Wednesday, September 13, 2006

What if Permanent Vegetative States aren't so Vegetative?

"The wheels lock, the car skids, you see the 18-wheeler heading for your windshield. You have just enough time to open your mouth. Then the bite of glass and metal, and merciful blackness.


Somebody's talking. You try to open your eyes, but nothing happens. You can't move or feel anything. In the murmurs around you, you make out a few words: prognosis, unresponsive, permanent. They keep talking about somebody who's here, somebody who never speaks and is never spoken to.


A child cries. You've heard that cry before. Out of the blackness, the
thought comes at you, engulfing you: The unspeaking person is you. You're dead. And then a more horrible idea: Maybe you're not.


You try to call out, to scream. No one knows you're here, awake inside your skull. No one will ever know."


I am not sure if there is a more awful fate possible. Surely it would lead to anguish followed by madness. Take the fate of Natascha Kampusch, the poor Austrian girl, and multiply it by something unnatural and you get close to what such a complete cutting off from natural human experience would mean. William Saletan's article for Slate describing the scientific understanding of the discovery that some, rare, cases of permanent vegetative state may be accompanied by a still aware mind must change the debate over 'pulling the plug' and the right to life of those in a Schiavo like state. It would appear that most PVS cases are not of this type. In particular, the more serious cases such as Schiavo are probably genuinely vegative. However, the possibility of it must change the equation, particularly if discovering whether a case of PVS is mentally aware is difficult as this article suggests.

We are all in something of an original position here. A PVS is generally caused by accidents and does not discriminate between wealthy and poor; healthy and unhealthy. Some may have a slighly higher chance of facing such an unenviable position, race car drivers perhaps, but most of us are all in the same boat. We have no idea if we will face a PVS and, if we do, there is the possibility that we will face the position of being entombed in our own heads as we are to wake up if not a lot more likely. That possibility scares me far more than missing out on the vague possibility sometimes cited by right to life advocates that I will wake up.

The debate used to be about heartache and cost to those left behind by people with no hope of revival. It used to be about practicality and allowing someone a dignified death rather than a non-life. Now, we must face the possibility that a vain hope of revival may be consigning the unfortunate to something awful.

1 comment:

edmund said...

what evidnce is there that anyone who has been comotose for years has been in such a situation- screaming to die?