The feat was a remarkable one since doctors at Sunnybrook Health Sciences Centre in Toronto had diagnosed him as being in a persistent vegetative state (PVS), a mysterious condition in which patients appear to be awake but show no clinical signs of conscious awareness.
The condition first came to prominence in 1998 when family members, and then courts and politicians, engaged in a protracted battle over the care of Floridian Terri Schiavo. The matter was finally settled in 2005 when Schiavo, who was in a persistent vegetative state, was removed from life support and died.
Doctors at Sunnybrook similarly wanted to transfer Rasouli to palliative care, but Rasouli's family refused. The doctors therefore sought a court order, and the Supreme Court of Canada heard arguments in the case on Monday.
The court's decision might not affect Rasouli since, given his ability to give a thumbs-up gesture, he is no longer considered to be in a persistent vegetative state (PVS). But the case could have a profound impact on the many other patients who have been diagnosed as being in a PVS, as it could answer pressing legal questions about when someone can be removed from life support, and who has the authority to order that such support be discontinued.
The Rasouli case also raises further troubling questions of fact: Was Rasouli's ability to give a thumbs-up gesture an indication that his condition had improved, or was he never in a persistent vegetative state? Was he, and other people similarly diagnosed, always consciously aware, but, thanks to being trapped in a paralyzed body, unable to express his thoughts?