Corrections to the blogosphere, the consensus, and the world

Monday, February 08, 2010

Persistent little cuss, isn't he?

Response to a NYT article on the latest PVS recovery case:
So why are people surprised? PVS was always a dodgy business, and since Andrews et al 1996 (K. Andrews, L. Murphy, R. Munday, C. Littlewood, C. Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ 313 (1996) 13-16; found that 75% of the patients in that study who had been diagnosed as being in PVS were eventually able to communicate) should from a scientific standpoint have been discarded altogether. In practice, of course, it makes us uncomfortable to believe people are suffering and we adopt schemas and diagnoses that obscure this.
For a fuller account, see my article (Borthwick CJ, Crossley R., Permanent vegetative state: usefulness and limits of a prognostic definition. NeuroRehabilitation. 2004;19(4):381-9), online at
It may also be worth noting that the term "persistent vegetative state' has been discouraged in the medical literature for at least the past fourteen years, researchers now favouring the the usage of the Royal College of Physicians (RCP) (1996) which refers only to the "vegetative state', the "continuing vegetative state', and the "permanent vegetative state'. The NEJM article, for example, refers only to 'vegetative or minimally conscious state'. The fact that the NYT automatically reverts to 'persistent' is yet a further example of a fossilized meme.

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