From the May 2005, Psychiatry edition of CNS News: Researchers at Weill College of Medicine-Cornell University, Columbia University, Georgetown University and the JFK Johnson Rehabilitation Institute report on a small study, "Research Shows That Minimally Conscious Patients Respond to Language-but How?" (not available on line), involving 2 patients and 7 healthy volunteers investigating functional magnetic resonance imaging (fMRI) to investigate the responses of patients with severe brain damage in a minimally conscious state (MCS). When the researchers played audiotapes of a familiar relative to the patients in MCS, parts of the brain that are activated in speech recognition in healthy people were activated in the patients. Since the MCS patients are typically treated as if they are unconscious and completely unaware, these findings are significant.
The study authors differentiate MCS from Persistent Vegetative States (PVS); in MCS there is an ability to react to the environment on occasion, while such an ability appears to be absent in PVS.
When I wrote about Terry Schiavo in Narcissism and Empathy, I made the point that in all the discussion of her condition, no one could possibly know with any certainty what she was or was not experiencing in her state. No one knows where consciousness resides within the brain and no one really knows where the "I" that experiences the world resides in the brain.
More recently I wrote about the growing recognition of how much of our mental activity is taking place out of our awareness. In Science and the Unconscious, I pointed to an MIT study which supported the existence of a complex unconscious mind which could determine overt behavior.
As our knowledge of the mind and brain and their interactions increases, we should remain quite humble about our ability to make definitive statements about other people's minds. Terry Schiavo's situation was a terrible tragedy but to imagine the situation was an easy to understand binary system (all or none in terms of her consciousness and experience) does an injustice to the complexity of the questions that were under examination. Definitive statements were made that she had no awareness or experience of her dehydration and starvation, I would suggest a little more caution in the future in making such comments would be welcome.
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