Expert Commentary

Perceptions of persons in the persistent vegetative state

2011 study in the journal Cognition measuring the public’s general perceptions of patients living in a persistent vegetative state.

Hospital patients (iStock)

A persistent vegetative state (PVS) occurs when patients, often the victims of brain trauma, remain in a profound state of unconsciousness. While PVS remains extremely rare, continuing improvements in medical technology have allowed doctors to keep patients alive who may never recover consciousness.

To better understand perceptions of PVS, researchers at the University of Maryland and Harvard University interviewed 201 people from New England and New York. The resulting 2011 study, “More Dead Than Dead: Perceptions of Persons in the Persistent Vegetative State,” was published in the journal Cognition.

The study’s premise hinges on a curious phenomenon, the authors state: “The dead have a certain presence in our perceptions and thoughts, whether they are imagined as ghosts, residents of heaven or hell, or memories. In contrast, a person in a persistent vegetative state (PVS) seems to be popularly understood has having no presence at all — the PVS patient is viewed simply as a body supported by machines, lacking in mental capacities. These competing images suggest that although PVS may fall biologically between life and death, it is possible that PVS patients may be perceived, oddly, as more dead than dead — with lesser mental capacities than the dead.”

The study’s findings include:

  • Individuals were first presented with the story of a car crash victim and three possible outcomes: life, death or PVS. They then evaluated the patient’s likely awareness, emotional state and personality on a scale of -3 to 3. According to those responding, a victim of PVS scored on average lower (-1.79) than in the “dead” state (-0.29).
  • When the story emphasized the body of a deceased accident victim, those who considered themselves as religious scored the PVS victim lower than both “dead” and the corpse, while irreligious people scored the corpse lower than “dead” or PVS.
  • When respondents were asked what their choice would be between death or PVS, with all other factors being equal, PVS was seen as being “worse” than death.

“These studies suggest that people perceive the minds of PVS patients as less valuable than those of the dead — ironically, this effect is especially robust for those high in religiosity,” the researchers write.

Keywords: medicine, science, religion, cognition, ethics

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