It’s has to be incredibly difficult to be faced with the choice of ending the life of a non-responsive brain injury patient. As a parent, spouse, sibling or child, this choice can’t get any easier.
Now, with new information on the brain activity in patients who have been diagnosed as being vegetative, this decision has gotten even harder.
Niels Birbaumer, a neurobiologist at the University of Tubingen in Germany, found surprising levels of cortical activity after studying EEG recordings of the brain activity in vegetative patients. The cerebral cortex is the area of the brain associated with memory, attention, awareness, thought and language.
Since the vegetative state was first labeled and defined, there has been a great deal of argument among everyone from scientists to lawyers and family members over the point where it’s OK to finally make the decision to end a life. This has been so difficult due to the varying concepts of what determines that someone is “alive”.
If they are breathing and the body is able to sustain itself on IV-fed nutrition, does this mean the person is still living? If they have no response to verbal communication or physical stimulation, does this mean they are no longer conscious and hence no longer “with us”? Because of this blurry line, scientists have been working to find a definite way to determine “true” brain death.
Birbaumer’s EEG recordings are an example of the recent studies to clarify this difficult matter. In one, Birbaumer and colleagues looked for patterns in the brain’s electrical activity as patients with severe brain damage had sentences read to them. The patients ranged from completely vegetative to those who could still control their gaze or other physical abilities.
Of the 38 participants that were labeled persistently vegetative, a state that is usually considered irreversible, 22 percent responded to errors that were deliberately mixed in with the sentences. This suggests that these patients are able to process more than was previously assumed and creates further questions on what a person who is in a vegetative state is aware of internally, if unable to respond externally.
Hopefully studies such as this one will help doctors to determine if someone is truly non-functioning and unable to have any awareness of their surroundings. This would make it easier for those whose trial it is to make and end-of-life decision.