נגישות

מכון שלזינגר לחקר הרפואה על פי ההלכה

Halakhic perspective of life suppoet for 3-year coma patient

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4 בפברואר 2011

הרב המשיב: אחר

שאלה:

My name is A. I am contacting you regarding a question of a good friend of mine who has been in a “coma” for 3 years following 3 strokes. He is hooked up to a respirator and the family wants to know its halachich paramaters. He is not brain dead technically but has no functions whatsoever and the doctors say he never will – irreversible brain damage.

תשובה:

A. There have been reports of communication of patients in vegetative state, in newspapers:

Communicating With a Patient in a Vegetative State (NY Times, February 4, 2010)

 

And  research is ongoing though not as yet applicable fuly to brain-damaged patent:

S. Laureys, A. Owen, N. Schiff , Brain function in coma, vegetative state, and related disorders , The Lancet Neurology, Volume 3, Issue 9, Pages 537-546

Abstract: We review the nosological criteria and functional neuroanatomical basis for brain death, coma, vegetative state, minimally conscious state, and the locked-in state. Functional neuroimaging is providing new insights into cerebral activity in patients with severe brain damage. Measurements of cerebral metabolism and brain activations in response to sensory stimuli with PET, fMRI, and electrophysiological methods can provide information on the presence, degree, and location of any residual brain function. However, use of these techniques in people with severe brain damage is methodologically complex and needs careful quantitative analysis and interpretation. In addition, ethical frameworks to guide research in these patients must be further developed. At present, clinical examinations identify nosological distinctions needed for accurate diagnosis and prognosis. Neuroimaging techniques remain important tools for clinical research that will extend our understanding of the underlying mechanisms of these disorders.

 

Mélanie Boly, BS et al, Auditory Processing in Severely Brain Injured Patients: Differences Between the Minimally Conscious State and the Persistent Vegetative State, Archives of Neurology vol. 61 no. 2 feb. 2004 :233-238.

Conclusions: Although assumptions about the level of consciousness in severely brain injured patients are difficult to make, our findings suggest that the cerebral activity observed in patients in an MCS is more likely to lead to higher-order integrative processes, thought to be necessary for the gain of conscious auditory perception

 

B. Has this specific patient been exhaustively examined to determine the exact neurological state?

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שאלות נוספות

דימום במהלך הההריון

שלום רב, אישתי בשבוע 29 להיריון. לפני שבוע החל אצלה דימום (כשעתיים לאחר שהיינו ביחד). בבדיקה התגלה שהשליה נמצאת למטה בשולי הפתח. כרגע אישתי מאושפזת

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