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Opinion: Armchair philosophizing doesn’t help conscious patients in vegetative states

By using their imaginations, some patients with unresponsive wakefulness syndrome can show that they are still conscious. But we must do more than just imagine what their lives are like.

“Imagine.”

This word let a severely brain injured patient tell neuroscientists she was still conscious using only her thoughts.

“Imagine.”

This word allowed a few covertly conscious brain injured patients to communicate for the first time.

“Imagine.”

This word could do more harm than good for these patients if we aren’t careful.

In 2006, one of us (A.M.O.) and colleagues at Cambridge University published a landmark study describing how functional magnetic resonance imaging (MRI) could be used to uncover consciousness in a patient in a so-called persistent vegetative state. Such patients show no evidence of awareness of themselves or their environment, and cannot move or speak.

Yet the team demonstrated that this patient could understand spoken commands

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