Memory During the Presumed Vegetative State: Implications for Patient Quality of Life

A growing number of studies show that a significant proportion of patients, who meet the clinical criteria for the diagnosis of the vegetative state (VS), demonstrate evidence of covert awareness through successful performance of neuroimaging tasks. Despite these important advances, the day-to-day l...

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Bibliographic Details
Published in:Cambridge quarterly of healthcare ethics 2020-10, Vol.29 (4), p.501-510
Main Authors: TAYLOR, NICOLA, GRAHAM, MACKENZIE, DELARGY, MARK, NACI, LORINA
Format: Article
Language:English
Subjects:
Bioethics
Brain death
Brain research
Cognition & reasoning
Coma
Consciousness
Covert
Criteria
Identity
Life experiences
Life support systems
Magnetic resonance imaging
Medical diagnosis
Medical ethics
Medical imaging
Memories
Memory
Neuroimaging
Patients
Persistent vegetative state
Quality of care
Quality of life
Recovery (Medical)
Standard of care
Task performance
Traumatic brain injury
Unconsciousness
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Summary:A growing number of studies show that a significant proportion of patients, who meet the clinical criteria for the diagnosis of the vegetative state (VS), demonstrate evidence of covert awareness through successful performance of neuroimaging tasks. Despite these important advances, the day-to-day life experiences of any such patient remain unknown. This presents a major challenge for optimizing the patient’s standard of care and quality of life (QoL). We describe a patient who, following emergence from a state of complete behavioral unresponsiveness and a clinical diagnosis of VS, reported rich memories of his experience during this time. This case demonstrates the potential for a sophisticated mental life enabled by preserved memory in a proportion of patients who, similarly, are thought to be unconscious. Therefore, it presents an important opportunity to examine the implications for patient QoL and standard of care, both during the period of presumed unconsciousness and after recovery.
ISSN:0963-1801
1469-2147
DOI:10.1017/S0963180120000274