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.

[secretagent]

From "Schiavo III":

Among the affidavits filed by the Schindlers, however, the most significant evidence comes from Dr. Fred Webber. Dr. Webber is an osteopathic physician practicing in Clearwater, Florida, who claims that Mrs. Schiavo is not in a persistent vegetative state and that she exhibits "purposeful reaction to her environment." He swore under oath as follows:

"Within the past year, I have treated patients with brain defects similar to Mrs. Schiavo’s. In most cases, using cardiovascular medication style of therapy, my patients have shown some improvement, although the degree of that improvement is variable. By "improvement" I mean cognitive and physical items such as speech recovery, enhanced speech clarity and complexity, release of contractures, and better awareness of the patient’s surroundings. In my opinion and judgment, based on my 26 years of practice, Mrs. Schiavo has a good opportunity to show some degree of improvement if treated with this type of therapy, although I cannot anticipate how much improvement."

The 2nd District Appeal Court remanded to the trial court to hold a medical evidentiary hearing. They made this move based on Webber's degree of specificity of predicted improvement of cognitve function.

Hammesfahr and Maxfield, the Schindlers' doctors, wouldn't back up his prediction of improved cognition. Hence, nothing near to a "preponderance of evidence" that Terri could expect improved cognition.

Please correct if I don't have the court's reasoning right.

[kaylar]

Some women would rather do anything than get out of bed in the morning, hold down a job, and support themselves. Jodi's stayed with him because she sees $700,000 when Terri finally has the decency to die and make them both rich. But it should be noted that at least one after Terri/before Jodi GF came forward and said she broke up with MS because she grew to fear him, and that he stalked her for some time. If that's true,and given what's been reported of the marriage, maybe Jodi CAN'T leave. A common threat abusive men make is, "Leave me, and I'll take the kids away from you and you'll never see them again." Given the way the courts have bent over for MS, I'd take that threat seriously.

[Dog Gone]

I think it's mostly greed (the life insurance payout he gets on her death),

Michael Schiavo's attorney claims that no such life insurance policy exists. This should not be a hard fact to determine definitively, one way or the other.

When Terri dies, there will be an autopsy regardless of whether she is cremated afterward.

It's very tempting to make arguments based on perceived motives of opponents, and most of us do that, but it's not really the best or most effective way to argue.

[litany_of_lies]

I agree as to Jodi's possible motivations being monetary. They have a shell insurance company in both of their names, which hasn't been adequately investigated.

What's hard to tell is whether she is a co-conspirator or another naive victim (I'm theorizing that Terri was a naive victim in the sense that she may have seen signs of abuse before marriage and didn't call it off, or got abused during the marriage and didn't head for the hills).

As to Jodi, I vote for co-conspirator, and predict that she and Mikey will turn on each within a year of Terri's death, if they are successful in finishing Terri off.

[litany_of_lies]

As I understand it, Mikey has ordered IMMEDIATE cremation, and it appears he is within his powers as guardian to do so.

The state could intervene if there is enough suspicion of foul play (they apparently don't think so at this point, despite some pretty decent evidence), or I would think the insurance company could pre-emptively demand one. But I don't think that either course is being pursued at this point.

[ClancyJ]

Sorry if I misunderstood.

[kaylar]

MS has refused to confirm or deny life insurance. (Probably on his lawyer's orders.) If Felos told me it was a sunny day, I'd grab an umbrella...I don't believe anything that man says.

There have been too many articles which have stated that Terri's body is to be immediately cremated to doubt it.

As for MS's motives, I base my beliefs on what they are on the sworn testimony of Terri's nurses and her coworker. I don't see why they'd lie, and perjury is a serious offense (not that some don't commit it, I know) so I believe they are trustworthy witnesses.

If even 1/10th of what has been stated in the various articles (articles, not posts ) re: MS is true, he is a greedy, evil, selfish, abusive-well, let's just call him a HINO, like some freeper (no idea who) started. It fits!

[litany_of_lies]

From #301: "Within the past year, I have treated patients with brain defects similar to Mrs. Schiavo’s. In most cases, using cardiovascular medication style of therapy, my patients have shown some improvement, although the degree of that improvement is variable. By "improvement" I mean cognitive and physical items such as speech recovery, enhanced speech clarity and complexity, release of contractures, and better awareness of the patient’s surroundings. In my opinion and judgment, based on my 26 years of practice, Mrs. Schiavo has a good opportunity to show some degree of improvement if treated with this type of therapy, although I cannot anticipate how much improvement."

That would seem to be enough to induce some fear into Mikey.

She might not ever recover to the point of being able to testify or be deposed, but what if Terri partially recovers and Mikey walks into the room with Jodi, only to see Terri recoil from him in total fear? That would put a damper on the Mike-Jodi relationship, don't you think?

[kaylar]

Too bad...I wish there was some way to demand an autopsy upon death, regardless of her "guardian's" wishes. If nothing else, it would be interesting to see if he would suddenly become very eager to keep her alive...Solely out of sympathy for his in laws, of course.

I want Terri to live, but wouldn't it be ironic if there IS a $700,000-1.5 million dollar life insurance policy out there (those are the figures I've seen )-and the company refused to pay out ? No idea if they could do so barring an actual conviction (Can a life insurance payout be denied based on suspicion, like for arson and homeowner's insurance? ) but if so, that would leave MS with less than $50,000 dollars...The malpractice suit money that was to have gone for Terr's therapy, and instead went into Felos' pocket. And I'm sure that sumis being decreased daily, unless Felos is doing this out of the (gag!) kindness of his heart, pro bono.

If Terri holds out for a few more months, and there is NO insurance policy : Poor Jodi and Mikey could wind up broke. Gee, that would be sad.

[Dog Gone]

Too bad...I wish there was some way to demand an autopsy upon death, regardless of her "guardian's" wishes.

A couple of nights ago, someone posted the Florida State Code which controls this issue, and unless it was a total fraud (I didn't check the source link), an autopsy is absolutely mandatory in this kind of situation.

It doesn't matter what Michael thinks, and again, we're ascribing motives to him that may or may not be there or even relevant.

If he wanted to avoid an autopsy, asking for a cremation would not accomplish that.

[Shortstop7]

It never ceases to amaze me when I see people refer to Terri as being in PVS. She is NOT!! No one expects her to jump out of bed tomorrow......though I wish to God that she could. She does deserve a fair chance at rehab which her moronic husband has denied her. Her family deserves the chance to love and take care of her.......

I'm so sick of people portraying Terri has being vegetative....it's a shame they don't read the facts of the case........

[litany_of_lies]

All I can say is that I hope you're right about the autopsy requirement and that we never find out whether you really are.

I fear that Mikey would do a cremation over the weekend before the autopsy enforcers step in. He would have to be warned in advance not to do it, IMHO.

[huck von finn]

When Terri dies, there will be an autopsy regardless of whether she is cremated afterward.

Yeah. This is one argument I've seen on these threads that I cannot understand. Do people assume that bodies to be cremated aren't autopsied? Or is that the assumption? I can't imagine that her body wouldn't be autopsied.

[huck von finn]

All I can say is that I hope you're right about the autopsy requirement and that we never find out whether you really are.

Where does the idea of her body's not being autopsied come from? Where did this information come from, and why?

[Theodore R.]

I fear that Mikey would do a cremation over the weekend before the autopsy enforcers step in

This is so likely, and George W. Greer has already endorsed this course of action. Even if she died on a Monday, Tuesday, or Wednesday, the autopsy people may arrive to late to do their "job."

Why do people, such as Crist, say there is "no evidence" of fraud and wrongdoing in this case? When does a "smoking gun" not at least trigger an investigation?

[Calpernia]

Hammesfahr and Maxfield cannot comment on cardiovascular therapy if they don't use it.

[huck von finn]

I fear that Mikey would do a cremation over the weekend before the autopsy enforcers step in

Like a bonfire in his back yard or something? C'mon. Have you ever had the body of a loved one cremated? Also, I cannot believe that the body would not be autopsied, and I believe there are laws in Florida to that effect in cases such as this one. There is so much ethical, scientific, and legal interest in the case that it would be a big stretch to think that it would not happen.

[Dog Gone]

Florida law doesn't allow a body to be cremated without an investigation, probably including an autopsy.

PUBLIC HEALTH

Chapter 406 MEDICAL EXAMINERS; DISPOSITION OF DEAD BODIES

View Entire Chapter

406.11  Examinations, investigations, and autopsies.--

(1)  In any of the following circumstances involving the death of a human being, the medical examiner of the district in which the death occurred or the body was found shall determine the cause of death and shall, for that purpose, make or have performed such examinations, investigations, and autopsies as he or she shall deem necessary or as shall be requested by the state attorney:

(a)  When any person dies in the state:

1.  Of criminal violence.

2.  By accident.

3.  By suicide.

4.  Suddenly, when in apparent good health.

5.  Unattended by a practicing physician or other recognized practitioner.

6.  In any prison or penal institution.

7.  In police custody.

8.  In any suspicious or unusual circumstance.

9.  By criminal abortion.

10.  By poison.

11.  By disease constituting a threat to public health.

12.  By disease, injury, or toxic agent resulting from employment.

(b)  When a dead body is brought into the state without proper medical certification.

(c)  When a body is to be cremated, dissected, or buried at sea.

link

[Shortstop7]

I've wondered why he didn't just divorce her for a while. Maybe he really does love her and she really did say she wouldn't want to live like this. What a concept, huh?

Oh yeah, I'm sure Michael really loves her and is so concerned. But, I betcha he's much more concerned about his fiance, their child and the baby on the way. What a concept, huh?

[Shortstop7]

"Think about that Ambose. Why do criminals have more rights than this woman?"

Thank you jwalsh! Excellent point..........