Authors:

OWEN, A.M., Coleman, M.R., Boly, M., DAVIS, M.H., Laureys, S. & Pickard, J.D

Reference:

Year of publication:

2006

CBU number:

6325

Abstract:

Vegetative state is one of the least understood and most ethically troublesome conditions in modern medicine. The term describes a unique disorder in which patients who emerge from coma appear to be awake, but show no signs of awareness. Although the diagnosis depends crucially on there being no reproducible evidence of purposeful behaviour in response to external stimulation, recent functional neuroimaging studies have suggested that ‘islands’ of preserved brain function may exist in a small percentage of patients who have been diagnosed as vegetative. On this basis, we hypothesized that this technique also may provide a means for detecting conscious awareness in such patients, who are assumed to be vegetative, yet retain cognitive abilities that have evaded detection using standard clinical methods. In this paper, data from a single patient are presented showing that, despite fulfilling the clinical criteria for a diagnosis of vegetative state, she retained the ability to understand spoken commands and to respond to them through her brain activity, rather than through speech or movement. Moreover, her decision to cooperate with us by imagining particular tasks when asked to do so represents a clear act of intention which confirmed beyond any doubt that she was consciously aware of herself and her surroundings.

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