New research may help unlock vegetative and minimally conscious patients

Seven years after doctors first defined the minimally conscious state, which is 10 times as prevalent as the more recognized vegetative state, it still lacks an international classification of diseases code from the World Health Organization, making it essentially invisible in modern health care. In 2007, an Institute of Medicine panel identified the need for a study to gather basic data like how many MCS patients there are and where they live, but the institute couldn't raise the funding. These patients are not terminal, but doctors are ill-equipped to decide not only who will recover but to advise families on what the mental life of a person in MCS is like. Reports of dramatic "awakenings" led to the discovery that neuroplasticity—structural growth in brain networks—can continue even 19 years after severe traumatic brain injury. Few living wills contain the possibility of a prolonged period in and out of awareness, and many families are tormented by how long they should wait before withdrawing care, typically done by stopping tube feeds. Slate