The 23-year-old woman in the current study was injured in July 2005. Within weeks, she opened her eyes and began sleep-wake cycles — typical of patients in a vegetative state — but she showed no sign of awareness or ability to respond to her environment.
A persistent vegetative state, in which the patient is awake but has no awareness of self or surroundings, is a state between coma and brain death. As many as 35,000 Americans are in such a state.
Owen and his colleagues studied her brain for five months using functional magnetic resonance imaging or fMRI. The technique highlights areas of the brain that receive increased blood flow when in use.
When researchers spoke sentences to her, a specific part of the brain showed activity — the same part that lights up in healthy people hearing the same sentences. When the sentences included homonyms like "creek" and "creak," additional parts became active. Random noises generated no response.
Finally, when they asked her to imagine playing tennis or wandering through her house, different areas of the brain were illuminated — again identical to the areas responding in healthy volunteers.
Eleven months after the accident, the team reported, the woman began tracking a small mirror with her eyes, a sign that she might be transitioning to what is known as a minimally conscious state, often a sign of further recovery.
Fins speculated that she had already begun undergoing this transition when the fMRI tests were conducted and that those tests simply detected it earlier than her behavior indicated.
The researchers have refused to say what her current condition is.
That is good news, and indicative of the mysteries we are nowhere near to unpacking – but the moral point isn’t shifted by this: even if there is no awareness, if a person is functioning, breathing on his or her own, etc, and needs food and water to be provided by others – we have no moral right to withhold that nutrition and hydration.
(And let us try not to fight old battles all over again. There are countless situations in which the dying reject food, consciously or not – that is part of the process of dying in many cases – in which, as life ebbs, all that a person can take is sips of water. That end-of-life scenario, which is part of the way dying can naturally occur. No one advocates force-feeding steak into people at the end of life who can’t swallow or whose bodies are shutting down. But when someone is not dying, it is immoral to refuse to feed or give him water. There are innumerable gray areas, as well, but I think the fundamental point even precedes the question of nutrtion and hydration – when someone is profoundly cognitively disabled…what is our responsiblity to that person?)
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