Catholic bioethicist weighs in on paralyzed man thought to be unconscious for 23 years

Brussels, Belgium, Nov 24, 2009 / 01:55 am

A paralyzed man who was misdiagnosed as comatose for 23 years is again communicating with the world after new brain scans showed he was in fact conscious. A Catholic bioethics expert suggests the case shows the wisdom of Catholic teaching on the duty to provide sustenance for those believed to be comatose.

Rom Houben, a former martial arts enthusiast, was paralyzed in a 1983 car crash. The Daily Mail reports that his doctors in Zolder, Belgium used the internationally accepted Glasgow Coma Scale to assess his physical and verbal responses, but each time he was graded incorrectly.

“I screamed, but there was nothing to hear,” said Houben, who after therapy now communicates with the aid of a computer. “I dreamed myself away.”

Three years ago, new technology scans showed Houben’s brain was still functioning almost completely normally. His case has just been reported in a scientific paper by the doctor who discovered the mistake, neurological expert Dr. Steven Laureys of the Coma Science Group and Department of Neurology at Liege University Hospital.

Laureys’ re-evaluation of Houben showed that the patient had lost control of his body but was still fully aware of what was happening.

“Frustration is too small a word to describe what I felt,” Houben said. “I shall never forget the day when they discovered what was truly wrong with me - it was my second birth.”

Dr. Laureys explained that medical advances caught up with the patient. His study claims that there may be many similar cases of false comas around the world, the Daily Mail reports.

According to Dr. Laureys, in Germany alone about 100,000 people suffer from severe traumatic brain injury each year. About 20,000 injuries are followed by a coma of three weeks or longer.

“Some of them die, others regain health. But an estimated 3,000 to 5,000 people a year remain trapped in an intermediate stage - they go on living without ever coming back again,” he added.

“Anyone who bears the stamp of ‘unconscious’ just one time hardly ever gets rid of it again,” he remarked.

Houben may never leave the hospital, but he now has a special device which lets him read books lying down.

“I want to read, talk with my friends via the computer and enjoy my life now that people know I am not dead,” he said, according to the Daily Mail.

Catholic News Agency spoke about the case in a Monday phone interview with John Haas, President of the Philadelphia-based National Catholic Bioethics Center.

Houben’s mistaken diagnosis was a “perfect example” of why artificial nutrition and hydration should be continued, Haas said.

He reported that the U.S. Catholic bishops last week passed a modified version of Directive 58 of the Ethical and Religious Directives (ERDs) for Catholic healthcare. This directive spoke of “the moral obligation to continue to provide hydration and nutrition to patients in a compromised state,” Haas said.

“This obligation extends to patients in chronic conditions (e.g. the 'persistent vegetative state') who can reasonably be expected to live indefinitely if given such care,” the ERD read.

“The bishops have always held to that position,” Haas explained, but some other Catholic voices have not.

In 2004, Haas noted, Pope John Paul II delivered an allocution in which he again said it is necessary to provide hydration and nutrition as long as it is “achieving its end” of nurturing the body.

Houben’s recovery, he said, would seem to be “a case where the Church’s position was actually ahead of the curve.”

Asked about Dr. Laureys’ comments about the difficulty of a patient permanently labeled as “unconscious,” Haas said he hoped health care providers would not have negative attitudes towards such patients.

However, he noted that Pope John Paul II described how “regrettable” it was that the medical term for such patients was “persistent vegetative state.”

Some doctors’ comments and medical terminologies “do tend to devalue and demean these people, which is really unfortunate.”

He said the case could help confirm the position of those who oppose physician-assisted suicide, but where the practice is legalized the patients are generally required to be conscious and responsive.

However, Houben’s case would be relevant to those with advanced medical directives who say they want artificial hydration and nutrition removed if they are unconscious and unlikely ever to wake.

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The Catholic tradition holds that hydration and nutrition cannot be removed if a person will die of dehydration and starvation, Haas reiterated.