The Light Is On

In a column for LifeNews.com this week, I address an article that appeared in Salon.com:

In the September 25th issue of the online magazine Salon, neurologist Robert Burton takes issue with an important—and to most people encouraging—article that appeared in the Archives of Neurology. The title of Burton’s piece suggests the direction he is headed: “The Light is On, But is Anybody Home?”

The former chief of neurology at Mount Zion-UCSF Hospital and the author of "On Being Certain: Believing You Are Right Even When You're Not," Burton is writing a series for Salon on the human brain.

The Archives of Neurology article questioned the received wisdom about patients diagnosed to be in a so-called persistent vegetative state (PVS). To the amazement of researchers, the brain of a woman, the victim of a car accident and said to be in a PVS, responded in a manner indistinguishable from fully conscious volunteers.

. . .

Burton has little use for the study. The study’s “conclusions are not beyond a doubt,” he wrote. “There are plenty of questions about whether this young woman is conscious and capable of choice.”

Burton goes on: “Are we now to believe that an fMRI can tell us the level and nature of a patient’s consciousness even when the patient can’t respond? Putting aside for a moment the very considerable questions of fMRI methodology, and interpretation, are we ready to accept technology as the final word in assessing mental states?”

I'm curious about what Burton would suggest as an alternative. Currently, the same patient could be diagnosed with PVS by one doctor and semi-conscious by another. Such a diagnosis is based on what we know about the brain in general (which could fill a thimble) and what technology can tell us about a specific patient's brain. Why wouldn't we use everything at our command? The status quo is based on a subjective and interpretive response to medical data-- in other words, an educated guess.