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Matthew Hutson

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Do We See People in Persistent Vegetative States As More Dead Than Dead People?

Posted: 05/22/2012 9:51 pm

In The Year of Magical Thinking, Joan Didion describes the year following the sudden death of her husband. At one point, while collecting his clothes for donation, she stops. She can't give away all of his shoes, for he might need them if he returns. This is the magical thinking of the title.

When people die, they're not completely gone. They live on in our minds. We might wonder what they think of our decisions, or we might carry on imaginary conversations with them. They are as alive to us as someone who just stepped out of the room.

The continued representation of the dead in our heads may contribute to afterlife beliefs (see chapter 5 of my new book The 7 Laws of Magical Thinking). You can't fully convince yourself that the person is kaput; your brain isn't wiped clean so easily. In one study by Jesse Bering, even people who said the soul dies when the body does continued to assign mental states to a fictional character after his death. One subjected noted that of course there's no afterlife and the dead character sees that now. So "out of sight, out of mind" isn't quite right when describing the departed. More like "out of sight, so the mind fills in the blanks."

But what if the person is still in sight? What do we think of people in persistent vegetative states, who can breathe but can't think? Mentally, they are dead, but since we're very aware of the body still lying there, we can't as easily imagine them as active characters in our lives. This combination of factors -- a dead mind but a living body -- may, ironically, lead us to think of people in a PVS as more dead than dead.

Kurt Gray, T. Anne Knickman, and Daniel Wegner recently tested this hypothesis and wrote up their findings in the journal Cognition. In the first study, subjects were divided into three groups and read about a character named David who had a car accident and then A) fully recovered, B) died, or C) ended up in a PVS with nearly his entire brain destroyed. Each group rated whether he had mental functions -- whether he could have a personality or know right from wrong, etc. -- on a scale from -3 (strongly disagree) to 3 (strongly agree). On average, living David scored 1.77, and dead David scored -0.29. But PVS David scored -1.73. People saw him as having less mind than dead David. So in a sense they saw PVS David as more dead than dead. But you could also say they saw dead David as not fully dead. The fact that they didn't deny him a mind as much as they could have, the authors argue, indicates subtle afterlife beliefs.

In the second study, the researchers asked people about PVS David, dead David, or a dead David whose description mentioned his embalmed body lying in a coffin. Again, subjects -- including both the most religious third and the least religious third -- saw PVS David as having less mental capacity than dead David. But the least religious saw corpse David as being similar to PVS David (they strongly disagreed with his having a mind), whereas the most religious saw him as being similar to dead David (they slightly agreed with his having a mind). For those low in religiosity, a focus on his nonfunctional physical body helped them recognize the nonfunctionality of his mind, just as the image of a PVS David in a hospital bed did. The most religious subjects, however, had explicit beliefs about the afterlife that allowed them to overcome the corpse reminder and continue to picture David frolicking in heaven or wherever.

In the third study, subjects imagined themselves in a car crash, and either dead or in a PVS. They said they'd have less mind in a PVS, and also that being in a PVS would be worse for both themselves and their families. Further, the attribution of less mind partially explained the greater undesirability of a PVS. People see being a vegetable as a state worse than death, in part because they irrationally believe they'd have a fuller mental life if someone just pulled the plug. (Of course, their mental lives would be equally nonexistent.)

"These data do highlight one irony," the researchers note: "People high in religiosity are more likely to see PVS as worse off than death, but are also more likely to advocate keeping such patients alive on life support."

They also point out that focusing on the body interferes with attribution of mind in everyday life, too. The more you objectify someone (a woman in a bikini, say), the less capable you think she is of thought.

So I guess if you really really want to excise someone's offensive personality from your memories, picture her (or him) as a corpse in a bikini. Don't be alarmed, however, if the image results in a little mental scarring.

 
 
 

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In The Year of Magical Thinking, Joan Didion describes the year following the sudden death of her husband. At one point, while collecting his clothes for donation, she stops. She can't give away all o...
In The Year of Magical Thinking, Joan Didion describes the year following the sudden death of her husband. At one point, while collecting his clothes for donation, she stops. She can't give away all o...
 
 
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01:33 AM on 05/26/2012
Advances in modern medicine have made possible new varieties of being dead.
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Hexandra
I see truth or lies in your eyes
03:18 PM on 05/25/2012
Ok this is a good one for me. I feel the person was still alive n breathing. The mind shuts down to heal parts of the body. Per say a coma state. My aunt was in a coma due to die, went to hospice there she was in a PVS. I came to visit her one night alone after 10:30 PM. I was looking around the room in the dark. All of a sudden, I had heard her little voice "call my name and asked for water" I ask all of you people who study people that are in a PVS this question? How did she know it was me behind her, in the dark, and called my name? I really feel deep inside they have some senses. Could it be smell,hearing n I did not utter a word, her eyes closed. She had given me the shivers from coming out of this coma, or PVS. I feel n believe, they can smell,n hear. In her mind, maybe she was determind to come out of this coma,PVS to communicate with someone that feels a lot of Love~Commpassion in their
10:38 AM on 05/25/2012
OK, but science is so often just another religion, and liable to the same fundamentalist type beliefs as any other religion is. Think of all the accounts of formerly PVSers who weren't actually P and heard everything going on around them. Notice how the science writer uses the word, "kaput." That's scientific? Shows he's not quite sure what the deal is either.
12:58 PM on 05/23/2012
"When people die, they're not completely gone." That's especially true if your body is donated to science. Then you can lead a pretty exciting existence after you die ...
http://failuremag.com/index.php/feature/article/mary_roach_on_stiff/
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11:08 AM on 05/23/2012
we live with a double standard of reasoning.
logically and scientifically our physical existence is not possible.
the big bang theory should question our process of nothing-life-nothing.
even with religious convictions we can not conceive how god could create something from nothing.
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Akla
Leave No Trace, Just a Good Impression
10:22 AM on 05/23/2012
That is odd, the PVS are rated less than the dead by the religious. Is it because PVS is associated with injury, specifically the brain injury mentioned as part of the study, and death is not? Did david die of his brain injuries? Hmmm?

People are afraid to make the decision to pull the plug. They put it off, thus are able to continue without making a hard decision. And yet they would put their pet out of its misery.

And now I sit here, picturing all of my favorite faux news media, gop leaders and politicians, and religious leaders, corporate leaders, and all the rest, in a bikini vegging away in a nursing facility. NOOOOOOOOO!!
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Hexandra
I see truth or lies in your eyes
04:09 PM on 05/25/2012
Pets have what is called soul agreements, maybe as humans we also have soul agreements. If a person passes they had a certain smell. Sometimes you will come across that smell, that smell is a persons essence trying to tell you "Hey I am still with you" Animals are the same way, an old pet vs new pet. New pet has the same qualities as the old pet in the past. Again the animal is trying to tell you I am back with you. If you don't like what I post n is to sciencetific for you that is your problem HP. I think outside the box n create ideas no one would ever think about.
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JohnFromCensornati
Free your mind and your ass will follow.
06:43 AM on 05/23/2012
Some non-religious people seem to believe that we have a "spirit". Even if they don't believe that their personal consciousness survives death, they think their spiritual "energy" does. They think that the brain is the hardware needed for the spiritual software to run. Maybe they think that the spirit can't escape a PVS body.
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Denice Brown
crazy cat lady
12:21 AM on 05/23/2012
I see PVS patients in the nursing home I work at. Indeed, many family members slowly drift away. Sometimes the PVS patient is subjected to a steady series of hospitalizations and heroic measures by families in denial of the reality. They don't see what others would call 'suffering'. They see a live body and want to keep it that way. I can't claim to understand it, watching year after year of breathing, tube feeding and diaper changing. What do families receive from the vigilant care of these persons? I wonder if it is fear of the wrath of god, fear of being accused of 'wishing' or 'allowing' a death. Perhaps it is delaying grief until 'whenever'. But I am not to say, I am here to care for the person to the best of my ability. Interesting article. And food for thought.