[science: good]

After all the (alcohol-induced) craziness here last night, a serious post to make up for it all. This article in Nature is a refreshing change from all the Schiavo hoop-di-hoop because it avoids many of the social traps surrounding the case. For those without a subscription, here are some choice quotes:

"A person who suffers brain damage may fall into an initial coma, a deep state of unconsciousness in which their eyes are closed. Within two to four weeks, many such patients open their eyes, despite having severe brain damage.

Some such patients may spontaneously move, cry or smile, but are unable to respond to commands. They are said to be in a persistent vegetative state (PVS). Their chances of recovery are very slim and decline with time. As in Schiavo, this type of profound damage often occurs after a heart attack robs the entire brain of oxygen.

Within the past 15 years, however, doctors have recognized a second category of patients, who occasionally respond to commands by, say, moving their eyes or reaching for a glass of water. These people are said to be in a minimally conscious state (MCS). They have generally suffered traumatic injuries that have left parts of their brain intact, and are thought to stand a slightly better chance of some recovery.

The common perception that irreparably brain-damaged patients can undergo miraculous recoveries, doctors say, is based on confusion between the two different conditions. "The frustrating thing is the conflation of these brain states," says medical ethicist Joseph Fins, also at Weill Medical College.

and further, about a study in published in Neurology (Schiff N. D., et al. Neurology, 64. 514 - 523) that used fMRI to examine brain activity in two MCS men listening relatives speak:

"The patients' brain areas for processing language lit up, the researchers showed, in a very similar way to those in healthy volunteers. By contrast, studies looking at PVS patients suggest that only isolated fragments of brain networks survive.

The researchers nevertheless have no idea whether the brain activity translates into any kind of feeling or experience for MCS patients. "We can watch this circuitry go but we don't know what it means," says the study's lead author, Joy Hirsch of Columbia University in New York."

Update: Additional reading on the funding for the Schiavo case can be had at this very well written piece by the bioethicist blog. The article brings up some very interesting food for thought for me: if so much money has already been used to fund the parent's side, can any legal case on their behalf even feign to have her best interest at heart? In other words, given that these "philanthropic" organizations have already spent a ton to win: could any reasonable argument ever pursuade them to give up, for the sake of Terri's dignity? Notice also that our old friends, the Discovery Institute, has its dirty little hands in play here: early in life they force creationism down the throats of the young, then later in life they strip any bit of dignity from suffering patients, all in the name of "life."