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.

[Old Professer]

Let's assume that we can get other people to see your quite rational analysis here; if just one rich-enough person would offer Michael Schiavo $1,000,000 to relinquish custody to the parents of Terri would this whole problem go away or would it be then shown for the miserable act we believe it to be?

[shhrubbery!]

This article will NUKE yours:

NY Times: What if There Is Something Going On in There?
(inside the minds of patients in 'persistent vegetative state)

[FITZ]

Don't worry ---- I am going to the links. There is also this to consider --- from one of the links:

This is because courts often discount a person's prior statements when they were made in general terms, in casual circumstances, as a spontaneous reaction to another person's medical treatment or while the person was young and in excellent health.38 Hence, in the absence of formal documentation or of repeated expressions in the setting of formal discussions, courts may find that the patient's wishes were not clearly expressed. The court's finding will sometimes turn on the nature of the life-sustaining measure. For example, some courts are more likely to permit withdrawal of a ventilator than withdrawal of artificial feeding.39 This difference primarily reflects the fact that ventilators are more readily viewed as "heroic" or "extraordinary" than are artificial feedings.

[TheAngryClam]

Unless, of course, the brain scans of Terri that are in the (sealed) court record that show she has no cerebral cortex left are correct.

That article depended on there still being a brain in there to have neurons firing.

[HiTech RedNeck]

Had Terri foreseen how Mike was going to act, would she have wanted things the way you do for yourself? The default should there be any question that one might not want it, should be on the side of life.

[ThanhPhero]

The article describes the vegetative state very well and precisely. The problem here is that Terri is not in such a state. Watch the videos. Terri is disabled but with therapy she might well be less disabled. She might have been trying to commit suicide, I suppose, by putting an overdose of potassium in her dinner.

[TheAngryClam]

Courts may... and some courts.

Not "the court will."

[Politicalmom]

Yes. After she was REFUSED the right to see if she CAN eat.

[T'wit]

>> ... he spelled out on his letterboard, "Speechless!"

Beautiful!

Stories of "miraculous" recoveries are common. My wife's niece was diagnosed with a hopeless brain disorder and only a short time to live. She not only survived, she lives a good life and takes care of herself, with no medical clouds on the horizon. And she has a heart of gold.

The Left knows this argument perfectly well. They themselves use it often to argue, for instance, against the death penalty because the convicted criminal might be found innocent some day.

Well, Terri and a thousand other disabled people -- innocent, harmless, blameless people -- might recover. But here the Left unfailingly argues that they must die. They exaggerate every detail to show that the person is a vegetable and mustn't be permitted to live.

That gives you a window on how they value life. On the one hand, they are pro-life for hardened criminals and killers on Death Row. On the other, they are pro-death for the innocent and helpless in nursing homes.

[Moonmad27]

Keeping her alive in that horrible state is cruel. This author is right in one point - the family wants to keep her alive until...what? How awful it would be to be trapped in her own body the way she is. I can't imagine a family wanting to keep someone that way.

[sirchtruth]

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.

How about grandstanding columnist letting go of their incoherent babbling and idiotic synoptic wrongheaded opinions!!

What would it even matter if she was in a vegatative state? There is no living will stating that she wanted to die if such a case occured.

These people have no idea what assbackward illegitimate thoughts they produce...

[TheAngryClam]

She also was suffering from a severe electrolyte imbalance due to bulimia at the time.

and Potassium Chloride is used as a low-sodium alternative to table salt, so she might have been cooking with that (no evidence for the second conjecture, the first is admitted by even her parents).

[FITZ]

But if she has no cognition as alleged, how can she suffer?

Exactly. If she's just laying there like a cabbage as some claim --- there is no suffering at all. She's only taking up a small space in this world, she's not keeping Michael from a divorce. He can move on.

[Politicalmom]

Well, that isn't the case here, since Terri's FAMILY (parents and siblings) want to take her home and care for her. I doubt there would BE many medical bills if she were actually CARED for.

[Dog Gone]

Do you really think that the outrage of the majority of the posters to these threads is based on a false hope of recovery?

I don't know if it's a majority, because I haven't tried any sort analysis like that. I have seen, and so have you, many comments that talk about the lack of therapy sessions for her, and even that her husband is trying to kill her so that she can't ever reveal how he tried to murder her.

I'm strangely neutral as to how this is resolved, perhaps because I know I'd prefer to die if I'm ever in Terry's condition. Why be a financial burden on society if I'm never going to enjoy even the simple things in life, and especially if I don't even know I'm there at all?

That's why I've had a living will for years.

On the other hand, if Terri's parents want to pick up the financial tab for keeping their daughter alive, how can anyone argue against that?

People will learn something from this case which is very important. If you don't want to be kept alive in such a situation, you should have a living will (or whatever it may be called in your jurisdiction). But, if you DO want to be kept alive, you should take the affirmative action to write that down and deliver it to more than one person.

None of this would be happening, if we only knew for sure what Terri wanted.

[HiTech RedNeck]

The cortex is the outer layer of the brain. Has anyone any inside info as to how much of it is gone in Terri? The medical records are sealed tighter than a drum and we only know what new-age spaced-out talk-to-other-souls Felos says.

[Old Professer]

But Ganzini, director of the Palliative Care training program at the Portland Veterans Affairs Medical Center, said the study should change some minds.

"We are not at the point of saying this is a reasonable alternative for everyone," Ganzini told Reuters in an interview. "But it is a possibility for many more patients."

As a veteran, this is certainly comforting; I was planning on kicking and screaming, but I guess I won't have the strength for that, now.

This next line from one of the nurses deserves a place in the next Book of Malaprops:

8 percent of patients were thought to have had a relatively poor quality of death

[pitinkie]

My dad stopped eating and drinking after multiple brain infarcts. He died at home after 5 days. He did not seem in pain and was aware his family was there. I did apply a Duramorh patch however. I do not advocate doing this to Terri because of her history and I think she is in a minimally conscious state.

[ThanhPhero]

proud of my fellow 'conservatives'

I am skeptical of the phrase "my fell..." here. I have yet to see any Ambrosian comments that would justify its use.

[FITZ]

Does her family keep her alive, only to lose her years later from multiple organ failure, amputation due to decubitus, difficulties in dehydration and nutrition, respiratory failure?...

Well --- every last one of us will die someday --- maybe years from now from one of those exact ways. Her family believes they see something more, they believe they have seen her respond in various ways to them. Michael believes she's nothing more than a carrot ----- so why doesn't he pack his things and move on? He's got a new family --- he can leave Terri to hers.