Medical Affidavit
March 3, 2005
Carolyn Heron M.D. Physical, Medical and Rehabilitation (PMR) doctor. Teaching physical diagnosis and treatment to students at Pilsen Family Medicine in Chicago.
I have seen videotapes of Ms. Schiavo on the news and judged her behaviors and facial expressions. I have also read a number of articles regarding her situation.
Based on my opinion Ms. Schiavo is not in a persistent vegetative state (PVS). Someone in a vegetative state does not respond appropriately to stimuli around her, and does not move voluntarily. A PVS patient may have a following with her eyes, but it does not translate into a facial response. There is no processing of information. Ms. Schiavo does show appropriate facial response to stimuli. She also sits up independently. These behaviors are not consistent with someone in a vegetative state. Therefore, she is at least in a minimally conscious state (MCS). I believe she is better than minimally conscious.
Ms. Schiavo does not choke on her saliva, therefore she has some swallowing function. This is also inconsistent with PVS. It cannot be assumed that Ms. Schiavo will not be able to live without the feeding tube. There are techniques for learning how to swallow. Furthermore she may have some ability now. There is also a method to swalling without aspirating. If the patient sits up straight and swallows using a thick substance she may be able to learn how to swallow.
I would not use the term “vegetative” in describing Ms. Schiavo. She is at least stage two, possible three, on the Rancho Los Amigos Scale.
Meical Affidavit
March 3, 2005
David Hopper Ph.D., Clinical Director of the Bioclarity Program at eh Nevada care Medical Center in Las Vegas, Nevada
1989-1991 Chief Meical Psychologist and Clinical Director of the Traumatic Brain Injury Unit at the University Medical Center of Southern Nevada.
I have published papers on brain injury treatment, including “Neurocognitive EEG Rehabilitation – Neurosensory Feedback Coma Stimulation” and Neurocognitive EEG Rehabilitaton – Use of EEG Biofeeback Following Brain Surgery” which involve using neurosensory feedback for coma stimulation. I have testified as an expert witness in many legal cases involving brain injury.
I have reviewed information about her condition, including reviewing photographs and video of her. I strongly believe that Ms. Schiavo deserves to have a neurological and neuropsychological evaluation.
I have treated ad reviewed cases on many patients who are similar to Terri Schiavo and have worked with many people who were diagnosed with PVS. Often a neurologist diagnoses PVS upon admission and there is no follow-up evaluation which leads to failure to update/change the diagnosis. There is a high misdiagnosis of PVS due to lack of proper cognitive and detailed neurological assessment.
Medical Affidavit
March 3, 2005
Lawrence Huntoon M.D. Neurologist clinical office Derby new York
Editor-in-Chief of the Journal of American Physicians and Surgeons
I have viewed the short video clips on the Terri Schiavo website. Based on those short clips there appears to be evidence that Ms. Schiavo responds to her mother and is able to distinguish her mother form other persons who interact with her. There is also evidence of sustained visual pursuit, which is the clip where she is following the balloon. These behaviors indicate awareness of the environment, and this type of behavior distinguishes minimally conscious state (MCS) from persistent vegetative state (PVS)
The definition and diagnosis criteria for minimally conscious state were published in “Neurology” in February 2002.
Food and water should be offered to patients in the ordinary way in the case where artificial nutrition and hydration are being terminated. Providing food and water in the natural way, by mouth, constitutes “ordinary care” not “treatment.” Ordinary, comfort care should always be provided irrespective of instructions regarding “limitation of treatment”