A man thought to have been in a vegetative state for twelve years told doctors he is not in pain.

The patient communicated through a question-and-answer technique using fMRI imaging developed by University of Western Ontario’s Adrian Owen.

Owen developed the technique by asking patients diagnosed as vegetative to imagine doing certain common activities, such as playing tennis or walking through a house. These tasks produce distinct brain scans in healthy subjects, and the patients were shown to be produce the same results.  Owen uses their ability to produce those distinct brain scans to ask them questions: for example, imagine playing tennis as a proxy for yes, walking through your house for no.

He confirmed the method by asking would-be vegetative state patients factual questions. Many were able to get them right.

Reports emerging today–of Scott Routley, a 39-year-old Canadian who had shown no signs of meaningful communication since a car accident 12 years ago–is the first example in which doctors used the technique to ask patients substantive questions about their own condition.

If the reports convince the medical community, it will be a triumph of the diagnostic technique over conventional clinical examination. It will also help in the care of such patients, since they could indicate pain levels or even convey what kind of music they wanted to hear.  Lurking in the background is the question that Owen still won’t ask, for lack of moral consensus: Do you want to die? But in the meantime, some families, like  Routley’s, will be happily vindicated in their belief that their loved one is “still there.”