Schiavo Videotape Misleading, Experts Say

Reuters ^ | 3.23.05

[ambrose]

Schiavo Videotape Misleading, Experts Say

Wed Mar 23, 2005 10:06 PM GMT

WASHINGTON (Reuters) - The videotape that runs endlessly on television stations around the world shows an apparently smiling Terri Schiavo being caressed by her mother's loving hand.

She seems to look deeply, even lovingly, into the off-camera eyes of her mother.

Schiavo's parents and their supporters, including doctors in Congress, have used the tape as evidence the 41-year-old brain-damaged woman is at least occasionally aware of her surroundings and might even be revived from her condition.

They are fighting to get her feeding tube reinserted against the wishes of her husband and legal guardian who says Schiavo would not want to be kept alive in that condition.

But many experts agree the tape is a cruelly misleading trick of biology.

"Pictures do lie," said Dr. Lawrence Schneiderman, a physician and bioethicist at the University of California, San Diego.

"Every time they have done a videotaped neurological examination, the courts have reviewed them and said, 'Yes this woman is unconscious.' Those movements of her eyeballs are reflexive and have nothing to do with recognition."

Studies of people whose cerebral cortices are damaged in the way Schiavo's is show that their eyes will respond to stimuli such as movement or a human face, but there is no way for them to be conscious of what they are seeing.

Florida Gov. Jeb Bush, who has been part of the fight to prolong Schiavo's life, said on Wednesday a review of Schiavo's medical records by a neurologist for Florida's Adult Protective Services indicated she may have been misdiagnosed and was more likely in a state of minimal consciousness rather than in a persistent vegetative state.

Such a condition, in which a patient slips in and out of consciousness, was sometimes mistaken for a persistent vegetative state, said Dr. Joseph Fins of New York Presbyterian Hospital/Weill Cornell Medical Center. But Schiavo was not in that state, Fins said.

"I think now it can be argued that with the advent of minimally conscious state (as a diagnosis), that permanent vegetative state as a diagnosis becomes much more certain," Fins said in a telephone interview.

It is almost certain that when someone suffers brain damage from a lack of oxygen, they are permanently vegetative, Fins said. Schiavo's brain was starved of oxygen after her heart stopped 15 years ago and most doctors who have examined her say there is no chance of recovery.

'UNNERVING PHENOMENON'

Dr. Ronald Cranford, a neurologist and bioethicist at the University of Minnesota Medical School, said reflexes can fool nonspecialists.

"To the families and loved ones, and to inexperienced health care professionals, PVS (permanent vegetative state) patients often look fairly 'normal,"' Cranford said in a statement.

"Their eyes are open and moving about during the periods of wakefulness that alternate with periods of sleep; there may be spontaneous movements of the arms and legs, and at times these patients appear to smile, grimace, laugh, utter guttural sounds, groan and moan, and manifest other facial expressions and sounds that appear to reflect cognitive functions and emotions, especially in the eyes of the family."

Dr. Timothy Quill of the Center for Palliative Care and Clinical Ethics at the University of Rochester in New York, said reporting about the case had confused people.

"Distortion by interest groups, media hyperbole, and manipulative use of videotape have characterized this case and demonstrate what can happen when a patient becomes more a precedent-setting symbol than a unique human being," Quill wrote in a commentary published on Wednesday in the New England Journal of Medicine.

"Anybody who been around patients in a persistent vegetative state knows that it is an unnerving phenomenon because they are alternate between sleep and wakefulness but that have no ability to interact," Quill said in a telephone interview.

"It is difficult for families because it is very difficult to discern that."

[Trust but Verify]

Can you accept that there is distortion on both sides?

[dfwgator]

My opinion is that come the next round of elections this issue will have been forgotten by most people.

[churchillbuff]

WHo ya gonna believe, me or your own eyes?

[HostileTerritory]

I'm curious--do you have any background with reading CT scans? I've seen the CT scan of Terri's brain, and while I can tell there's a big blank spot in the middle, I would never presume that I have the background or knowledge to say what that means.

It bothers me a great deal that Americans on both sides of the issue feel they can make independent judgments on Terri's state. Whether they judge based on a heavily-redacted videotape put out by Terri's Mom, or based on what Michael Schiavo says, it doesn't matter. The Good Lord made doctors for a reason and there is a tremendous amount of material out there, much of it sworn testimony, that is better than anything I can come up with.

I would hate to have any of our armchair neurosurgeons here diagnosing me in case I had an illness.

[Trust but Verify]

Michael is her guardian, like it or not. Even if she had never said she 'didn't want to live like that', he would still be able to make the decision.

We will never know whehther Terri said that or not. Are you married? Do you share things with your spouse that you don't share with your parents and siblings. We don't have living wills (yet), but we are both fully aware of what our spouse wants done.

[sirchtruth]

Are you prepared to tell thousands, probably tens of thousands of people who have made the decision to withdraw nourishment for themselves or relatives that their actions weren't good or honorable?

Are your prepared for a court to order your execution by starvation based on someone's hearsay testimony for supposedly being a vegetable?

If you think for a second that what is happening is a GOOD thing, I would like for you to explain HOW it's good and honorable based of the circumstances of this case.

[TASMANIANRED]

I'm on your side here.

The strongest evidence is what is in the rehabilation records. Michael controls them.

[deadhead]

You're Welcome. When I see a picture or video of Terri, I see a human being who is very much alive. Saddened by this case, depriving one of nutrition (food and water) is so very, very cruel

[Trust but Verify]

There is nothing good or honorable in this case. This should have been settled amicably a long time ago. I can't tell you why that didn't happen. I will not need a court to 'order my execution' as you so delicately and inaccurately put it. My family is well aware of my wishes.

I. however am not prepared to see the law turned upside down over one tragic case.

[northernlightsII]

This is so scary these judges are walking among us,ready to dispense with people as they wish.

[El Gato]

most famously Dr. Stephen Hawking

I guess somebody should have pulled the plug on Hawking way before he even got his PhD or thought about evaporating black holes, the big bang, and all that rot.

"I have had motor neurone disease for practically all my adult life. Yet it has not prevented me from having a very attractive family, and being successful in my work. This is thanks to the help I have received from Jane, my children, and a large number of other people and organisations. I have been lucky, that my condition has progressed more slowly than is often the case. But it shows that one need not lose hope. "
Stephen Hawking

Hawking has 3 children and a grandchild. He did not marry until after he was diagnosed with ALS. He didn't even meet his wife until about the time he was diagnosed.

I wonder if 10 years ago, Terri could have learned to work a voice synthesizer like his. It only requires him to move his eyes and/or press a single switch in his hand. If she could, I wonder what she'd say?

[sirchtruth]

I. however am not prepared to see the law turned upside down over one tragic case.

Name the law that the courts are basing their decision on not to reinstate the feeding tube?

[EggsAckley]

Yup. I'm trying very hard to steer clear of them this week. Bomb throwers.

[Trust but Verify]

How about the law passed in Washington last week that was thrown out by the appeals court panel and refused to be heard by the full court. And what about the stupid subpoena issued? Should we start issuing subpoena's to infant's? They could communicate their wishes as effectively as Terry Schiavo.

I guess what I'm saying is that unlike many people, I'm not willing to let the ends justify the means.

[El Gato]

I for one would like to see CAT/MRI scan to see if there really is any brain function

Not allowed by her nominal husband and the Judge.

[AHerald]

Just posted over at NRO:

READ IT AND WEEP [K. J. Lopez]
A doctor who has seen Terri Schiavo says she's aware of what's going on, feels pain. This is painful.

[A Citizen Reporter]

Thanks for that link. Very interesting. A Doctor who has evaluated Terri has reflected upon his diagnosis and decided that PVS does not describe Terri's condition.

[AHerald]

You're welcome. An eye-opening affidavit, to say the least. It should give genuine pause to those who've supported the tube removal on the basis of the PVS diagnosis.

[deadhead]

Thank You for posting the link.

[steenkeenbadges]

"Can you accept that there is distortion on both sides?

Yes. What I have trouble accepting is the fact that this is being portrayed as a "right to die" scenario (whatever that means), but Ms. Schiavo wasn't dying. Not even in the beginning of this whole ugly mess.

To err on the side of life is infinitely more likely to stand up under God's judgement than assuming something not really proven. It's like abortion in the "first trimester" (or second or third...). When I've asked pro-abortion women how they determine the exact moment that the first ends and the second begins, their response is shakey and evasive. So how do you determine exactly when an act's consequences become certain?

Besides, Bastardo Schiavo (sorry) has refused divorce, a million dollars and other "outs" to simply turn Terry over to the people who love her without limit. In the United States, we take care of our helpless. We don't toss them in the trash heap - especially when someone is stepping up to the plate to take complete responsibility.