Momma!
"I could hear everything, says man after two years in coma," reports John Hooper for The Guardian.Salvatore Crisafulli, 38, has had great difficulty in speaking since recovering, but, asked if he could remember the past two years, he replied "yes" and wept. In true Italian style, his mother told reporters that his first word had been "Mamma". The recovery is being hailed as a miracle in his home city of Catania in Sicily, and came to light on the day Italy's bioethics committee was voting on whether to feed patients in a persistent vegetative state.
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So, let me get this straight: Salvatore Crisafulli was ASKED if he could remember everything; not TESTED?
And, in the two years before he could speak with great difficulty, two times 20,000 people ente[ed] some form of coma?
Do we know if the doctor misdiagnosed him due to motor paralysis and perhaps blindness as the basis for his nonresponsivness? Whether he just made a slow recovery? Or is the miracle hypothesis the only one that has not been ruled out?
I assume the media is always looking for such cases, yet we hear about them rarely. The article in the Guardian gives us some data for Italy, however: One in 40,000 maximum.
I would guess that the media reports such events as often as they happen. In contrast, how many MILLIONS of stories are there, that we dont hear about? How about the need for money to help those who survived and were among the 40,000 killed by the earthquake in Pakistan, where there are millions homeless? Hundreds of thousands left behind by hurricane Katrina? And remember the Tsunami?
--Its the fourth principle of medical ethics: Justice: distributing benefits, risks and costs fairly.
- by Stanley A Terman, PhD, MD on Oct 11, 2005 at 1:32 PM | link
Dr. Terman, who's money are you talking about?
- by One in a million on Oct 11, 2005 at 9:56 PM | link
You ask, who's money?
Better stated, whose resources?
If you assume that resources are finite, then isn't allocation prudent? In retrospect, was it a better use of resources to pay $100,000 per year to maintain 20,000 PVS patients, who will always be unconscious, than to reinforce the levies in New Orleans so many hundeds, perhaps thousands of conscious people could survive?
Yet I do not hold myself out as the one to make such decisions about -- that awful word, "rationing."
I would only encourage a discourse of what constitutes "personhood" and if there are medical states where technology only prolongs inevitable dying or biological functioning where dying has already occured.
- by Stanley A Terman, PhD, MD on Oct 12, 2005 at 12:54 PM | link
Dr. Terman, your reply begs many questions.
First the gentleman was in Italy.
Second, do you believe that if we could have somehow moved money from Italy to Louisiana that the NO politicos would have used this money for the levees any more than they used the other money allocated for them?The money they had in the past went for casinos and tourism. They decided that the chances of a level 5 hurricane were not as great as the chances that they could make money from tourists.
BTW, the definition of death has nothing to do with "personhood." A person is either alive or dead. I understand that (in most states in the US) the definition is "total brain death." I don't believe that we have the technology to prolong those lives by more than a week.
(I don't know of anyone who advocates prolonging dying, do you?)
- by Beverly on Oct 13, 2005 at 3:42 AM | link
The definition of death COULD have a lot to do with "personhood," or awareness, or ability to respond to the environment, or cognitive ability -- depending on IF a group of "experts" decide to agree on some definitions, as was done for "neurological death" a couple of decades ago.
I was tying to make a global point about resources, but since you asked about Italy, specifically: As noted, the country has 20,000 people enter comas every year. What Italy does, can influence others around the world. How many Supreme Court Justices are Catholic? Four?
No one advocates prolonging dying, of course; but they advocate to ERR ON THE SIDE OF LIFE, so the question is: How do you define life?
Finally, don't underestimate the power of technology. Terri Schiavo might have lived another 15 years or longer.
- by Stanley A Terman, PhD, MD on Oct 13, 2005 at 2:06 PM | link
Perhaps we could balance the lives in Italy with those in the Netherlands, and leave the US out of it.
(BTW, life is the ability to carry out metabolic processes in an organized manner. Anyone with brainstem death will suffer autonomic system failure within a week, even in the ICU at maximum support.)
- by Beverly on Oct 14, 2005 at 5:18 AM | link