This past week, news sources in Europe and the US have been telling the story of Richard Rudd, who was left with spinal cord injuries and in an apparent coma after a motorcycle accident. As medical staff and family prepared to disconnect Mr. Rudd’s ventilator, a final examination by one of his physicians held open the possibility that Rudd was conscious and could make his life-and-death decisions himself. Mr. Rudd’s story was the subject of a BBC documentary aired this last week. Click on the link below for a video promo of the film:
As I mentioned above, Rudd’s story was featured in many outlets. My sentimental favorite is the article in The Guardian, titled “Blink, and you live – doctors’ message to man in a coma“:
A man who was left paralysed and seemingly unable to communicate following a traffic accident was saved from having his life support machine turned off when he managed to blink three times to tell doctors that he did not want to die.
Richard Rudd’s family had been agonising about turning off life support, his father said, after his son had said he would not want to live in a paralysed state.
But his son’s remarkable response raises questions about when life should end and about how and when a family can decide if their loved one has suffered enough.
If the title of that Guardian article sounds familiar, there’s a reason. In 2004, The Guardian published a story that discussed the life-and-death consequences related to determination of consciousness in brain-injured patients. It opened with the story of a Belgian woman who was originally believed to be in a vegetative state:
When a 39-year-old Belgian woman suffered a stroke and fell into a coma, doctors concluded that she was unlikely to regain consciousness and, after a time, diagnosed her condition as persistent vegetative state (PVS). One of the criteria on which they based their decision was her inability to blink or track a moving object with her eyes. It was only when they discovered that the stroke had damaged a cranial nerve, preventing her from opening her eyes, that they realised their error. If they opened her eyes for her, she followed their instructions. Having regained full consciousness soon after her stroke, she revealed she had overheard all the bedside discussions as to whether it was worth keeping her alive. At no point had she wanted to die.
The story was titled “Blink and you live.”
In the immortal words of Yogi Berra – “It’s déjà vu all over again.” –Stephen Drake