
Vegetative patient says 'I'm not in pain' - kposehn
http://www.bbc.com/news/health-20268044
======
ZeroGravitas
The quote seems deceptive as presumably the patient had a brain scan reading
that they interpreted as "no" shortly after asking "Are you in pain?".

Just from the article I'm dubious. They presented no evidence that this isn't
wishful thinking, which I'd be keen to establish it wasn't if I was in their
place. Could just be journalists fudging the message though.

~~~
bcgraham
This article leaves out some of the detail from older articles (specifically
[1]) about this patient where they describe the painstaking process by which
they determined these patients were answering yes-or-no questions
knowledgeably. See also [2] for an older article with more detail around the
process.

[1] [http://www.nbcnews.com/health/health-news/brain-scans-
reveal...](http://www.nbcnews.com/health/health-news/brain-scans-reveal-which-
vegetative-patients-are-alert-trapped-bodies-f6C10902050)

[2]
[http://www.nytimes.com/2010/02/04/health/04brain.html?em](http://www.nytimes.com/2010/02/04/health/04brain.html?em)

------
mherdeg
The patient in this article, Scott Routley, died in September 2013:
[http://www.macleans.ca/society/technology/beyond-
words/](http://www.macleans.ca/society/technology/beyond-words/)

------
ballard
This suggests future work on assistive devices that may be able to "speak for"
a patient by ML and manual algorithmic adjustment... Huge quality-of-life
improvement potential for people with limited/impaired vocal-ability.

Beyond that, there is far wider potential for translating brain scans directly
and skipping vocal-aural pathway by communicating with others digitally.

~~~
return0
Unfortunately fMRI is not suitable for the kind of precision needed for such
stuff. Usually implanted electrode arrays are used instead
[http://en.wikipedia.org/wiki/Multielectrode_array#Applicatio...](http://en.wikipedia.org/wiki/Multielectrode_array#Applications)

~~~
Houshalter
There is evidence that it is. They have been able to record images people are
seeing from fMRI data. The information is there, it's just a matter of
processing it.

~~~
ballard
Right now, researchers are putting together functional brain structure maps
combining fMRI, SPECT and PET scans for Alzheimer's research. Apart from the
inconvenience of wearing a giant magnet, pulling together one or more brain
scan techs with compute resources might be a way to pull it off. Heck, if the
compute power needed were too bulky to be practical, it might be possible to
offload it to a hosted service. (Talking a solution 15-18 yrs out anyhow.).
It's entirely reasonable that keyboards would be slower than thought input in
50 years.

------
pcrh
I guess it depends on what kind of pain is being referred to. I can't imagine
myself being both conscious and in a vegetative state without experiencing a
lot of psychological distress.

~~~
breadbox
You're imagining who you are now being in that state, not who you would be
after enough brain damage to leave you in a vegetative state. Imagine that
you're not (for example) laying down long-term memories, or that your ability
to sense the passage of time is compromised.

~~~
wetmore
The article says he was able to lay down long-term memories - he knew that his
sister had a daughter, who was born after his accident.

~~~
netnichols
That was another patient, not the main focus of the article:

> Another Canadian patient, Steven Graham, was able to demonstrate that he had
> laid down new memories since his brain injury.

------
dokem
12 years? Put the poor bastard out of his misery already.

~~~
smoyer
I'm guessing you're being down-voted for the way you expressed your sympathy,
but if it were me, I'd want some brave family member to consider ending my
misery. I certainly wouldn't want to be "trapped" in a non-functioning body
unless there was a good chance I'd recover at some point.

It's good to hear he's not in pain, but what would they do if he expressed a
desire to be "put out of his misery" via the fMRI?

~~~
aaronem
There's enough bandwidth for yes-or-no questions, right? I wonder if anyone
will ever come up with the courage to ask such a patient "Do you want to die?"

~~~
brazzy
Would it really be a much different case than with people who are fully
capable (without technical help) to express their desire to die?

------
StavrosK
Can we use one of those $60 brainwave-detecting toys for this? I would imagine
training would consist of the patient trying to modulate a tone's frequency
with thought, and then testing would have the person answer yes/no with high
or low tones.

------
PhasmaFelis
Jesus, this is terrifying.

I need to go remind my family to unplug me if I'm ever in a state like this.
Death is infinitely preferable to being trapped in my body for endless years.

------
aaron695
I'd be pretty sure this is just 'facilitated communication'.

If it is even close to 1 in 5 like they claim there should be a lot more teams
out there on this sort of thing.

------
contingencies
So a whole bunch of people have been imprisoned while conscious ... stuck with
no capacity to communicate but a constant hospital white noise as their
sensory input for decades. Scary.

~~~
return0
They are known as locked-in patients. [http://en.wikipedia.org/wiki/Locked-
in_syndrome](http://en.wikipedia.org/wiki/Locked-in_syndrome)

------
Crito
I can't imagine that this is the first time somebody has put a vegetative
patient into an MRI. Does anybody know what makes this time different? Are
they using a new imaging technique, or is the patient perhaps in a different
(previously undiscovered?) state from other "vegetative" patients?

Edit:

Hitting up wikipedia to refresh on the terminology and delimitation of
different states, I found this:

> _" In 1983, Rom Houben survived a near-fatal car crash and was diagnosed as
> being in a vegetative state. Twenty-three years later, using "modern brain
> imaging techniques and equipment", doctors revised his diagnosis to locked-
> in syndrome.[26] [... interesting stuff about facilitated communication, and
> how it is bullshit ...] Houben's case had been thought to call into question
> the current methods of diagnosing vegetative state and arguments against
> withholding care from such patients.[26][32][33]"_

[http://en.wikipedia.org/wiki/Locked-
in_syndrome#Rom_Houben](http://en.wikipedia.org/wiki/Locked-
in_syndrome#Rom_Houben)

Seems potentially similar, but from three decades ago.

------
kimonos
Couldn't imagine if this happens to one of my family members..

------
Zigurd
So, to all you brain upload enthusiasts: What if the Mark I upload experience
feels like acquiring an intellectual deficit and living in a dark can? Still
better than death?

~~~
mjburgess
"upload consciousness" is just a meaningless juxtaposition of words, the
modern pseudo-intellectual crank lexicon.

One might as well say, in other ears: "capture personality with cathode rays"
or "compress the fluid of the soul" or or "render oneself in brass automata"
or "bottle the element of the mind".

It is essentially an argument from ignorance combined with an argument from
authority: "look what we've discovered! we dont know it's implications! here's
some implications (sprinkled with academa-bable)".

~~~
hackinthebochs
I find it disheartening that this "hyper-skeptical" brand of pseudo-
intellectualism has taken hold in certain circles. Suppressing imagination and
foresight in favor of a cold reverence to facts is misguided. Creativity and
vision (along with need) is the driver of scientific progress; you cannot have
one without the other. So dismissing thought experiments and speculation as
"meaningless juxtaposition of words" is utterly missing the point of
everything that has been accomplished by scientific progress thus far.

It doesn't take much of a leap at all in fact to realize that uploading one's
consciousness to a virtual world is very plausible. If the meaningful stuff of
consciousness is information rather than matter, it is in fact a certainty. Of
course, questions of whether you're uploading _your_ consciousness rather than
a copy abound, but I think there are solutions to even that issue (which I've
discussed here:
[http://www.reddit.com/r/philosophy/comments/237qqj/kurzweils...](http://www.reddit.com/r/philosophy/comments/237qqj/kurzweils_idea_of_minduploading_now_an_integral/cgumytp))

~~~
negativity
What exactly do you mean by "consciousness"?

I think the word "consciousness" holds very different meanings for different
people. I don't think you're interpretting the word in the same way other
people do.

Furthermore, after reading the comment you linked to, I disagree with the
premise of gradually replacing each organic neuron with a synthetic surrogate.
But, hey, if you're into the idea of slowly eroding your central nervous
system, and back-filling the tissue with a machine that picks up the slack, I
won't stop you.

The remnants won't be you though. If we amputate a goldfish from it's brain,
and the body continues to be guided by an electronic apparatus, the gold fish
is no more. The husk that remains is a grotesque puppet.

If, as my parents were slowly debilitated by alzheimers, they elected to
supplement their mental functions with computer assistance, I would regard
them as I might regard a dead animal that was stuffed and mounted.

There is no such experience as climbing inside the circuits of a computer to
experience immortality.

There is no such experience as slowly disolving one's self into a mixture of
microscopic machinery, after which we suddenly blink our eyes and become
miraculous robots.

We die. The robot blinks, and masquerades as us for the benefit of the living.
Nothing more.

~~~
hackinthebochs
>What exactly do you mean by "consciousness"?

I mean exactly what you mean by consciousness. There is no big mystery here.

I take it you are a believer of a "soul" or some kind of panpsychism? If so,
then you have no place to deride anyone else's opinions as "technobabble", as
yours are simply "babble".

If you believe in material matter giving rise to consciousness, then it _must
be the information contained with that matter_ that is of value, rather than
the matter itself. At that point replacing biological neurons with electronic
ones makes no difference as long as they function exactly the same.
Information does not care about the medium, only the mechanism.

~~~
benpbenp
There is a gigantic mystery which you are sweeping under the rug.

Sure, a purely materialistic conception of the universe is very neat and
appealing. But you are at risk of missing something of fundamental importance
to the overall nature of being if you simply shut down any possible additions
to this conception.

The mystery is this: Why can't we observe consciousness? No, literally, we
cannot observe it. The scientific process at least requires a starting
observation, some phenomenon which requires explanation, something you can
point to and say, "What's that?". The sun rising and setting. Brownian motion.
Whatever.

Consciousness on the other hand is merely the fact that the universe exists
from a perspective. You only ever have access to one perspective, your own,
you can never _observe_ any other instance of perspective "out there", "in the
world". It is not a thing, an "object". It is a subject, "you".

~~~
hackinthebochs
I don't shut down any possible additions to the concept of consciousness, I
just require that any additions be motivated by need. At this point in our
understanding there simply is no _need_ to presume some sort of metaphysical
happenings. The brain being the sole generator of consciousness currently
appears to be powerful enough to explain everything we know about
consciousness. Add on to that all the evidence brain activity correlating with
conscious experience, exciting the brain in specific locations _generating_
conscious experience, and brain damage in various locations having clear and
permanent affects on consciousness, and we have strong evidence that the brain
is in fact all there is. We may not be able to "observe consciousness
directly", but we have constrained its possible whereabouts to "within the
brain". Sure, more work needs to be done, but we are far from completely
ignorant here.

~~~
benpbenp
I really don't think these types of experiments tell us anything about the
fundamental question of consciousness. The question being, why am _I_ here
experiencing it all? Why is it not just, well, "automated", without _me_ here
as an "observer"?

So you have a research subject and you stick a pin in his brain and that makes
him, I don't know, forget the alphabet. You say that contributes to the theory
that consciousness is generated by the brain.

Two objections.

1) I already knew you could stick a pin in his eye and he would probably fail
to recall the alphabet for several minutes. What I am getting at is that the
fact that human consciousness is "heavily invested" in the material universe
is bleeding obvious from the get-go. What does recent knowledge about the
brain add to this? There is a heluva lot of _functionality_ there, sure. There
is a serious nexus of sensation, communication, and computation there, sure.
But the above-referenced, Fundamental Question of Consciousness (TM), remains
untouched.

2) How do you know your subject (the one with the pin in his brain) is truly
conscious? Yes, I am talking about the possibility of a p-zombie[0]. You might
want to say, "All reasonable people can here assume that the subject is a
truly conscious being." And indeed I agree we can generally, in life, make
such assumptions. However, you are hoping for scientific understanding of the
nature of true consciousness, so you bloody-well hope for a scientific method
to verify a truly conscious being. Otherwise it's like hoping to have the
periodic table before you can test whether a material is gold or lead.
However, there can be no such hope for a future method of verification,
because presently there is not even any observation of the very thing to be
verified! This would be like expecting someone who, I don't know, perhaps grew
up imprisoned in a cave to develop a model of the solar system.

[0]
[http://en.wikipedia.org/wiki/Philosophical_zombie](http://en.wikipedia.org/wiki/Philosophical_zombie)

~~~
hackinthebochs
>The question being, why am I here experiencing it all? Why is it not just,
well, "automated", without me here as an "observer"?

It's simple really: you have to observe to decide. Imagine not having any
vision-qualia. How would you read? Your vision-qualia is the substrate from
which your conscious mind makes decisions. You cannot have conscious decision
making without qualia. Conscious experience is simply high level
representations of information interfacing with your decision-making
apparatus. Nothing more, nothing less.

The concept of p-zombies are inherently contradictory. P-zombies are by
definition indistinguishable from a conscious entity through any test. Yet
when I ask a p-zombie a million questions designed to get at its conception of
its conscious experience, it responds in the exact same way as the conscious
entity. Furthermore, all observations of its behavior prove to be equivalent
to the conscious entity. So the p-zombie must contain the exact same
information regarding "conscious experience" as the assumed conscious entity.
Therefore, the two systems are information-equivalent.

What is the difference between these two supposed systems? They are
information-equivalent, and yet you claim the conscious entity experiences
something the p-zombie doesn't. But of course, by definition of experience,
that occurrence must be able to shape your future behavior. This contradicts
information-equivalence.

You might say: well the representation of that information is different in the
p-zombie vs the conscious entity. This doesn't work either. Just like the
universe has no privileged reference-frame, it has no privileged information
representation either.

Therefore, either qualia is a meaningless concept, or it is purely dependent
on information representation.

Furthermore, if you accept that our brains are a large part of what makes up
our minds, then somehow our physical brains "interface" with the substrate of
consciousness. Neuroscientists should be able to find this interface.
Physicists should be able to probe this "consciousness substrate" using the
same physical properties of matter that our brains do. We have found nothing
of the sort. The only thing in our brains are bundles of neurons and
neurotransmitters. Those of you that suppose metaphysical explanations for
consciousness are just as guilty of "god of the gaps" as those who would look
up at the stars and posit a god holding them in place. Don't be that person.

A relevant reddit comment of mine from a while ago:
[http://www.reddit.com/r/philosophy/comments/1o1yxm/the_menta...](http://www.reddit.com/r/philosophy/comments/1o1yxm/the_mental_block_consciousness_is_the_greatest/ccong98)

------
shadowcats
Can this technology be refined?

Someone should do a startup to build devices that allow higher bandwidth
communication.

~~~
valarauca1
I realize this forum is for technological entrepreneurial pursuits but are you
kidding me?

A single MRI costs ~2 million used (Angel Investors are always the hard ones
to grab). GE Medical Holding invests _more then 1 billion dollars a year in R
&D_ with almost 18 billion a year in revenue. This is like reading up on a
Intel Processors and wondering if their is a way for you to personally refine
_and profit_ from refining the technology.

Yes there is a chance, but good luck.

Sources:
[http://en.wikipedia.org/wiki/GE_Healthcare](http://en.wikipedia.org/wiki/GE_Healthcare)

~~~
adrianN
But you wouldn't have to use a MRI. In fact a MRI is not practical at all
because the patient needs to be inside it to communicate. Much better would be
an implantable electrode array. I'm sure they're much cheaper than a MRI too.

~~~
Natsu
Infection is a serious risk with anything implantable, but it would be cool if
someone could make it work.

