6 ms·

This is a great argument against "pulling the plug" on folks in vegetative states.

daeken 13y ago
You don't pull the plug on those in a vegetative state. They have brain activity and a functioning brain stem -- generally they're just on a feeding tube.
- cstavish 13y ago
  I certainly could be wrong here, but wasn't Terry Schiavo in a persistent vegetative state?
  - wnevets 13y ago
    http://www.nbcnews.com/id/8225637/ns/us_news/t/schiavo-autopsyshows-irreversiblebrain-damage/ http://www.nbcnews.com/id/8225637/ns/us_news/t/schiavo-autop... > An autopsy on Terri Schiavo backed her husband’s contention that she was in a persistent vegetative state, finding that she had massive and irreversible brain damage and was blind
    - caycep 13y ago
      Someone published the CT scan of the brain, IIRC, there certainly wasn't a lot left. Not by volume, at least...
- caycep 13y ago
  Ideally there would be some sort of advanced directive, living will, etc. Being on a breathing machine and feeding tube is pretty terrible...a lot of people would beg to pull the plug...
jtheory 13y ago
It's certainly a great reminder that I should (as should everyone) make a living will. If you ever end up in a persistent vegetative state, it's grueling for your family & loved ones. We now have the tech to keep you sort-of alive for many years, but it's not cheap, of course. There have been ridiculous controversies in the US (see http://en.wikipedia.org/wiki/Terri_Schiavo_case http://en.wikipedia.org/wiki/Terri_Schiavo_case for a good example) about families that have decided (with the support of medical professionals) to pull the plug after years of suffering... and there may be protests from the devout (because to some people, any action or explicit inaction that causes a life to end is murder), political interference all the way up to high levels, etc.. It's also somewhat sad that if it's time to give up on restoring a person to working order, the ways of doing that may be limited to somewhat slow & cruel methods (like removing a feeding tube) rather than more humane methods, due to the legal terrain. There's a certain level of brain damage from which it's not possible to recover a functional person; it's hard to draw that line (see OP for emphasis on that), but it's a line that people in real life are obligated to draw on a regular basis. If you make a living will that specifies that you do not wish to be kept on life support if your brain activity is below X for Y time (a bit of research required here), you can save the people you leave behind a great deal of heartache by not foisting the decision on them.
- carbocation 13y ago
  Removing a feeding tube, when consistent with the patient's wishes, is not cruel; rather, when appropriate, it is one of the most humane ways to permit a dead or dying brain's body to die.
  - Cass 13y ago
    It's not exactly cruel, but it's also not exactly the most pleasant way to die. We recently pulled a patient's feeding tube (in accordance with her own wishes - she had terminal cancer, and had been able to see the end coming for a while), and it took her a full freaking eighteen days to die on no sustenance but a single cup of water someone gave her on day six. We obviously had the poor woman on a morphine pump the whole time, so she was too out of it most of the time to suffer much, but it's not a perfect system - she kept having moments where she'd become more awake and agitated, and I did feel like she was experiencing some suffering in those moments during our best efforts. Coincidentally at the same time, I had to have my cat put to sleep. The vet came to my house, he received a single injection, and then he peacefully fell asleep in my arms without so much as a twitch. The entire process took not five minutes altogether. I know which way of dying I'd prefer, if it was my terminally ill body at stake.
    - voidlogic 13y ago
      Ironic, isn't it, that humane treatment is reserved for non-humans.
- LordKano 13y ago
  Terri Schiavo's family was split. Her parents wanted to keep feeding her while her husband fought to remove the feeding tube and prevent anyone from feeding her by mouth. Conveniently for Michael, Terri was allowed to starve to death and he was free to spend whatever remained of the 2 million dollar medical malpractice judgement on himself, his new consort and their children.
  - jtheory 13y ago
caycep 13y ago
Well, not really. The treatment makes them twitch an eyelid a little more often than without brain zapping. Whether that's a quality of life you'd want still needs to be deliberated by all those involved...
- timdiggerm 13y ago
  Here, it's not about whether their current quality of life is good or not (obviously not), but about whether there's hope for eventual recovery. Treatments like this suggest there could be.
  - phren0logy 13y ago
    That is the most optimistic possible interpretation of this research. Sure, it's possible this line of research could lead to recovery, but the idea that the brain is "on pause" while in a persistent vegetative state and would be capable of returning to normal function is probably not reality.
  - caycep 13y ago
    In these cases, it's important to define recovery - in a lot of these cases, brain is dead, and dead is dead. Sometimes, the rest of the brain is plastic enough to "reroute"so you get something back, but most of these cases, to "recover", you'd essentially have to build a new brain... Keep in mind TDCS isn't a fancy brain machine interface that's intelligently interacting with neurons, it's just dumb direct current that's being sent into tissue... I think the overall line of research certainly is worthwhile pursuing, just that this specific tDCS project may be being overhyped in just how much it means...
boobsbr 13y ago
"pulling the plug" happens when the patient has brain death, which is different from a vegetative state. http://en.wikipedia.org/wiki/Brain_death http://en.wikipedia.org/wiki/Brain_death

You don't pull the plug on those in a vegetative state. They have brain activity and a functioning brain stem -- generally they're just on a feeding tube.

cstavish 13y ago
I certainly could be wrong here, but wasn't Terry Schiavo in a persistent vegetative state?
- wnevets 13y ago
  http://www.nbcnews.com/id/8225637/ns/us_news/t/schiavo-autopsyshows-irreversiblebrain-damage/ http://www.nbcnews.com/id/8225637/ns/us_news/t/schiavo-autop... > An autopsy on Terri Schiavo backed her husband’s contention that she was in a persistent vegetative state, finding that she had massive and irreversible brain damage and was blind
  - caycep 13y ago
    Someone published the CT scan of the brain, IIRC, there certainly wasn't a lot left. Not by volume, at least...
caycep 13y ago
Ideally there would be some sort of advanced directive, living will, etc. Being on a breathing machine and feeding tube is pretty terrible...a lot of people would beg to pull the plug...

jtheory 13y ago

It's certainly a great reminder that I should (as should everyone) make a living will. If you ever end up in a persistent vegetative state, it's grueling for your family & loved ones. We now have the tech to keep you sort-of alive for many years, but it's not cheap, of course. There have been ridiculous controversies in the US (see http://en.wikipedia.org/wiki/Terri_Schiavo_case http://en.wikipedia.org/wiki/Terri_Schiavo_case for a good example) about families that have decided (with the support of medical professionals) to pull the plug after years of suffering... and there may be protests from the devout (because to some people, any action or explicit inaction that causes a life to end is murder), political interference all the way up to high levels, etc.. It's also somewhat sad that if it's time to give up on restoring a person to working order, the ways of doing that may be limited to somewhat slow & cruel methods (like removing a feeding tube) rather than more humane methods, due to the legal terrain. There's a certain level of brain damage from which it's not possible to recover a functional person; it's hard to draw that line (see OP for emphasis on that), but it's a line that people in real life are obligated to draw on a regular basis. If you make a living will that specifies that you do not wish to be kept on life support if your brain activity is below X for Y time (a bit of research required here), you can save the people you leave behind a great deal of heartache by not foisting the decision on them.

carbocation 13y ago
Removing a feeding tube, when consistent with the patient's wishes, is not cruel; rather, when appropriate, it is one of the most humane ways to permit a dead or dying brain's body to die.
- Cass 13y ago
  It's not exactly cruel, but it's also not exactly the most pleasant way to die. We recently pulled a patient's feeding tube (in accordance with her own wishes - she had terminal cancer, and had been able to see the end coming for a while), and it took her a full freaking eighteen days to die on no sustenance but a single cup of water someone gave her on day six. We obviously had the poor woman on a morphine pump the whole time, so she was too out of it most of the time to suffer much, but it's not a perfect system - she kept having moments where she'd become more awake and agitated, and I did feel like she was experiencing some suffering in those moments during our best efforts. Coincidentally at the same time, I had to have my cat put to sleep. The vet came to my house, he received a single injection, and then he peacefully fell asleep in my arms without so much as a twitch. The entire process took not five minutes altogether. I know which way of dying I'd prefer, if it was my terminally ill body at stake.
  - voidlogic 13y ago
    Ironic, isn't it, that humane treatment is reserved for non-humans.
LordKano 13y ago
Terri Schiavo's family was split. Her parents wanted to keep feeding her while her husband fought to remove the feeding tube and prevent anyone from feeding her by mouth. Conveniently for Michael, Terri was allowed to starve to death and he was free to spend whatever remained of the 2 million dollar medical malpractice judgement on himself, his new consort and their children.
- jtheory 13y ago

caycep 13y ago

Well, not really. The treatment makes them twitch an eyelid a little more often than without brain zapping. Whether that's a quality of life you'd want still needs to be deliberated by all those involved...

timdiggerm 13y ago
Here, it's not about whether their current quality of life is good or not (obviously not), but about whether there's hope for eventual recovery. Treatments like this suggest there could be.
- phren0logy 13y ago
  That is the most optimistic possible interpretation of this research. Sure, it's possible this line of research could lead to recovery, but the idea that the brain is "on pause" while in a persistent vegetative state and would be capable of returning to normal function is probably not reality.
- caycep 13y ago
  In these cases, it's important to define recovery - in a lot of these cases, brain is dead, and dead is dead. Sometimes, the rest of the brain is plastic enough to "reroute"so you get something back, but most of these cases, to "recover", you'd essentially have to build a new brain... Keep in mind TDCS isn't a fancy brain machine interface that's intelligently interacting with neurons, it's just dumb direct current that's being sent into tissue... I think the overall line of research certainly is worthwhile pursuing, just that this specific tDCS project may be being overhyped in just how much it means...

boobsbr 13y ago

"pulling the plug" happens when the patient has brain death, which is different from a vegetative state. http://en.wikipedia.org/wiki/Brain_death http://en.wikipedia.org/wiki/Brain_death