Feeding tube removed from comatose woman at center of long-running legal battle

Associated Press ^ | 10-15-03

[Ohioan from Florida]

Here are the first four paragraphs of the article, sorry that I don't have the whole thing:

"Daniel Rios is 24 years old, with wavy black hair, a thick mustache and a glassy stare that seems to look both at you and through you. One day almost four years ago, while he was taking a shower, a blood vessel ruptured in his brain, and he collapsed on the bathroom floor. After emergency surgery, he lay in a coma for three weeks. When he finally opened his eyes, he could not speak or move his body; his head simply lolled. In the months that followed, the doctors monitoring him at the Center for Head Injuries at the J.F.K. Johnson Rehabilitation Institute in Edison, N.J., saw few signs that he had any meaningful mental life. Sometimes he looked as if he were crying. Other times his eyes would follow a mirror passed before his face. On his best days he was able to close his eyes on command. But those days were rare. For the most part he lay unresponsive, adrift in a neurological twilight."

"One morning just over a year after his accident, Rios was taken to the Sloan Kettering Institute on Manhattan's East Side. There, in a dim room, a group of researchers placed a mask over his eyes, fixed headphones over his ears and guided his head into the bore of an M.R.I. machine. A 40-second loop of a recording made by Rios's sister Maria played through the headphones: she told him that she was there with him, that she loved him. As the sound entered his ears, the M.R.I. machine scanned his brain, mapping changes in activity. Several hours afterward, two researchers, Nicholas D. Schiff and Joy Hirsch, took a look at the images from the scan. They hadn't been sure what to expect -- Rios was among the first people in his condition to have his brain activity measured in this way -- but they certainly weren't expecting what they saw. ''We just stared at these images,'' recalls Schiff, an expert in consciousness disorders at Weill Medical College of Cornell University. ''There didn't seem to be anything missing.''"

"As the tape of his sister's voice played, several distinct clusters of neurons in Rios's brain had fired in a manner virtually identical to that of a healthy subject. Some clusters that became active were those known to help process spoken language, others to recall memories. Was Rios recognizing his sister's voice, remembering her? ''You couldn't tell the difference between these parts of his brain and the brain of one of my graduate students,'' says Hirsch, an expert in brain imaging at Columbia University. Even the visual centers of Rios's brain had come alive, despite the fact that his eyes were covered. It was as if his sister's words awakened his mind's eye."

"To the medical world, Rios and the hundreds of thousands of other Americans who suffer from impaired consciousness present a mystery. Traditionally, there have essentially been only two ways to classify them: as comatose (eyes closed and responses limited to basic reflexes) or vegetative (eyes opening and closing in a cycle of sleeping and waking but without any sign of awareness). In either case, it has been assumed that they have no high-level thought. But Schiff, Hirsch and a small group of like-minded researchers are studying people like Rios and finding that the truth is far more complicated. Their evidence suggests that even after an injury that leaves a brain badly damaged, even after months or years with little sign of consciousness, people may still be capable of complex mental activity. ''If I say, 'Touch your nose,' and you touch your nose, and then I say 'Touch your nose' six more times, and you don't do it, how do we account for the one time you did?'' asks Joseph T. Giacino, a neuropsychologist who collaborates with Schiff and Hirsch."

[justshutupandtakeit]

Thanks for your information and opinion.

[justshutupandtakeit]

Thanks for the information.

[Graymatter]

Terri's dad on Hannity radio show now, 4:45pm est.

[justshutupandtakeit]

I have not debated or claimed it to be right or wrong, merely asked questions. Those who do not like the questions apparently believe I am some sort of Monster. But the questions remain.

We are not far away from the day when life can be prolonged indefinitely with machines and high tech medical procedures.
Will it be appropriate to prolong the life of 80 yr. olds indefinitely at the cost of hundreds or thousands of dollars a day? If so how long?

This is not a trivial question nor one which implies we should not provide medical services which can return one relatively quickly to a normal, productive life. Should we provide new livers to inmates in jail for murder or kidney or heart transplants? Where will this line be drawn? Will courts and lawyers have to be the ones making these decisions rather than doctors?

[justshutupandtakeit]

Thanks but I am cubicle bound and unable to listen. Maybe he will be on H&C tonight also and I can watch.

[.38sw]

Should we provide new livers to inmates in jail for murder or kidney or heart transplants?

We are already doing that. Last year (I think it was last year; the older I get the faster time goes by) an inmate in a California prison received a heart transplant. The article in the paper said that medical "ethicists" have determined that even someone on death row should receive a heart transplant if it was deemed medically necessary. I personally find that to be an outrage.

[Theodore R.]

What is holding Jeb Bush back? Is it cowardice? Why is he cowardly here? Is he afraid that if he sends the state police in that there will be some kind of armed confrontation with Schiavo's bodyguards? Does this man have the leadership skills in a crisis to be President in 2009?

[Theodore R.]

nightmares about Terri

I really don't think it is possible for Schiavo to have nightmares about Terri. He is incapable of evaluating his own evil. He considers himself "doing good" here. The Bible says that in the last days, people will call evil "good" and good "evil."

[justshutupandtakeit]

I agree it is hideous in the extreme.

[strela]

I share your anger over the cold-heartedness of this woman's husband, but please be careful in your choice of words

I echo that sentiment. And, the individual to whom the words were directed has proven to be a litigious personality.

[honeygrl]

I'm hoping for nightmares when he sleeps that she's after him .. yaknow.. stuff you'd see in a horror flick.

[honeygrl]

Think Freddy Kruger type nightmares.

[MarMema]

Keeping Terri alive costs next to nothing. My son, with diabetes, runs up medical costs each month about 10 times what it would cost for Terri to be fed with a feeding tube, at home, and turned a few times a day by her parents.

When Karen Ann Quinlan began breathing on her own, her parents took her home and did this for her. She lived another 8 years.

The entire burdensome population in vegetative states in this country costs about 3% of the total healthcare dollars spent.

You don't hear these numbers from the pro-death side because they know it is a drop in the bucket to pay to keep people like Terri alive.

[MarMema]

Will it be appropriate to prolong the life of 80 yr. olds indefinitely at the cost of hundreds or thousands of dollars a day? If so how long?

Is it appropriate to kill someone because they have aged over 80 years? If so, at what age?

[secretagent]

Another article - quote:

As Zimmer eloquently describes it, "Even the visual centers of Rios's brain had come alive, despite the fact that his eyes were covered. It was as if his sister's words awakened his mind's eye." Zimmer likens these scans to "eavesdropping" on the patients' inner worlds. ''It's free speech for people who have no speech,'' Hirsch says.

Theories to explain these "enigmatic hints of awareness" are too complex and too lengthy to go into in any depth. Suffice it to say that higher-level thought (such as language and memory) is believed to occur in networks of neurons located at the surface of the brain in the cortex. According to Zimmer, these neurons "form loops which dip deep within the brain where they converge and then return to the surface."

One theory is that the activity of the loops is "synchronized" by a special set of neurons deep in the brain. When the synchronizers are damaged, "harmony" is disrupted and the brain "slips into a vegetative state." But even after extensive brain damage, Schiff and his colleagues believe, "some of the loops may still function, though in isolation - - like fragments of mind."

[Theodore R.]

Will it be appropriate to prolong the life of 80 yr. olds indefinitely at the cost of hundreds or thousands of dollars a day? If so how long?

Yes, because this is life.
However, your question does not apply in Terri's case. She is 39 and is the victim of gross, gross abuse.

[Theodore R.]

In reality, medicine is already rationed that is what the price system does.

So is law similarly rationed. The one with the ability to retain the "better" lawyer is more likely to win in the legal system than one with a lawyer on a shoestring, regardless of the facts of the case. Terri has had to depend on pro bono lawyers, an injustice to them and to her.

[secretagent]

Thanks!

http://www.freerepublic.com/focus/f-news/986663/posts?page=875#875

BTW you don't have to hyperlink if you never use html commands: FR will automatically do it then.

[Ohioan from Florida]

Yes, that author was referring to the same NYTimes article I was talking about. The research shows definitive measurable proof that some of these people are not being treated in a way that is conducive to them regaining any abilities. It's not because they can't regain them, it's because we haven't figured out how to do it yet. In many circumstances, people have been improperly diagnosed as PVS or else when they started to regain consciousness, the caretakers didn't recognize the signs of it. The Schindlers have and some of their doctors have, but the doctors on Schiavo's side don't want to believe it. IMHO, their egos have gotten the better of them, and they think they know it all, and have all the mysteries of life figured out. At least they act that way.