Human Exceptionalism

Terri Schiavo-Type Patients May Feel Pain

“Persistent vegetative state” is the only medical diagnosis I know of that contains a pejorative. No human being is a carrot. And the more we learn about these persistently unconscious patients, the more we  seem to be discovering that they may not be “gone” after all. Now, a study shows that they may experience pain. From the New Scientist story:

IT IS a nightmare situation. A person diagnosed as being in a vegetative state has an operation without anesthetic because they cannot feel pain. Except, maybe they can. Alexandra Markl at the Schön clinic in Bad Aibling, Germany, and colleagues studied people with unresponsive wakefulness syndrome (UWS) – also known as vegetative state – and identified activity in brain areas involved in the emotional aspects of pain.

Yikes. Some changes in care may be needed:

Nonetheless, Kotchoubey is confident that the way people with UWS are cared for will change, even if their diagnoses remain the same. “I know that many doctors working with such patients have been instructed to treat their patients as if they can understand them and perceive at least something in the environment, perhaps pain, pleasure, or emotion,” he says.

But not all people are treated this way. Prior to the study, one of the people in Markl’s study was given no anesthesia before a tracheotomy, which involves an incision in the neck to allow breathing without using the nose or mouth. As people with UWS are clinically considered unable to understand pain, doctors do not have to give an anesthetic.

Dehydrating to death over 14 days would also hurt. Terri Schiavo died that way without benefit of anesthesia, indeed, not even allowed ice chips on her lips.  Her cruel case aside, don’t expect the practice to stop. They will just be anesthetized while their bodies drain of fluids (some already are) or lethally injected. 

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