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Responding to Patients in the Persistent Vegetative State (Schiavo)
http://www.xenos.org ^ | Fall 1996 | Donal P. O'Mathuna, Ph.D.

Posted on 03/23/2005 5:52:58 AM PST by RedBloodedAmerican

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Long read, but interesting.

So how bad off was Terri in her first few years? With proper care, she would not be where she is now; she has gotten worse due to neglect.

1 posted on 03/23/2005 5:52:58 AM PST by RedBloodedAmerican
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To: Peach

Found this interesting, thought you might also.


2 posted on 03/23/2005 5:53:18 AM PST by RedBloodedAmerican
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To: RedBloodedAmerican
This MD tried to testify for her and was ignored.(William M. Hammesfahr, M.D.) It is basically his final conclusion of Terri's condition. I have left out parts because it is lengthy but I think you can get the jest.

MD's all over the country are disagreeing with the PVS diagnosis.

Seems that if you want a severely brain damaged person killed all you have to do is shop around for the right doctor.

Impression:

The patient is not in coma.

She is alert and responsive to her environment.

She responds to specific people best.

She tries to please others by doing activities for which she gets verbal praise.

She responds negatively to poor tone of voice.

She responds to music.

She differentiates sounds from voices.

She differentiates specific people's voices from others.

She differentiates music from stray sound.

She attempts to verbalize.(!!!!!)

She has voluntary control over multiple extremities

She can swallow.(!!!!)

She is partially blind

She is probably aphasic and has a degree of receptive aphasia.

She can feel pain.

On this last point, it is interesting to observe that the records from Hospice show frequent medication administered for pain by staff.

With respect to specifics and specific recommendations in order to carry out the instructions of the Second District Court of Appeal:

From a neurological standpoint: The patient appears to be partially blind.

She needs a full opthamological (eye) evaluation and visual evoked potentials done to flash and checkerboard patters. The opthamological examination is to evaluate her retina and her ophthalmic nerve to try to determine the cause of her visual limitations and if any treatment exists. The evoked potentials looks at the nerve between the eye and the visual centers in the brain, to see if there is treatable damage and the type of damage, if any in these areas.

This is important, as for individuals to interact with her...

*snip*

Communication: She can communicate. She needs a Speech Therapist, Speech Pathologist, and a communications expert to evaluate how to best communicate with her and to allow her to communicate and for others to communicate with her.

Also, a treatment plan for how to develop better communication needs to be done.

*snip*

ENT: The patient can clearly swallow, and is able to swallow approximately 2 liters of water per day (the daily amount of saliva generated). Water is one of the most difficult things for people to swallow. It is unlikely that she currently needs the feeding tube.(!!!!!) She should be evaluated by an Ear Nose and Throat specialist, and have a new swallowing exam.

*snip*

Her physical exam and videotapes also suggest a spinal cord injury is also present, as she has much better control over he face, head, and neck, than over her arms and legs.

This reminds one of a person with a spinal cord injury who has good facial control, but poor use of arms and legs. It is possible that a correctable spinal abnormality such as a herniated disk may be found that could be treated and result in better neurological functioning. This should be looked for, as may be treatable.

Thus, there may be an injured disk or spinal cord; the disk injury is more treatable, the spinal cord injury, if present without a disk injury, may be more difficult to treat.

A person with a spinal cord injury and hypoxic encephalopathy will need different treatment and rehab recommendations than one who just has a hypoxic encephalopathic.

Interestingly, I have seen this pattern of mixed brain (cerebral) and spinal cord findings in a patient once before, a patient who was asphyxiated.

*snip*

____________________________ William M. Hammesfahr, M.D.

3 posted on 03/23/2005 5:56:53 AM PST by Earthdweller (US descendant of French Protestants)
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To: RedBloodedAmerican

I've read that. Thanks.


4 posted on 03/23/2005 5:58:10 AM PST by Peach (The Clintons pardoned more terrorists than they ever captured or killed.)
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To: RedBloodedAmerican

Thanks. I'll read the body of the essay later, but I did read the conclusion.

I agree with the writer's sentiments.


5 posted on 03/23/2005 5:58:17 AM PST by ColoCdn (Neco eos omnes, Deus suos agnoset)
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To: Earthdweller
One of the hardest of these is to let a loved one die when medical technology could keep him or her alive.

A feeding tube is not an example of "medical technology". It's the functional equivalent of a spoon. The consequence of removing it isn't "letting" a person die; it is causing the person's death in the same way that letting go of someone's hand who is held over a precipice is causing his death, not "letting the nature of gravity take its course."
6 posted on 03/23/2005 5:59:45 AM PST by aruanan
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To: Earthdweller

I posted the last few days some stuff by Hammesfahr. I was interested in him after his comments on cable news about Terri. But looking at his testing, he doesn't have trials that have any accountability. It makes me suspect of his work, personally. However, there are plenty of others who have accountability and are associated with large medical units, like UCLA, who have voiced their opposition to what is happening to Terri.


7 posted on 03/23/2005 6:01:00 AM PST by RedBloodedAmerican
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To: Peach

Well, I figured you had but wasn't sure, so pinged you. I still think she is 'salvageable', if you can call it that, to a point where she could bring her parents joy. More time goes by, the less she will recover to any degree. How could Michael and the courts have gotten this far?


8 posted on 03/23/2005 6:02:47 AM PST by RedBloodedAmerican
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To: RedBloodedAmerican
FYI...

I've met Dr. O'Mathuna a few times. I was a regular attender of Xenos for a number of years - that was where I met him.

9 posted on 03/23/2005 6:03:11 AM PST by Bosco (Remember how you felt on September 11?)
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To: RedBloodedAmerican

Because even her parents admitted they knew that Terri was PVS.

Because these kinds of cases have been handled between families and doctors for years without judicial in intervention.


10 posted on 03/23/2005 6:04:51 AM PST by Peach (The Clintons pardoned more terrorists than they ever captured or killed.)
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To: RedBloodedAmerican

There are 30,000 people currently designated PVS in this country.

Their days are numbered.


11 posted on 03/23/2005 6:06:58 AM PST by Rutles4Ever (Warning: may eat own)
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To: Peach

This article was written in 96. She supposedly told Michael she didnt want to live on life support in 97, IIRC.
Didn't anyone want to give her therapy back then, or was Michael afraid she would recover and tell her story?


12 posted on 03/23/2005 6:07:27 AM PST by RedBloodedAmerican
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To: Rutles4Ever

Yup. Courts are going to start the thinning.


13 posted on 03/23/2005 6:08:06 AM PST by RedBloodedAmerican
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To: Peach

"Because even her parents admitted they knew that Terri was PVS.

Because these kinds of cases have been handled between families and doctors for years without judicial in intervention. "

I have read your rationale for why you support the Judge and Mike, and how you portray the parents. You have made your call and you have the joined with the side that believes that judges are supreme.

What you have totally ignored is that Constitution that tells us where RIGHTS come from and there is nothing Godly about what is taking place right before our eyes. Christ told us about those who sit in the seat of Moses, Matthew 23, and you dear lady have joined their lot.


14 posted on 03/23/2005 6:11:12 AM PST by Just mythoughts
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To: RedBloodedAmerican

Terri collapsed and never spoke again in 1990 so she didn't tell MS anything in 1996 or 7.

And she had loads of therapy for the first three years after her collapse.


15 posted on 03/23/2005 6:11:16 AM PST by Peach (The Clintons pardoned more terrorists than they ever captured or killed.)
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To: Just mythoughts

God has not kept Terri alive. A feeding tube has kept Terri alive.


16 posted on 03/23/2005 6:13:25 AM PST by Peach (The Clintons pardoned more terrorists than they ever captured or killed.)
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To: Peach
"Because even her parents admitted they knew that Terri was PVS."

This is the biggest problem with their defense. They keep repeating this even when doctors across the country disagree with that diagnosis every day.

I think I will start a "shop for the right MD" website for people looking to "off" their severely brain damaged dependents.

The way things are going it should be very lucrative.

17 posted on 03/23/2005 6:13:59 AM PST by Earthdweller (US descendant of French Protestants)
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To: RedBloodedAmerican
>Because some doctors decided that Terri would not recover, therefore she has PVS.

Because some judges decided that Terri would not recover, therefore no feeding tube and "nobody better feed her!"

18 posted on 03/23/2005 6:16:01 AM PST by First_Salute (May God save our democratic-republican government, from a government by judiciary.)
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To: RedBloodedAmerican

"So how bad off was Terri in her first few years? With proper care, she would not be where she is now; she has gotten worse due to neglect."

"When PVS resulted from a nontraumatic injury (e.g. cardiorespiratory arrest), only 15% of adults recovered consciousness, with severe disability being more common."

"However, the chances of recovery are much lower after longer periods in PVS. Therefore, the MSTF concluded that PVS should be considered permanent.... three months after a nontraumatic injury."

?????


19 posted on 03/23/2005 6:16:23 AM PST by Smartaleck
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To: RedBloodedAmerican
So, the ethical question arises: should we withdraw artificially administered food and fluids from these patients and allow them die?

It’s not ethical to permit death by slow starvation. We humanely execute our criminals with lethal injections, why shouldn't the same easy death not be extended to comatose patients?

The end stages of diseases like Alzheimer's, Huntington's, and Parkinson's sometimes leave patients in PVS. If we need not feed or hydrate them when they reach that stage, will this influence how we care for them earlier?

These people are usually at the end of their lives when these diseases strike. They will persist in vegetative states for only a few years. Contrast that with someone who gets stricken at a young age, who will endure decades of the condition.

I know I do not want to live in a vegetative state if I have no hope of improvement. Yes, I should and will put this in an advance directive. I think most people do not want to live in a vegetative state. In the absence of an advance directive, should the Golden Rule apply?

20 posted on 03/23/2005 6:18:50 AM PST by A Ruckus of Dogs
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