"Many times patients do change their mind," Hirsch said. "When you are 23 and say, 'Gee, whiz, if that happens to me I don't want to live.' But when it does happen to them, people still feel that life is very worth living, even if it means a wheel chair or severe incapacity. People do change their positions and the medical profession has to be sensitive about that.'"
Hirsch and her colleagues were the first group to use diagnostic technology to discern whether there is cognition and perception in patients who cannot speak for themselves.
In one case, they asked a patient to imagine a tennis game while doctors performed a functional MRI on his brain.
"When you put them in the scanner and either ask them to perform tasks or name an object silently in their mind, they can produce a brain pattern," she said. "We can differentiate if they are locked in or truly vegetative."
This technology, similar to what Belgian doctors used to determine their patients' hidden cognitive ability, is only "emerging," according to Hirsch and is not part of standard care and many patients like Schiavo are neglected.
Patients who linger in vegetative states are in the "backwaters of our medical treatment plans," she said. "We feel we cannot do anything for them and there is sort of a tendency to neglect them."
Still, she said that doctors need these new tools to help families make better decisions about whether their loved ones will recover from brain traumas.
"We need to take these disorders of consciousness seriously with an attitude not that we cannot do anything about them, but we may need be able to do something for them. There is hope."
Though some American doctors are skeptical of Rom Houbens' miraculous recovery, Belgian neurologists say he has been given a "second life."
And the story strengthens the Catholic argument that miracles can, indeed, happen when forced feeding is allowed to continue -- regardless of a patients' wishes.
For Bobby Schindler, who fought so hard to keep his sister on feeding tubes, knowing if she had brain activity might have made the difference.
"We loved her and just wanted the right to care for her as long as she lived regardless of whether her condition could be improved or not," he said. "Terri was basically warehoused and we were not allowed to test."
"She was not dying and there is a good chance she would have lived a normal life span," said Schindler. "She died because food and water was taken away."