Human Exceptionalism

Unconscious Patient Heard End Care Push

Sometimes, I think, the medical system is in too big a rush to assume that people with brain damage are out and gone.

This is the fruit of a “quality of life” value system that increasingly infects medicine. Human life matters far less now than the supposed quality of the life expected to be lived. 

That’s very dangerous. Here’s an example: An Australian woman had a stroke. She appeared completely unconscious, but was really awake and aware. And she heard the push by her medical team to end life support. From the story:

Kate Allat is a mother who suffered a stroke at 39. She spent 10 days in a coma after the stroke, and came around in a hospital bed – but her consciousness was a living nightmare. The Daily Mail reports Kate’s mind was functioning perfectly, but everyone around her, including medics, thought she was brain dead. She lay paralysed, without the ability to speak or even breathe on her own, listening as medics discussed switching off life support with her loved ones.

Kate was suffering from “locked-in syndrome” – where you can feel, hear and think – but you can’t communicate at all. It took two weeks for Kate to be able to communicate with medics and loved ones she was mentally alert. “They thought I was in a vegetative state. I couldn’t move a muscle. There was no signal I was in there,” 

Imagine hearing people discuss prognosis and knowing that you could be cut off from life. Brrrr.

I know another such case: Kate Adamson–who said that being without food and water was worse pain than when she was operated upon with inadequate anesthesia–also was misdiagnosed incorrectly as persistently unconscious.

We should remember that before supporting the dehydration of people with extensive brain damage.

There are many lessons to learn from this, among which are:

1. A proper diagnosis of persistent unconsciousness takes months, not days. Don’t be pushed into a decision that can’t be reversed.

2. Never speak in front of an unconscious patient about things you would not want her to hear. She might be awake.

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