Researchers have shown that a patient diagnosed as being in a vegetative state does have conscious thought. Using functional MRI (fMRI), Adrian Owen (Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK) and colleagues assessed the patient’s neural responses to various spoken sentences and requests to perform imagery tasks and these were compared with controls’ responses (Science 2006; 313: 1402). Patients can enter a vegetative state after a head injury or after being in a coma. They have no awareness of self or environment but are defined as being awake—patients will typically have intact brainstem centres and reflexes.