Minimally Conscious Feel Pain

A study has found that people with serious cognitive impairments who are conscious--people who are routinely dehydrated to death in most states--feel pain. From the story:

Severely brain-damaged patients in a "minimally conscious state" may still feel pain and require painkilling treatment, according to European researchers.

A minimally conscious state (MCS) is different than a persistent vegetative state (PVS), which involves wakefulness without awareness of self or surroundings. MCS patients do show some evidence of awareness of self and their surroundings. However, caregivers have difficulty assessing MCS patients' levels of conscious pain based on their behavior, according to background information in the study by Dr. Steven Laureys, of the Coma Science Group at the University of Liege, Belgium, and colleagues.

They compared brain activity following electrical stimulation of the median nerve in five MCS patients (ages 18 to 74), 15 PVS patients (ages 18 to 75), and 15 healthy people (ages 19 to 64). The researchers focused on brain areas responsible for pain sensation (the cortical pain matrix), including the thalamus, the primary somatosensory cortex, and the insular, frontoparietal and anterior cingulate cortices. The MCS patients showed the same level of activity in these areas as healthy people and significantly more activity than PVS patients. The MCS patients also showed better "connectivity" between different brain regions responsible for pain than PVS patients.

So will dehydration proponents now conclude that the lives of these patients should be sustained? Of course not! They will say that the ability to feel pain means more than ever that they should be put out of their misery. Or, as often happens, the misery of their families.

Dehydration of a Conscious Patient in Florida Reported as No Big Deal by St. Petersburg Times

For more than ten years I have been telling anyone who will listen that unquestionably conscious cognitively disabled patients are being denied sustenance in every state in this country--so long as no family member objects (and eventually, if futile care theory takes hold, it will be even if they do). Here's the latest proof: A young man was catastrophically injured by a drug overdose. For years his parents kept vigil, and then decided to transfer him to the hospice in which Terri Schiavo died, which removed his feeding tube. But he wasn't unconscious. From the story:

His brain was severely damaged, and he never spoke again. If his mother pulled his chin, he could mouth "Mama." If she leaned close, he could kiss her. That "broke my heart," Sue, 53, said.

For nearly three years, his mother and father did nothing but "work, sleep and spend time with Bradley," she said. There was a chance his condition would improve. But it didn't. Infections kept landing him in a hospital. Finally, his family transferred him to the Hospice of Florida Suncoast, where Terri Schiavo died.

They removed his feeding tube, and his mother lay in bed beside him. He died July 2.

It is my understanding that a patient is supposed to be PVS in Florida before a tube can be removed. But never mind. That law isn't really designed to protect, but give false assurance.

I think the bigger story here is the blase`, matter-of-fact reporting about the matter by the Tampa Bay/St. Petersburg Times--which exhibited profound, nay, nasty, bias against the Schindlers during the Schiavio debacle. Can you imagine the paper's reaction had a dog or a horse been denied sustenance?

This is the truth: Once we decided that people who are diagnosed as persistently unconscious could have sustenance denied based on quality of life, then we stripped all profoundly cognitively disabled people from moral equality. The wall was breached allowing utilitarian bioethical values to come pouring in. Now, virtually anyone who needs a feeding tube and can't make their own decisions--conscious or not--can and are being denied food and water. What a testimony about the state of the times in which we live.