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.

[george wythe]

You're being deliberately obtuse.

The Schindlers were given a chance to present two doctors of their choice at the evidentiary hearing in 2002, and they only provided one neurologist whose license is on probation.

The Schindlers had a chance to present Dr. Webber as their second expert, but instead introduced a radiologist.

Dr. Webber had asked to testify in court in the affidavit submitted in 2001; Dr Webber was given the chance in 2002. Dr. Webber did not show up. Why?

I previously posted these excerpts from Schindlers v. Schiavo IV opinion written by the Second District Court of Appeals in Florida.

In 2001, the Schinlers provided an affidavit by Dr. Webber about a new treatment that could help Terry. The appeal court using such affidavit ordered the trial court to rehear the case, allowing Dr. Webber to testify.

The new evidentiary hearing was held in 2002, allowing 2 doctors chosen by the Schindlers, 2 doctors chosen by Schiavo, and 1 doctor chosen by the court.

In 2002, when given the chance to testify in person, Dr. Webber was a no show.

In our last opinion we stated that the Schindlers had "presented no medical evidence suggesting that any new treatment could restore to Mrs. Schiavo a level of function within the cerebral cortex that would allow her to understand her perceptions of sight and sound or to communicate or respond cognitively to those perceptions." Schiavo II, 792 So. 2d at 560. Although we have expressed some lay skepticism about the new affidavits, the Schindlers now have presented some evidence in the form of the affidavit of Dr. [Fred] Webber, of such a potential new treatment.

On remand, this court anticipated but did not require that Dr. Webber, who had claimed in his affidavit that he might be able to restore Mrs. Schiavo's speech and some of her cognitive functioning, would testify for the parents and provide scientific support for his claim. However, Dr. Webber, who was so critical in this court's decision to remand the case, made no further appearance in these proceedings.

Despite Dr Webber's absence, the trial court again listened to the evidence in a brand-new evidentiary hearing in 2002, and allowed 5 experts to testify; 2 chosen by the Schindlers, 2 chosen by Schiavo, and 1 chosen by the court.

Extensive videotaping of the doctors examining Terry were provided to the court:

Instead, the parents provided testimony from Dr. William Maxfield, aboard-certified physician in radiology and nuclear medicine, and Dr. William Hammesfahr, a board-certified neurologist. Michael Schiavo, Mrs. Schiavo's husband and guardian, selected Dr. Ronald Cranford and Dr. Melvin Greer, both board-certified neurologists, to testify. The fifth physician, selected by the guardianship court when the parties could not agree, was Dr. Peter Bambakidis, a board-certified neurologist practicing in the Department of Neurology at the Cleveland Clinic Foundation in Cleveland, Ohio. He is a clinical professor of neurology at Case Western Reserve University. His credentials fulfilled the requirements of our prior opinion.

Through the assistance of Mrs. Schiavo's treating physician, Dr. Victor Gambone, the physicians obtained current medical information about Theresa Schiavo including high-quality brain scans. Each physician reviewed her medical records and personally conducted a neurological examination of Mrs. Schiavo. Lengthy video tapes of some of the medical examinations were created and introduced into evidence. Thus, the quality of the evidence presented to the guardianship court was very high, and each side had ample opportunity to present detailed medical evidence, all of which was subjected to thorough cross-examination. It is likely that no guardianship court has ever received as much high-quality medical evidence in such a proceeding.

Did the Schindlers presented new evidence to back up their claims?

On the issue that caused this court to reverse in our last decision, whether new treatment exists which offers such promise of increased cognitive function in Mrs. Schiavo's cerebral cortex that she herself would elect to undergo this treatment and would reverse the prior decision to withdraw life-prolonging procedures, the parents presented little testimony. Dr. William Hammesfahr claimed that vasodilation therapy and hyberbaric therapy "could help her improve." He could not testify that any "specific function" would improve. He did not claim that he could restore her cognitive functions. He admitted that vasodilation therapy and hyberbaric therapy were intended to increase blood and oxygen supply to damaged brain tissue to facilitate repair of such tissue. These therapies cannot replace dead tissue.

[Gringo1]

"Once again your lack of comprehension does not disappoint."

Say something that makes a lick of sense given the legal argument here and maybe you will get an answer.




"I believe that God is in charge. I further believe that even if He isn't, Terri left nothing in writing - all we have is the highly suspect word of her husband that her wish is to die."


Here is where your bias comes in.

So your argumentis that the world should do what the god squad says because she didn't write anything down, you do not like her husband, and god is in charge.

And once again:
"So tell us how she can be suffering now, while being nourished, but how she won't suffer once she starts starving"

Tell me how she isn't suffering. How do you know?
This shell game can go on forever, and the word game cuts both ways.You want me to offer proof, I want you to offer proof....woohoo! we are really getting somewhere now.

Face it, the god squad lost in court when it tried to strip her legal guardian of his rights, and will again when the Florida legislatures Save Terri Law gets a hearing before people who are not blinded by religious zealotry and a hatred of Terri Schiavos husband.

[TaxRelief]

Gosh, yes. You are right. Stephen (aka liar) Barrett = quackwatch. (George you really need to check your sources before posting. Hint: Look for credibility.)

From: quackpotwatch.org

ABUSING THE LEGAL SYSTEM TO HARASS AND INTIMIDATE...

Barrett brags about how he sues people. He sends threatening letters demanding money of those that disagree with him publicly, claiming he "will flatten them." He gloats in his communications about how much money he has cost those that disagree with him.

To [Tim Bolen], there is no substance to any of Barrett's legal actions - it's ALL "harassment and intimidation." It is the way Barrett operates.

My research finds that Barrett has NEVER won a case in a court of law - period. And, he has never, EVER, had to face a jury. He has, though, LOST legal actions, because of legal screw-ups, six times that I know of, at the hands of Judges.



CRACKPOT LAWSUITS?

(1). Stephen Barrett sued an author and a publisher over statements made about Barrett in a book. The author lives in Louisiana, and the publisher is in Virginia. Barrett lives in Pennsylvania. So why then did Barrett sue them in Minnesota?

That's what the Minesota Judge wanted to know, and when he wasn't satisfied with the answer, he dismissed the cases. Barrett LOST TWICE (author and publisher).

Was there a sale on lawsuits in Minnesota that day?

(2). Barrett sued the authors of another book, and someone who quoted it, in Pennsylvania. The authors lived in California, and the person who quoted the book lived (at the time) in Oregon. The Oregonian challenged the jurisdictional issue - and of course the Pennsylvania Judge (probably scratching his head) agreed, dismissing the case. Barrett LOST again.

The authors, not to be outdone, pointed out to the Pennsylvania Judge, that Barrett conveniently neglected to file the case within the statute of limitations time period. The Judge agreed (again, probably scratching his head) dismissing the case. Barrett LOST TWICE more (two authors).

(3). Barrett sued a prominent California MD over an article published in a magazine. The doctor pointed out to the Judge that, again, Barrett neglected to remember (or intentionally forgot?) the time limits imposed by the statute of limitations principle. The Judge agreed (more head scratching?) and dismissed the case. Barrett LOST again.

(4). Barrett has since sued a DEAD MAN in Oregon. We are awaiting the outcome of that action. I surmise that when you are dead it may be difficult to defend yourelf in a court of law. Barrett may have found, in this tactic, a way to WIN a case.

If this works for Barrett, I can picture his quackpot minions scanning the "Obituary" columns in their local newspapers.



BARRETT'S CRACKPOT "NON-LAWSUIT" AGAINST ME...

There are simple rules for legal actions. They must be followed. Those rules are relatively the same across the US. As you can see from above, Barrett has a little trouble with two of those rules, "Jurisdiction" and "Statute of Limitations."

But I have another rule to point out he's having trouble with. It is called "Service." When you sue someone you have to OFFICIALLY tell that person, or entity, that you are suing them. Although it would certainly be handy to be able to sue someone, and not have to tell them, so you could have the judge, the courtroom, and the jury "all to yourself" - it just isn't "our way" in America.

Supposedly, Barrett filed a lawsuit some time last November, 2000, against me, and several other alleged defendants. However, AFTER FIVE MONTHS, NONE OF US HAVE EVER BEEN PROPERLY SERVED.

I have no explanation for Barrett's antics on his website, regarding the alleged lawsuit.

Draw your own conclusions...



Tim Bolen

JuriMed - Public Relations and Research Group

jurimed1@yahoo.com

[Calpernia]

So are you saying Dr. Webber is/would have been allowed to examine Terri?

[TaxRelief]

The important question is this:

Was the good Doctor's license on probation before
or after the evidentiary hearing?

Probation or payback?

You decide.

[Dog Gone]

It was my understanding that Judge Greer had ordered NO autopsy as requested by his buddy, Michael. Did something change?

I hadn't heard that, and I would find it a little surprising. According to the Florida Code, it's not the judge's decision to make.

[george wythe]

The Department of Health of Florida reports that the Schindler's neurologist has his license in probation.

The Department of Health of Florida website reports that the Schindler's neurologist has two fines in his record, one for $2,000 and another for $52,084.40

Therefore, the claims in Quack Watch have been taken seriously by other doctors beyond Quack Watch.

Furthermore, Harvard's neurologists' bulletin board reports about the Schindler's neurologist:

If you do a medline search using his name, you will find that NO reliable medical journal has published his work.

What this means is that, if he had evidence that he felt WOULD be scientifically proveable, and submitted that evidence, upon review by his peers it was found to be not valid.

Most of us are helped to a degree by increased blood flow, which is why exercise is generally recommended, but I believe dialating the vessels to accomplish that could be deadly to certain individuals.

The St Petersburg's Times confirms the above:

Some patients said Hammesfahr's mixture of heart and blood pressure drugs worked wonders. But other doctors said nobody could tell whether his treatment works because he has not subjected his theory to controlled, scientific studies. He was mentioned on Quackwatch, a Web site focusing on fraud and quackery in medicine, and his articles were turned down by well-known medical journals.

Is this controversial doctor the only neurologist that the Schindlers could find to support their case?

[RGSpincich]

The trial court summarily denied the petition for examination and 1.540(b)(5)motion. 800 So.2d at 643

The appellate court granted the examination October 2001.

PDF File Appellate Ruling October 17, 2001

III. PROCEEDINGS ON REMAND

Although the court’s obligation to make this decision arises from Mrs. Schiavo’s constitutional right of privacy, the fact that a state trial court must make this lifeand- death decision unfortunately necessitates a very public airing of her constitutionally protected privacy rights. The open proceedings are essential to assure that the public understands the legitimacy of this process. In this regard, we conclude that the Schindlers’ petition for an independent medical examination should be treated as a request for discovery within this proceeding. We conclude that the trial court should grant this request within very specific confines.

In their motion, the Schindlers have presented the affidavits of seven doctors. Of these doctors, only Dr. Webber has gone so far as to suggest that available treatment could restore cognitive function to Mrs. Schiavo. Because this claim raises the motion to the level of colorable entitlement requiring an evidentiary hearing, the Schindlers will need to present similar evidence at the hearing to support their claim for relief from the judgment. Recognizing that the opinions of the remaining doctors may have been limited by their inability to examine Mrs. Schiavo or obtain necessary diagnostic information, we

(6 Although it may be sensible for both sides to select physicians who are already involved in this case, we are not restricting them to such physicians.)

-11- do not restrict the Schindlers to presenting only the testimony of Dr. Webber. Rather, the Schindlers may choose two doctors to participate in discovery and present their opinions at an evidentiary hearing.

In addition, to control the scope of this hearing and to prevent the proverbial “war of experts,” Mr. Schiavo may introduce in rebuttal the testimony of two doctors of his choosing.6 In order to obtain the best available medical evaluation and because at least one of the Schindlers’ experts in his affidavit has accused the treating physicians of malpractice, we further conclude that the trial court should appoint a new independent physician to examine and evaluate Mrs. Schiavo’s current condition. ...

[george wythe]

So are you saying Dr. Webber is/would have been allowed to examine Terri?

I'm not saying anything else to you since you are being deliberately obtuse.

Read the links I have already provided.

Dr. Webber whined in an affidavit that Judge Greer had allowed him to testify about his methods in 2001.

The court of appeals ordered a brand-new evidentiary hearing to allow Dr. Webber to testify.

The Schindlers were given the chance to produce Dr. Webber and another doctor chosen by them to make their case in a brand-new evidentiary hearing in 2002.

Dr. Webber did not show up, to the surprise of the appeals court.

[Saundra Duffy]

Several of us have asked you to explain how it is that if she's PVS and therefore not suffering, it's torture to keep her alive.

The "suffering" is by Michael Schiavo because he's losing money every day she's alive.

[Calpernia]

Whatever happened to his license, the date of probation is 10/27/2003

Since when does a physician have to be published?

>>>Is this controversial doctor the only neurologist that the Schindlers could find to support their case?

Is quackwatch.org the only website that George Wyeth can find to support his case?

[Armed Civilian]

Hello again you pseudo, compassionate, conservative, troll. We meet again. I should have known this article would be from you. Do you have your protectors out here again? or will you actually reply to me. You seem to never want to engage, just let others protect you. Is tamsy out here? I have known and been aroud those with feeding tubes who are brain damaged, their life is as valuable as yours. Who else would you like to see dead since that seems tho only thing you will post out here.

[Armed Civilian]

Today you are the statue.

[Armed Civilian]

Suffering, I can't wait for the LK interview tonight. His lies are disgusting.

[george wythe]

The important question is this:

Was the good Doctor's license on probation before or after the evidentiary hearing?

Probation or payback?

You decide.

Published October 22, 2002

A neurologist who says a treatment he pioneered might help improve the condition of Terri Schiavo has been accused by the state of making unproven claims about the effectiveness of the procedure.

The Florida Department of Health filed administrative complaints against Dr. William Hammesfahr last year accusing the Clearwater physician of falsely advertising his treatment and exploiting a patient for financial gain.

So let's see. The evidentiary hearing started in October 12, 2002, the complaint was filed the previous year.

I think I need

[Calpernia]

>>>The appellate court granted the examination October 2001.

Now that is really interesting. Cause the petition denying Dr. Webber from examining Terri is, "The trial court summarily denied the petition for examination and 1.540(b)(5)motion. 800 So.2d at 643":

APPENDIX TO JURISDICTIONAL BRIEF OF PETITIONER 1.October 17, 2001, Opinion of the District Court of Appealof the Second District of Florida.

[MEGoody]

The reality is, the brain is so complex, humanity is just beginning to have an inkling about how it works.

Terri has brain activity. There is disagreement among family members and 'experts' on how alert she is.

Absent a living will, and when there is disagreement about the individual's wishes among family members, we should err on the side of life.

[Calpernia]

And our circle dance comes to a close. An ethical doctor cannot testify on behalf of a patient unless he can examine her.

Smooches to you.

[Legerdemain]

I have yet to read anywhere what the prognosis might be of anyone who has already lived this long in a PVS. The article defines in a cogent and clinical manner the exact definition of a PVS. But it still doesn't present a decent argument for ending or continuing a patient's existing state of living.

I posted this question to my brother who is a doctor and his response is she will never recover, and that when someone is in a cvs for just 3 months the odds are infantismal they will ever recover

So, it appears that after 12 additional years, the chance's are 0% of a recovery. And I am gueesing that if "God" was going to perform a miracle, he would have done it by now. So, let this woman pass away in peace and stop the insanity

[MEGoody]

"When you good christianscan explain to me how you know what god wants, I'll explain how she is suffering."

We know that God does not want Terri dead yet. If He did, she'd be dead.

Your turn.