Minimally Conscious Feel Pain
A study has found that people with serious cognitive impairments who are conscious--people who are routinely dehydrated to death in most states--feel pain. From the story:
Severely brain-damaged patients in a "minimally conscious state" may still feel pain and require painkilling treatment, according to European researchers.So will dehydration proponents now conclude that the lives of these patients should be sustained? Of course not! They will say that the ability to feel pain means more than ever that they should be put out of their misery. Or, as often happens, the misery of their families.
A minimally conscious state (MCS) is different than a persistent vegetative state (PVS), which involves wakefulness without awareness of self or surroundings. MCS patients do show some evidence of awareness of self and their surroundings. However, caregivers have difficulty assessing MCS patients' levels of conscious pain based on their behavior, according to background information in the study by Dr. Steven Laureys, of the Coma Science Group at the University of Liege, Belgium, and colleagues.
They compared brain activity following electrical stimulation of the median nerve in five MCS patients (ages 18 to 74), 15 PVS patients (ages 18 to 75), and 15 healthy people (ages 19 to 64). The researchers focused on brain areas responsible for pain sensation (the cortical pain matrix), including the thalamus, the primary somatosensory cortex, and the insular, frontoparietal and anterior cingulate cortices. The MCS patients showed the same level of activity in these areas as healthy people and significantly more activity than PVS patients. The MCS patients also showed better "connectivity" between different brain regions responsible for pain than PVS patients.
Labels: Dehydration., Minimal Conscious State. Ability to Feel Pain
posted by Wesley J. Smith @ 10:09 AM
8 Comments
8 Comments:
Wesley,
The fact that those sub-groups of humanity singled out as ok to kill can feel pain is really irrelevant because, as you pointed out, the only pain that matters is the pain of the person deciding to kill.
It took us a few decades to go from it being ok to kill some groups of humans to it now being openly discussed that some of those groups actually have a duty to die and others should be killed even against their express wishes.
Not long now until the concentration camps return. But I think they will be tastefully decorated and called "facilities".
I would have erred on the side of caution anyway, and opted for active euthanasia with painkillers anyway. It can either do nothing, or alleviate much pain - sure the best option.
Before or after taking their organs and conducting living experiments on them?
On the pain aspect, it's not surprising that a comatose person could feel pain; pain is a much lower brain function than conscious thought, down in the autonomic system. I knew a family with a child who was persistently vegetative due to a drowning accident, and his family for years performed the patterning exercise therapy to keep his limbs functional in hopes of eventual recovery. When they showed up he would display anxiety (mostly guttural noises), apparently sensing that their presence meant the onset of the painful therapy. He eventually passed away without regaining full consciousness.
Removing a feeding tube is to me a horrible way to end a life. Starvation is slow and painful.
The point I take from this discussion is the importance of a living will. I would not wish to be maintained in the state that child was in, but there has to be a way to end it without pain. In the presence of clear pre-consent by the patient, which would have to be ratified by designated living representatives, there has to be a legal method for medical personnel to end my life painlessly.
And if my organs can possibly benefit anyone anywhere, they are welcome to them, and I have the donor card to prove it.
If a child can recognize the presence of others, remember what their presence meant from previous visits, and then anticipate the near future (anxiety requires an awareness of the future tense), it occurs to me that he is not really in a "vegetative" state or lacking in conscious thought. Awareness of others and what their presence means for the future self, I would argue, is evidence of conscious thought. It is more a problem of communication.
A further note: it seems to me that when people say "I wouldn't want to live like that" they are acknowledging that the person is indeed aware and conscious. If I am really "checked out" and "vegetative" then I shouldn't care what happens to my body, and if keeping it alive brings peace to my loved ones and protects human dignity, then so be it. It is only if one contemplates the "buried alive" primal fear we humans seem to possess that the "wouldn't want to live" reasoning makes sense.
So killing off those who are in such a state is really an attempt to ease our fear of being trapped alive and aware and unable to communicate, in effect isolated within our interior space (which these days, in our culture seems to be a pretty small closet for most people).
Jessie, the brain has many levels of operation. I would recommend "The Dragons of Eden" by Carl Sagan as a primer on the different areas of the brain relate to our evolution as higher-functioning primates.
The point being, you can have pain reactions and even anticipation without being conscious. That's down in what Sagan and others call your "lizard brain."
The child I described had no voluntary motor control, no speech, and had no responses other than what I described. But I never argued anyone, not even the child I described, should be "killed off," nor would I ever discourage the family from giving up hope. What they did was heroic. I only said that if I choose not to live, as you described, "trapped alive," there ought to be a way for medical people to do that that's more humane than starvation.
"Before or after taking their organs and conducting living experiments on them?"
If I used active euthanasia before conducting experiments, they would hardly be 'living experiments' now would they.
If I was going to conduct living experiments (and, if it is ethical to kill them, it should therefore be ethical to experiment on them), I'd like to see the same pain-minimisation that is required for experiments on mice.
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