In 2006, the neuroscientist Adrian Owen and his colleagues they noted and reported what happened when a woman reduced to a neurovegetative state was asked to imagine playing tennis. His brain showed a path of activity quite similar to that of a healthy person.
“He wasn't completely absent,” Owen writes in his book In the gray area. A neuroscientist explores the boundary between life and death. "He replied, he did what we asked."
Since the late '90s, Owen has been hunting for signs of conscience in people who are now considered devoid of it. His patients have disorders due to accidents, brain damage. Someone is there for other situations that have resulted in oxygen deprivation to the brain. Disorders of consciousness are different from a coma: in vegetative states or states with minimal signals, people are awake, but not present. They may have their eyes open, they move them occasionally: they are "almost" there, but that "almost" makes the difference.
Someone is still with us
Owen and others have presented studies showing how from 15 to 17% of patients with consciousness disorders can produce brain responses such as the woman who was asked to imagine tennis. An important step, which however leaves a lot of anger: we know that some of these people are there, somewhere, but we don't know how to bring them back here.
Un paper published last week in the magazine The Neuroscience of Consciousness examined a breakup proposal. Give patients with disorders of consciousness psilocybin, the active ingredient found in hallucinogenic mushrooms (and being studied by a brand new medical branch) to induce the recovery of consciousness, or the ability to manifest it.
Andrew Peterson, assistant professor at George Mason University's Institute for Philosophy and Public Policy, said his gut reaction to reading the proposal was shock, but then it got his attention.
The idea of giving psilocybin to these patients is based on theories regarding the relationship between brain complexity and consciousness. Complexity is the level at which different regions of the brain communicate with each other, and lower levels of awareness are associated with lower complexity.
Psychedelia seems to increase complexity levels beyond the limits of normalcy, as he says Gregory Scott, neurologist at Imperial College London and co-author of the paper proposing the use of psilocybin. There is no definitive scientific evidence that states of consciousness "improve" with the use of the substance, but a large number of case studies show several examples of increased brain complexity. That's why Scott and his colleague Robin Carhart-Harris they proposed a test.
The experimentation
The trials would serve to measure the therapeutic value of psilocybin, and show us something new about consciousness. Psilocybin interacts with a particular serotonin receptor, and increases neuronal activity in relation to it. Many of these neurons are concentrated in points that are believed to be involved in the formation of consciousness, and seeing the presence of responses to stimuli would be confirmation that these are crucial areas of the brain.
Scott and Carhart-Harris recommend extreme caution and testing initially on healthy subjects in the state of sleep or sedation, to see how much psilocybin intervenes on consciousness in these states. In case of positive results, the researchers plan to extend the tests to patients in a neurovegetative state.
The reason is absolutely (and rightly so) ethics. There are currently no tests, and it would be a crime to carry them out on non-consenting people who are incapable of showing discomfort or possible suffering. Psilocybin has been rated a “breakthrough therapy” by the FDA due to test results in depressed and drug-refractory patients. Patients in a neurovegetative state, however, are another matter.
The ethical risks of the experiment
First of all, there is the possibility that this neurovegetative state is a protection from the discomfort and suffering of having lost the cognitive abilities necessary to live. If those patients currently do not have consciousness, it does not mean that finding it would be a source of happiness. It could be the opposite, and represent a cruel prison for them.
Ditto in case of anxiety or frightening effects, which patients in that state would suffer without being able to react in any way.
“Just because patients' relatives and friends, or the public, would like to bring them back with us doesn't mean that doctors feel entitled to do anything on them,” says Owen. However, in the case of positive responses in healthy subjects, Owen himself would not give up on proceeding. because giving up a cause like that would still be a crime. 20 years of new knowledge on the subject would not have happened if he himself had given up fighting.
And then, let's be honest: these are people who would have died 20 or 30 years ago. Today they are still there in those beds because medicine has made enormous progress (even with radical machines that put death on standby for those who should already be dead, such as ECMO).
