6 August 2008— Eluana Englaro has been lying motionless in a hospital bed in Italy for 16 years. In 1992, Englaro survived a serious car crash that left her brain damaged, completely unresponsive, and unable to eat, drink, or breathe on her own. She is now in a class of patients diagnosed as ”persistently vegetative.” Her father, convinced that Eluana would have opposed the medical intervention she received, has fought in court for the past nine years for the right to remove her feeding tubes and turn off her respirator. In early July, he finally won, but Italian state prosecutors have 60 days to appeal.
End-of-life decisions in nonresponsive patients like Englaro and American Terri Schiavo pose a deep challenge to the science of consciousness. When these types of cases go to trial, courts spend much of their time hearing opinions on whether the patient is truly in a vegetative state and whether he or she has any chance of improving. The controversy surrounding these disputes is due in part to the primitive methods we rely on when assessing consciousness. But some scientists are working on technical ways to measure consciousness in patients with brain injuries.
Niels Birbaumer, a neurobiologist at the University of Tübingen, in Germany, used EEG recordings to study the brain activity of patients diagnosed as vegetative and found unexpected levels of cortical activity. He presented his work this month at the Euroscience Open Forum, in Barcelona, and discussed the medical implications.
In one of the studies, Birbaumer and his colleagues looked for patterns in the brain’s electrical activity as patients listened to sentences being read aloud. The experimenters attached 10 to 20 electrodes to the scalps of 98 patients who had suffered severe brain damage. The group was composed of both completely vegetative patients and others that still retained control of their gaze or other simple physical abilities. In the experiment, patients listened to a series of seven-word sentences. Half the time the sentences were semantically logical. The other half of the sentences ended with a nonsensical word. An example might be ”I baked a cake in the banjo.”