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April 22, 2005

Persistent vegetative state: diagnosis with an agenda

Topics: Medical Issues

A person diagnosed in a wakeful coma (so-called 'persistent vegetative stated or PVS) still has a functioning brain stem, which controls the mechanisms of breathing, digestion, and reflexes, so they are not brain dead. They have partial brain function.

So, if PVS is such a poor term to describe the medical condition of a wakeful coma, why is it a diagnostic term in the first place?

PVS is a very useful term if you are an advocate of euthanasia. If you believe that killing people who (in your opinion) don't have much "quality of life," whom you see as "trapped in their bodies" at the door to eternity, and who (in your judgment) are better off "released" from a life confined to bed, then the term persistent vegetative state works very well indeed.

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Posted by tim at April 22, 2005 2:06 AM


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OMG

-yawn-

Posted by: Fritter at April 22, 2005 2:59 AM

>

Excellent article. I am soooooo guilty of throwing around the word "vegetable," as a description of comatose or brain damaged people... even though in my wildest dreams I'd never use it as an excuse to kill a human being. Still, the term has crept into our national lexicon and now I can clearly see why. Language is a key tool in advancing every agenda, good and bad.

I will never use the word vegetable again, unless it relates to a recipe.

The new word is DISABLED.

Posted by: SallyVee at April 22, 2005 6:00 AM

With all do respect - this is a commentary and nothing else.

Please read the fine print at the end -

"Carl Rossini is an advertising instructor, with graduate and undergraduate degrees in history, as well as a MBA. He lives in the Dallas area."

I don't believe Mr. Rossini has any expertise on commenting on this medical subject just as I would have none commenting with an MBA and undergraduate degrees in accounting and economics.

Sorry - that is my opinion!

Posted by: Blogging Beth at April 22, 2005 7:17 AM

Yep ... its an opinion. The title gives it away. He is commenting on what he perceives as the "agenda" as well as the public perception associated with the use of the word "vegetative".

Posted by: tim at April 22, 2005 8:18 AM

From the July/August 1992 magazine HEADLINES, the cover story is COMA, Latest Research and Clinical Issues.

Working Definitions in Early Coma Recovery:

Although we frequently think and refer to coma as any prolonged period of unconscioosness, the term is more accurately applied to a person in this state for no longer than three to four weeks. A person in a coma has no sleep/wake cycles, and the eyes remain closed. When the sleep/wake cycles return and blood pressure, respiration, and digestion normalizes, the patient is considered to be in what some refer to as a vegetative state. In this stage, although eye opening may occur, true visual tracking or sustained fixation is not present. Many experts suggest that a patient be classified as being in a persistant vegetative state (PVS) if he or she continues to remain in a vegetative state at least one year after a traumatic brain injury. Therefore, PVS indicates a prognosis rather than a diagnosis(NeuroRehabilitation 1991;1,3:33-40). Other professionals believe the term "vegetative" is dehumanizing and inaccurate, and they suggest postcomatose unawareness as a more suitable alternative (Brain Injury 1991,5;1-2).....

Posted by: Caryn at April 22, 2005 8:27 AM

"A person walks and talks, eats, puts on clothes, takes a shower, goes to work, and has fun in any spare time. A vegetable just lies there in the supermarket, gets sprayed with water, and is eaten. Or, if it gets old, wrinkly or rotten, it is thrown away."

Sorry Beth--Carl Rossini has a very valid point. He was coming at this from a logical, human standpoint, not a "medical opinion". And he is correct. When a vegetable gets old, wrinkly or rotten, it is thrown away.

So, if we dehumanize people and call them vegetables, we have a standard by which to eliminate them. When they are "old, wrinkly or rotten" we should just throw them away. That is what Euthanasia Advocates do--they eliminate the "life" of the disabled, and reduce public opinion to consider the disabled person a "non-person". People don't want to live as vegetables, so why should we allow them to live as vegetables?

Mr Rossini's point is that People are People--they are not vegetables and shouldn't be classified as such. Only by removing their humanity can one justify starving them to death. See, vegetables shrivel and dry when they don't get food and water, but they have no brain, so they don't feel it. If we diminish the human person to a vegative state, then we can deduce that they, like vegetables, can shrivel and die without pain. No problem. Throw the rotten, dead vegetable out.

If a person is "brain dead" then they will eventually die; the brain cannot be dead and continue to function. So, call a spade a spade; brain-damaged means some brain functions are inhibited. Brain-dead means the brain cannot sustain life (and obviously Terri's brain wasn't dead until it was starved for almost two weeks). Remove the respirator if needed, remove artificial heart functions. If the brain continues to provide those functions--it's not dead (Karen Ann Quinlan lived for years after these functions were stopped). But do not remove food and water. If the body processes them, then the brain is ALIVE. If the body cannot process them, then the brain function is likely gone and the person cannot remain alive.

Call a spade a spade. People are not vegetables; although I do believe some of the judges and others who support dehydration and starvation of the disabled/infirm have mush for brains.

Posted by: Tress at April 22, 2005 2:13 PM

Mr. Rossini's point about "brain death" is incredibly important. Neither he nor I am a doctor, but in point of fact it is an error of _laymen_ to refer to people in any sort of non-responsive state as, per se, "brain dead." I've researched this and found a medical journal article, web sites on organ donation, and the like, and all agree that "brain death" precludes the ability to breathe on one's own. It is those who extend its use who are talking like uninformed nonprofessionals.

Rossini's further point is also supported medically: it is incredibly difficult to tell, clinically, what a person's state of consciousness and cognitive awareness is. Some imaging techniques help, but the guys doing imaging say, "This has to be a clinical diagnosis" and the guys doing the clinical diagnosis say, "We need more imaging." The truth is that the diagnosis is hard even given _both_ lots of clinical evidence _and_ sophisticated imaging. It is even more difficult to tell what a person's prognosis is--whether he will in fact recover. While responsible doctors admit both of these things, indeed, they are not in question medically, the practical fact is that the phrase "PVS" continues to be used as if it designates a much more _simple_ and _cut and dried_ diagnosis. The truth is that something with this many fuzzy edges and diagnostic difficulties should _never_ have been enshrined in law as having such strong legal relevance as PVS has in the laws and legal precedents of several states. This is a case of what I call "medical name magic," where the fact that a person's condition has been given a name makes people think that those who label the condition with that name in that case are engaging in an activity as medically objective, easy, and scientific as diagnosing measles when in fact this is not true.

Posted by: Lydia at April 22, 2005 3:04 PM

One highly regarded study indicates a staggering percentage of doctors are secretly suffering from undiagnosed cases of Arbitrarily Spontanious Diagnosis Syndrome. Read more here:

http://cchr.org/publications/pdf/english/pseudo_EN.pdf


...and here:
http://cchr.org/publications/index.htm


Background information regarding the medical history of these doctors:

http://gopchristian.blogspot.com/2005/04/where-did-nazi-doctors-go.html

Posted by: gopchristian at April 23, 2005 12:24 PM

+JMJ

I never understood how the word "vegetative" became a medical term. I remember when I was a child (over 20 years ago) trying to get adults to explain this to me. Now I am an adult and the concepts of "vegetable" vs. "human" still seem quite different to me.

If humans are never vegetables, than how is not dehumanizing to refer to someone as being in the state of being "vegetative"? It takes a greatly immoral, unjust and perverse agenda to draw that type of connection and standardize it in the scientific community.

The dehumanization of people to the point of starvation can not be morally justified, anymore than starving a hardened criminal on death row (do they not receive meals?) and prisoners of war (it is commonly construed as cruel and unusual punishment), and even those who are dying (it is STANDARD PRACTICE for doctors to provide hydration to patients dying of terminal illnesses, even in their final hours, as it is considered humane to provide that comfort).

Terri was not dying of an incurable disease, nor was she a criminal, but it is arguable that she was a prisoner of our judicial tyranny in America.
She died because she was murdered. She was starved to death. She was no vegetable, but a disabled human being.

And for that, she was murdered.

Posted by: parva ancilla at April 23, 2005 4:44 PM