End the Madness: PVS is reversible or misdiagnosed

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Standards for diagnosis of persistent vegetative state (PVS) have not been widely accepted by the medical community. Yet this designation is used in practice to motivate the withdrawal of care and death of patients through-out the world. Terri Schiavo was one such individual who lost her life while Haleigh Poutre cheated death despite being declared "virtually brain dead" and in a "hopeless" state of "persistent vegetation" by her doctors. Yenlang Vo’s life currently hangs in the balance after being labeled PVS (her family is frantically searching for a doctor in Texas who will care for her – please help).

An absolutley stunning study is now being reported in which sleeping pills were used to revive people classified as PVS to the point where they were able to have conversations.

Zolpidem [also sold as Ambien] is usually used to treat insomnia.

South African researchers, writing in the NeuroRehabilitation, looked at the effects on three patients of using the drug for up to six years.

[snip]

Each of the three patients studied was given the drug every morning.

An improvement was seen within 20 minutes of taking the drug and wore off after four hours, when the patients restored to their permanent vegetative state.

Patient L had been in a vegetative state for three years, showing no response to touch and no reaction to his family.

After he was given Zolpidem, he was able to talk to them, answering simple questions.

Patient G was also able to answer simple questions and catch a basketball.

Patient N had been "constantly screaming", but stopped after being given the drug when he started watching TV and responding to his family.

Incredible! The drug was used daily over a 3-6 year period to arouse the patients. The efficacy did not decrease over time and there were no long term side effects.

Skeptics suggest that the patients were misdiagnosed and were never really PVS:

Mike Barnes, professor of neurological rehabilitation at the Hunters Moor centre in Newcastle, said it was possible that the patients had not had "true" PVS.

"A diagnosis of PVS means the patient should not wake up and respond."

He said a study carried out by specialists 10 years ago had shown that up to 45% of patients diagnosed with PVS actually had a range of different conditions, from which they could wake up.

Professor Barnes added: "This drug could be unmasking a condition from which people are able to wake up temporarily.

"But if they did have PVS, it would be a remarkable finding, and certainly worth further research."
Misdiagnosis is indeed a reality, given Barnes remarks and the results of a recent study of 84 patients having a "firm diagnosis" of PVS which found that 41% regained consciousness by six months, 52% by three years.

The quandary euthanasia advocates now face – as well as Texas hospitals that employ the state’s futile care laws to end treatment - is that PVS is either reversible or consistently misdiagnosed. Either way, the PVS label should never be used to make a life and death decision.

Pamela Hennessy, formerly a volunteer for the Terri Schindler-Schiavo Foundation, responded to the news in a commentary that included the following conclusion:

Not long ago, the organizers of Not Dead Yet (a disability advocacy group) called for the moratorium of ordinary care removal from patients diagnosed in a persistent vegetative state until more solid medical determinations could be made of the condition.

Now, I’m doing it.

This does seem to be both sensible and ethical, at least for those who care about their patients and the value of human life.

For those who remain skeptical, check out the testimonials published at BlogsforTerri. Here are a few:

Husband Recovers after being Diagnosed as PVS

Terri is No Different than My Child

Italian Coma Victim Awakens After Two Years, Says He Heard Everything

She was Clinically Dead

My Husband Recovered

HT: Partnership for Medical Ethics Reform

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