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•HOW IS A VEGETATIVE STATE DIFFERENT FROM A MINIMALLY CONSCIOUS STATE? A comparatively new designation, minimally conscious state describes people who are not in a vegetative state but who don't show consistent evidence of awareness. For example, they may indicate yes-or-no responses even if they aren't accurate. (Schiavo's parents have argued that their daughter is minimally conscious.) A recent study using specialized brain scans found near normal activity levels in the cortical language centers of some such patients when their loved ones spoke to them, indicating they may retain the potential for cognitive function. Patients in a minimally conscious state are also more likely to improve and benefit from therapy than those in a vegetative state.
•DOES A PERSON IN A VEGETATIVE STATE SUFFER AFTER NUTRITION AND HYDRATION HAVE BEEN WITHDRAWN? No one knows for certain, of course, what it feels like to be unaware--hence the awful anxiety that is at the heart of the Schiavo debate. But it's quite possible for death under those conditions to be peaceful, at least as far as outside observers can tell. (Indeed, taking to one's bed and refusing to eat while drinking little or nothing was until recently a common way to die.) Moistening the lips and mouth will keep the skin in this area from cracking. The lack of fluid leads to a buildup of ketones that induces a coma, along with kidney failure or cardiac arrest--a deceptively dramatic-sounding breakdown that nonetheless can release a patient from life quite gently. --By Christine Gorman
BASED ON INTERVIEWS WITH DR. JAMES BERNAT OF DARTMOUTH MEDICAL SCHOOL, DR. JAMES CLEARY OF THE UNIVERSITY OF WISCONSIN MEDICAL SCHOOL, DR. JOSEPH FINS OF WEILL MEDICAL COLLEGE AT CORNELL UNIVERSITY, DR. ROBERT LISAK OF WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE AND DR. KEITH SILLER OF N.Y.U. MEDICAL CENTER