Is Terri Schiavo Dead? Eat, drink, and vegetate

Reason ^ | 10-23-03 | Ronald Bailey

[ambrose]

October 23, 2003

Is Terri Schiavo Dead?

Eat, drink, and vegetate

Ronald Bailey

Terri Schiavo has been in a persistent vegetative state since 1990. Her husband wants to withdraw the nutrition and hydration her body has been receiving and allow her body to die. Her mother, father, and sister—and now Florida Governor Jeb Bush—want to continue supplying her body with food and water until... what? She wakes up? Dies of pneumonia?

What is a persistent vegetative state? According to the National Institute for Neurological Disorders and Stroke people in PVS "have lost their thinking abilities and awareness of their surroundings, but retain non-cognitive function and normal sleep patterns. Even though those in a persistent vegetative state lose their higher brain functions, other key functions such as breathing and circulation remain relatively intact. Spontaneous movements may occur, and the eyes may open in response to external stimuli. They may even occasionally grimace, cry, or laugh. Although individuals in a persistent vegetative state may appear somewhat normal, they do not speak and they are unable to respond to commands." People suffering from PVS can generally be distinguished from afflicted but cognitively intact patients who suffer from "locked-in syndrome" by the fact that "locked in" patients can track visual stimuli and use eye blinks for communication.

According to most neurological experts, Terri Schiavo is definitely PVS—her eyes do not really track visual stimuli and she cannot communicate using eye blinks. However, Terri Schiavo's parents have posted several short ambiguous video clips online which are meant to show that Ms. Schiavo responds to stimuli. But what they show seems to fit an AMA's report of how PVS patients can respond to environmental cues without being aware. Specifically, the report notes, "Despite an 'alert demeanor', observation and examination repeatedly fail to demonstrate coherent speech, comprehension of the words of examiners or attendants, or any capacity to initiate or make consistently purposeful movements. Movements are largely confined to reflex withdrawals or posturing in response to noxious or other external stimuli. Since neither visual nor auditory signals require cortical integrity to stimulate brief orienting reflexes, some vegetative patients may turn the head or dart the eyes toward a noise or moving objects. However, PVS patients neither fixate upon nor consistently follow moving objects with the eyes, nor do they show other than startle responses to loud stimuli. They blink when air movements stimulate the cornea but not in the presence of visual threats per se."

Ms. Schiavo has been in this state for 13 years. What are her chances of recovering at least some awareness? Minnesota neurologist Ronald Cranford told the Washington Post, "There has never been a documented case of someone recovering after having been in a persistent vegetative state for more than 3 months. However, the journal Brain Injury reported the case, of a 26-year-old woman who, after being diagnosed as suffering from a persistent vegetative state for six months, recovered consciousness and, though severely disabled, is largely cognitively intact. However, it is generally agreed that if a patient doesn't become responsive before six months, his or her prognosis is extremely poor. A report on PVS by the Australian National Health and Medical Research Council finds that "patients in a state of post-coma unresponsiveness may emerge from it to become responsive," that "the probability of emergence becomes progressively less over time," and that "there is general agreement that emergence is less likely in older people, and in the victims of hypoxic brain damage." Terri Schiavo is the way she is because oxygen was cut off to her brain for 14 minutes; in other words, she suffered severe hypoxic brain damage.

So is Terri Schiavo still alive? The odds are way against it. It's time that her long-suffering parents and the grandstanding politicians let her go in peace.

[najida]

There have been several physicians who gave a press conference yesterday who believe that Terri can be rehabed. Remember, we DON'T know all there is to know about brain damage...

Not too long ago, locking people in a pit of snakes, sticking rods in their brains and scrambling them, 5 point restraints for days at a time were considered "good therapy'. Babies didn't need anthesthesia during surgery because they weren't supposed to feel pain. Many with Cerebal Palsy were deemed mentally deficient because they couldn't express themselves.

Me? Personally, in 10, 20, 50 years, if it comes to light that the severly brain damanged and those in PVS's have a higher level of consciousness, I want to be able to live with myself knowing I treated them well. I want to err on the side of hope and decency.

And there are those who believe Terri is in a PVS. Tell ya what I learned working with those in a PVS..... And I have spent most of my life in buildings with gobs of them. How they were treated reflected back on the souls of their caregivers. Seriously folks, it ain't about 'them' it is about "you". Those who used the excuse of "They are gone, it doesn't matter' were pretty much cold-hearted, arrogant creeps. And it shows in their actions and words. Those who made sure they got good care, stimulation, affection etc.....were those who "GOT" being a decent human being.

[FITZ]

I think it was an ischemic event --- I would still question whether her skull is really a fluid filled cavity as that doctor said. I would guess that some or many neurons did die and portions of her brain could be atrophied. Many circuits could be shut off forever. I would never think she could ever be "good as new" or anything close. But maybe her family isn't wrong about her having some cognitive response.

[litany_of_lies]

Name ONE person who has gone to jail whose sole "crime" was abusing (not dealing, only using/abusing) LEGAL prescription drugs. No other ancillary crimes allowed (like stealing them).

Tick. tick, tick, tick........

[FITZ]

I read somewhere that Christopher Reeves has actually walked a little --- using those bars --- not well or fast of course but that he made his legs move well enough for that. Brain injury is serious --- but sometimes alternate paths are found and injured neurons grow back very very slowly and good rehab can help a patient regain some of what they lost.

[Dog Gone]

I offered my opinion on how this would probably turn out, not my "version of the world."

I'm not sure why I deserve your rebuke, but I hope you feel better for doing that.

[secretagent]

I share the family's hope that therapy can help Terri.

I would still question whether her skull is really a fluid filled cavity as that doctor said.

Cranford reported areas with fluid, not the whole skull. Brain parts die, then fill with cerebrospinal fluid.

The doctors seem to disagree as to whether Terri has a small bit of cortex left or none, and whether that little bit of cortex could aid in rehab.

No harm in trying, except if "the prisoner within" wants to die. But Terri's resistance to infections argues for life, not against.

[Dog Gone]

That's just it. I don't know why Michael Schiavo won't, at this point, divorce Terri and get on with whatever he wants to do with his life. Let her parents assume responsibility and move on.

It seems like everyone would be happy.

[Calpernia]

Exactly. And no where will you find any doctor that specifically stated "I can make him walk again". This seems to be the type of testimony the court was trying to get the Schindler doctors to say.

[litany_of_lies]

Mikey won't turn Terri over to her parents because a pattern of spousal abuse by Mikey is likely what led to Terri's collapse in the first place. He can't take a chance that she will regain coherence, because if she does, she'll spill the beans, and Mikey will be wearing orange overalls.

No other possible motivation exists, unless you're naive enough to believe Mikey when he says that he's only doing it to carry out Terri's wishes.

[Ethan_Allen]

"I sense that the medical community and their bean-counting friends in the government and at the HMOs is beginning to organize against Terri and those in similar cases. If the Schindlers get hold of her and Terri recovers coherence, it will set their entire "right to die" and "futile care" agenda on its ear. This is beginning to look like the MOAB (Mother of All Battles) for the pro-life movement."

BUMP.

[CindyDawg]

I was talking to someone awhile back and this person would not even consider any of these parents concerns because something like this can not happen in this country. In my opinion the truth is usually somewhere in the middle but if even, only a few of these concerns are legit, then the courts have to ask how did this happen? Like I said, it's JMO but I feel that is why we are having such a problem with getting this investigated. If it is proven there is truth regarding the parents complaints then , somewhere the ball was dropped and I feel some officals might, rather not know than deal with it.

[CindyDawg]

If Terri was ready to die, she would be dead. She's fighting very hard for some reason. Do yall know how rare it is to go six days without food and water and not go into renal failure? Most die after about three days.

[Dog Gone]

He can't take a chance that she will regain coherence, because if she does, she'll spill the beans, and Mikey will be wearing orange overalls.

Let's think about this. Is she showing signs of improvement over the past decade? Is she indicating that she plans to say anything against her husband, and then take the stand? Is there any reason at all to think that such a scenario is remotely possible?

Terri's husband may have abused her in the past, and perhaps he's even responsible for her present condition. But there's no way that he's trying to kill her to silence her.

She has severe brain damage. Nobody disputes that.

She will never ever in a million years be able to make an accusation that is subject to cross-examination at trial.

Her husband is trying to kill her, without a doubt. But it can't be out of fear.

[Normally a Lurker]

Well said.

[blueriver]

What do you think motivates Jodi - the mother of his kids who has been living with him for over ten years. If we take his word for it that he is doing this deed out of pure dedication to his wifes wishes then wouldn't that make Jodi second fiddle to Terri? Which leads me to conclude that there is something in this for Jodi as well. So what could that possibly be? The only think that comes to mind is the thousands of dollars they have spent over the past ten years on Terri's dime and a possible life insurance policy that MS refuses to comment on.

[fiesti]

Now go read the article on World Net Daily. At least somebody's getting it right

[fiesti]

I have yet to read anywhere what the prognosis might be of anyone who has already lived this long in a PVS.


Well I tell ya what....Terri's family excluding Michael love her deeply and if they want to take care of her for 100 years that is their business She is not on life support and has committed no crime to be put to death in a very inhumane way

[kaylar]

I think it's mostly greed (the life insurance payout he gets on her death), spiced by hatred of her (for not having the decency to die and make him rich years ago ) as well as rage against his inlaws for keeping him from what's righfully his-ie, the life insurance. But it's fear too, or why else has he stated that Terri is to be cremated IMMEDIATELY upon death?

[Krodg]

Truth be told, I'd suspect that most of the people waving the "bloody shirt" around here oppose the right to die, under all circumstances.

I'm glad you added the 'most' in your statement, otherwise I would be very offended.

I don't see how one can support the right to life without also supporting the right to die. The two go hand in hand.

Since I don't speak for 'all' of Terri's supporters, I will just give my opinion. I support the right to life and I support the right to die...I do not support the right to murder. Since all 'evidence' of her wishes comes from one side, it doesn't sound 'clear and convincing' to me.

Perhaps if he had not already suspended all therapy and stimulation before he requested court approval to starve her, 'some' of us might have believed he had her best interests at heart. His actions are what keep the issue alive..not her's.

JMO

[najida]

That was perfect!

Why can't 'rabid chimpanzee judges on acid' see that?