(Oregon Right to Life) — An in-depth feature article published by the New York Times Magazine earlier this month shines a spotlight on recent research suggesting that patients diagnosed as existing in a “vegetative state” may be more conscious than originally thought. The reporting lends urgency to the conversation around the right to life of the disabled and medically vulnerable, including patients who seem to lack conscious experience.
New York Times Magazine writer Katie Engelhart published the article on April 9 following a year spent researching the topic.
Engelhart’s piece, “Vegetative Patients May Be More Aware Than We Knew,” begins with telling the story of a couple, Aaron and Tabitha Williams. In 2024, Aaron suffered cardiac arrest and entered a so-called “persistent vegetative state,” with no blink reflex or ability to respond to sound.
Believing it would be “murder” to remove his life support if there remained any hope he would recover, and distrustful of the negative predictions made by medical staff, Tabitha began to do her own research.
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According to the report, “[a]lmost right away, [Tabitha] came across news coverage of a study that had been published in The New England Journal of Medicine” which “described the results of a 17-year international, multisite study that examined 241 unresponsive patients with ‘disorders of consciousness,’ each in a coma, vegetative state or minimally conscious state.” The study found that a quarter of the patients described as “behaviorally unresponsive” were actually “covertly conscious” – that is, although unresponsive by all appearances, they were really “aware and listening,” capable of carrying out the “high-level commands” of researchers.
Researchers in the study had used advanced neural imaging with the patients to detect cognitive responses to their directions, such as “imagine playing tennis,” or “imagine opening and closing your hand.” Of the group involved in the study, 60 patients, or about 25%, “appeared to do what they were told,” Engelhart noted, despite the fact that they “were all severely brain-damaged — they had brains that, in some cases, looked too physically degraded to possibly sustain a conscious thought.”
The implications of the research are significant.
In her report, Engelhart cited estimates that approximately 50,000 Americans are currently in a “chronic vegetative state,” and between 200,000 and 400,000 are in a “minimally conscious state.”
“If the paper’s findings were extrapolated,” she said, “this meant that tens of thousands of them could, at that very moment, be covertly conscious but assumed to be unthinking.”
The article noted that the research concerning “covert consciousness” presents “profound ethical dilemmas” having to do with decisions to continue or end life-sustaining care.
Engelhart referenced research indicating that about 70% of Canadian patients with traumatic brain injuries who passed away in the hospital died from the removal of life support – not as a direct result of their injuries.
“So that’s a big chunk of people that are dying because we are not pursuing aggressive care,” Joseph Giacino, the director of rehabilitation neuropsychology at Spaulding Rehabilitation Hospital, told the outlet.
The eye-opening report brings fresh urgency to conversations surrounding the right to life of the disabled and medically vulnerable amid the commonplace removal of life support from brain injured patients, as well as the increased acceptance of legal assisted suicide and euthanasia worldwide.
Oregon Right to Life supports the sanctity of human life from the moment of conception until natural death. We oppose all cases of euthanasia, whereby a person is deliberately killed through direct action or omission even if that act is by their permission… Examples of euthanasia include allowing disabled newborns to die of routinely treatable medical conditions, withholding food or water from the comatose or lethally injecting a terminally ill patient. Read the full statement and all our position statements here.
