Are people in a persistent vegetative state "Vegetables" ?

Playing tennis in your head

The case which has clearly contributed the most to broadcasting the issue of people in a persistent vegetative state is the one of Terri Schiavo.  In medical history, persistent vegetative state (PVS) is relatively recent (start of the 70s). The technical developments in intensive care made during the 60s have in effect allowed patients, showing a serious deterioration of brain functioning, to survive.

Most recently, two teams - one directed by the neuropsychologist Adrian Owen (University of Cambridge), the other by Steven Laureys, neurologist (Centre de Recherches du  Cyclotron, University of Liege) - established that the brain activity of a patient in a permanent vegetative state (a 23 year old English female) indicated that she was conscious of herself and of her surroundings. The experiment consisted of giving oral commands to the young lady whilst a functional magnetic resonance imaging machine measured her brain activity.  The scientists asked her to imagine that she was playing tennis and walking around her house.

The parts of the brain which control spatio visual and motor functions showed an activity identical to that of dozens of healthy volunteers who were asked to do the same.  The researchers concluded that the patient, although meeting all the criteria of being in a persistent vegetative state, maintained the ability to understand oral instructions and respond to them with brain activity, despite not responding with words or movement. This experiment raises the attention of those working in the scientific, medical and nursing world who are confronted with the harsh reality of people living in a persistent vegetative state.
 
Falling into and coming out of a coma
 
These days, many people – among whom are young people - are victims of accidents or of illnesses (2) causing acute and serious and brain injuries with a period of coma which is more or less long term. Coming out of a state of coma is characterised by the opening of the eyes.  This "awakening" does not necessarily mean that the patient resumes communication with their environment.

Some patients, who have come out of a coma, find themselves in a qualified "vegetative" or "minimally conscious" state.  This state, after a certain period of time, generally fixed at a year (3) is known as "persistent".