A farce?

Its been making headlines and blog posts everywhere.... a Belgian man has been fully conscious and paralyzed for 23 years, and treated as if he was in a vegetative state....

But then, in comes James Randi, saying its a farce, nothing more than facilitated communication, using a kind of high tech ouiji board. 

I had my doubts when I first heard the story... How could a completely paralyzed man communicate with us?  Apparently its as simple as holding his hand and guiding it along a keyboard. 

But if this part is a farce, and I would be inclined to agree with James Randi here, how do we explain the brain scans that say that he is in fact conscious and responsive to stimuli....

I'm terribly confused about this particular case.  But one thing is for sure, if we keep scanning vegetative people's brains, we would eventually find more seemingly vegetative people with active brains.  So what do we do about these cases?  How do we care for those who are conscious and fully "locked-in" (assuming such a condition exists)? 

In my ethics course, when we discuss euthanasia and quality of life, it quickly becomes apparent that its a highly subjective thing.  Some might think that a quadrapalegic life is not worth living... I think that if I had a helping spider monkey and was able to watch Lost, then life would still be worth living.

But the problem with "locked-in" people is that they cannot voice their desires, except with perhaps a brain scan.  But brain states aren't exactly equivalent to yes and no answers.  So even if they are fully conscious, I think it might boil down to an excrutiatingly cold-hearted utilitarian calculation.  Does the locked in patient provide friends and family more joy than not?