Comments on: Pulling The Plug Too Soon?

By: Thomas Cochrane

Thomas Cochrane — Fri, 23 Apr 2010 16:58:09 +0000

The study is intriguing, but it doesn’t link the fMRI findings to prognosis, which is the most important factor that goes into a decision to ‘pull the plug.’

Look at it this way: if you were in VS and knew you’d be stuck there permanently (the prognosis bit), you either would or wouldn’t want to pull the plug. Now if you’re misdiagnosed as being in VS and knew you’d be stuck there permanently (the prognosis bit), would you be more or less interested in pulling the plug?

Until the prognosis bit is tied to this new test, it’s clinically unhelpful, and has basically no implications for decisionmaking in the cognitively devastated patient.

By: Thomas Cochrane

Thomas Cochrane — Fri, 23 Apr 2010 16:42:22 +0000

“if the brain was dead how now after seven months it recovered all its functions?”

You mentioned that your sister was in a vegetative state, not brain dead. The prognosis for a young patient in VS after trauma is poor, but it doesn’t become certain until about 12 months.

So there’s not much surprising in the story…I’m glad things turned out well.

By: Donald Clary

Donald Clary — Thu, 22 Apr 2010 14:07:22 +0000

An excellent and thought provoking article. Coincidentially,
I also reviewed a posting today from a “certified nurse legal consultant,” a registered RN who (among other things) assists family members in making these types of decisions. It appears that greater thought is being directed to these questons.

By: ResearchBlogging.org News » Blog Archive » Editor’s Selections: Prozac genes, chili burn, vegetative states and reindeer rhythms

Wed, 14 Apr 2010 15:13:46 +0000

[...] Pulling the plug too soon? Persistent vegetative states are mis-diagnosed 40% of the time. Brain Blogger examines the terrifying consequences. [...]

By: Martin Wixson

Martin Wixson — Mon, 12 Apr 2010 13:40:27 +0000

Having worked with families who have faced this issue, I can’t help but wonder how many were misdiagnosed or prematurely “written off” as vegetative and made the decision to pull the plug. It will be interesting to see what the medical profession will do with this new fMRI technology as it pertains to the diagnosis and treatment of severe brain injury. Good article.

By: Shaheen E Lakhan, MS, MEd, PhD, MD

Shaheen E Lakhan, MS, MEd, PhD, MD — Sun, 11 Apr 2010 15:44:59 +0000

Dear Maria,

Thanks for your sharing your story. As we strive to better classify “brain death” and “vegetative states” using modern imaging (including fMRI for specialized neural activity and ultrasound for intracerebral circulation), cases like yours only remind us that we still have a journey ahead of us to better diagnose and prognosticate neurological outcomes. Congratulations to your sister and your family.

Sincerely,
Shaheen

By: Maria Pomeroy

Maria Pomeroy — Fri, 09 Apr 2010 23:09:23 +0000

My sister was diagnosed with persistent vegetative state a year ago as a result of a car crash. My mom kept feeding and taking care of her at home. After seven months she woke up and now she is recuperating. She is not just conscious but with all her brain functions intact. She is speaking not only in Spanish but also in English. She is aware of everything and the doctors that are now attending her are gladly surprise at how well she is doing. This article had answered many questions I had about the competency of the Doctors and the nagging question “if the brain was dead how now after seven months it recovered all its functions?”