case that made international headlines when it turned out that he had been misdiagnosed by his physicians as unconscious for 26 years. New diagnostic techniques showed near normal brain function.  And, it appeared, he could communicate with the help of a speech therapist using a press keyboard.

That was where the controversy began. The bioethicist Art Caplan said that video tapes of Houben so communicating looked like “facilitated communication,” which he called “Ouija Board.” (Caplan never contended Houbens wasn’t conscious.)  Now, he sends me a translated excerpt from Der Spiegel that reports Dr. Laureys could not get Houben to answer questions correctly.  From the story (German link only):

The staff at the nursing home had tried it first with an onscreen keyboard, which he used with his right, not completely paralyzed finger. For a while it looked like a good idea: With a little practice Houben succeeded , typing rapidly. And, while he made many mistakes, his messages could be understood.

A speech therapist had, however, stood behind him and supported his hand. The neurologist Laureys said that he was previously convinced speech therapist was not doing the writing. However, Laureys now realizes that the examination was not thorough enough. To obtain valid results, the patient must undergo a lengthy procedure. People with severe traumatic brain injury are not always willing to follow complex instructions, they frequently fall asleep, and sometimes they sink into prolonged delirium. To avoid invalid results, repeated testing over several weeks is needed.

Laureys has now carried out these tests. Result:  Houben probably not even have enough strength and muscle control in his right arm to accurately type. The speech therapist, in an effort to help the man type, unconsciously took the lead – such illusions occur in the method again and again. Additionally, the information that Houben gave to the SPIEGEL last year, therefore, did not come from him.

In the current test series, Houben saw or heard 15 items,, while the speech therapist was absent. Then, the man would each write down the correct word – succeeding not once. The method of “assisted writing” itself is thus discredited, but not necessarily. Laureys also investigated the control questions with another paralyzed respondent with a similar brain diagnosis, obtaining 15 correct answers: “It means you have to really examine each individual case.”

In other words, Houben couldn’t answer correctly, but a different patient did using a similar technique???

If I learn more, I will present it here.