Study: Patients in “Vegetative State” Often Misdiagnosed

International   |   Steven Ertelt   |   Nov 10, 2011   |   4:22PM   |   Washington, DC

A study published today in the British medical journal The Lancet found patients are often misdiagnosed as in a “vegetative state” when they are not. The study has ramifications for patients like Terri Schiavo who are abandoned by doctors or family members as supposedly “too far gone.”

The Lancet study noted that “a population of patients exists who meet all the behavioural criteria for the vegetative state, but nevertheless retain a level of covert awareness that cannot be detected by thorough behavioural assessment.”

Using a bedside electroencephalography (EEG) technique to assess patients, researchers studied 16 patients diagnosed as “vegetative” and 12 healthy “controls.” These patients were directed to imagine that they were making a fist and wiggling toes.  A fifth of the patients “could repeatedly and reliably generate appropriate EEG responses” similar to those of the conscious controls.

“Bedside detection of awareness in the vegetative state” raises significant questions about the countless patients who may have been misdiagnosed as being in a so-called “vegetative state,'” the study continued.

Suzanne Schindler, Terri’s sister and a director of the Terri Schiavo Life & Hope Network that carries on in her name by helping disabled patients secure appropriate medical care and treatment, told LifeNews today the results of the Lancet study are “nothing new.”

“Science has known for years that many patients diagnosed to be in a “vegetative state” were, in reality misdiagnosed,” she said. “The real question is why these understandings haven’t caused us to rethink the morality of removing food and water from such persons.”

“Regrettably, Terri never was afforded these types of examines,” Schindler continued. “This was despite the fact that upwards of 40 medical professionals, some being the most prominent neurologists in the nation, believed that Terri was not in a PVS or could have been helped with proper diagnosis/treatment if given the opportunity. We begged Judge Greer to permit further testing and therapy during the time Terri’s case was awaiting appellate court hearings. Such testing could not have hurt Terri but could have helped her. And yet, Judge Greer consistently refused. Not even the autopsy was able to confirm whether or not Terri was in a PVS.”

“These findings, along with many others similar findings since Terri’s barbaric death, only reinforce our family’s contention that the PVS diagnosis needs to be eliminated. Particularly given the fact that it not only dehumanizes the cognitively disabled, but it is being used in some instances to decide whether or not a person should live or die, as it was used in Terri’s case. None of us deserves to be deprived of food and water,” Schindler added.

Burke Balch, J.D., the director of National Right to Life’s Robert Powell Center for Medical Ethics told LifeNews that an untold number of patients have lost food and water or medical treatment as a result of a wrong persistent vegetative state diagnosis.

“Many patients, probably thousands, have had their food and fluids cut off and died, based on what we now know may well have been mistaken assumptions that they had lost all capacity for consciousness,” he said.

“The Lancet EEG study, together with earlier functional MRI studies, holds out the hope that we may develop ways to communicate with aware patients who have routinely been diagnosed as “vegetative,” much as today eye movements and blinks are used to communicate with some patients with paraplegia.  That would certainly be a positive alternative to starving them to death,” Balch added.

The Lancet study comes on top of previously published studies using more complex and less readily available fMRI (functional magnetic resonance imaging) technology that demonstrated some patients in a “vegetative” state, when instructed to imagine they were playing tennis, generated brain waves comparable to those of healthy “controls.”

While the Lancet study shows that EEGs could detect signs of consciousness in patients who had been diagnosed as “vegetative,” it does not follow that when EEGs do not detect these signs, such patients are definitely unconscious.  As the study itself notes, the fact that the EEG did not pick up these signs of consciousness in 25% of the healthy and aware controls shows unequivocally that a null EEG outcome does not necessarily indicate an absence of awareness.

Balch added, “Just as what were once generally accepted mental health diagnoses of ‘idiot’ and ‘moron’ have long been dropped from standard medical vocabulary, it is to be hoped that these studies will help lead to abandonment of the dehumanizing and inaccurate term ‘vegetative’ as an acceptable medical diagnostic term.”