Coma that never was raises hard questions
The Age
Friday November 27, 2009
FOR one family, it was news of great joy. For many others, it may increase their anxiety about the condition of those they love who have been declared to be in vegetative states. Twenty-three years ago a Belgian man, Rom Houben, was taken to hospital after a car crash. Mr Houben survived, but was unable to move, speak or express any kind of understanding. He was assumed to be in a "permanent neuro-vegetative" condition, and for two decades that remained the medical assessment. But modern tomography has confirmed what his relatives always believed: that Mr Houben understood everything that happened around him, although his paralysis prevented him from showing it. He was conscious. This discovery has resulted in changes in his care, and with treatment by speech therapists and physiotherapists, and the use of a computer keyboard, Rom Houben is now beginning to communicate again. It is an amazing story of human resilience, but it also raises some disturbing questions.How many other patients hitherto believed to be in a vegetative state might in fact be conscious, as Mr Houben was? As the director of neurology at St Vincent's Hospital, Professor Mark Cook, warned this week, other people could be experiencing what Mr Houben had to endure. Professor Cook is urging the carers of the estimated 100 Australians in vegetative or minimally conscious states to arrange brain scans, and it must be hoped that this will happen. A further question concerns consent for medical treatment €” or its withdrawal. As The Age has noted before in the context of the euthanasia debate, a sufferer's consent is not in every instance clear, or easily obtained. The Rom Houben story has again raised the question of whether those deemed to be incapable of awareness are always in fact so.
© 2009 The Age
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