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Staying Alive: The Breakthrough that Lets Vegetative Patients Communicate With Us
As doctors fight for the final say, the latest neuroscience is redrawing the boundaries of life and death while revealing a scary truth—that maybe we shouldn't be so quick to pull the plug.
Illustration: Serge Bloch
Hassan Rasouli checked into Toronto’s Sunnybrook Hospital to have a brain tumour removed on October 16, 2010. The surgery was successful, but the then-59-year-old engineer contracted bacterial meningitis and fell into a coma. In January 2011, Hassan’s doctors determined that he was in a persistent vegetative state, with virtually no chance of regaining consciousness. They recommended his feeding tube and ventilator be taken away.
The Rasouli family, who had emigrated from Iran six months earlier, were thrown into turmoil. Daughter Mojgan, 29, and her 23-year-old brother, Mehran, agonized over letting their father go. Was there really no hope? The doctors put great pressure on their mother, Parichehr Salasel, to make a decision. A doctor in her native country, Salasel refused to give up. “We all still felt his presence,” says Mojgan.
End-of-life protocols in Canada, however, are murky. Consent from a substitute decision maker—in this case, Hassan’s wife—is required to pull the plug; but if doctors believe there is an ethical justification for allowing a patient to die, they can turn to a specialized tribunal to get permission to discontinue life-extending treatment. Hassan’s doctors insisted he was suffering needlessly and that they were prepared to act in his best interests. The Rasoulis won a court order confirming their right to decide Hassan’s fate, but the doctors appealed. They lost that appeal and took their case to the Supreme Court.
Then something unexpected happened: Hassan started to show improvement. Last summer, he was blinking to words spoken in Farsi and, according to Mojgan, could give a weak thumbs-up. Sunnybrook’s neurology department reassessed him, upgrading his condition to minimally conscious, but his doctors pressed ahead with their case anyway, hoping a victory would force changes in existing life-support protocols. With court arguments looming, Mojgan, a master’s student in urban planning, wondered if more concrete proof existed of her father’s consciousness.