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.

[ambrose]

Terri Ping

(don't be offended if I left you out, I don't keep ping lists)

[tallhappy]

What a creep.

These bloodthirsty freaks are nasty.

They want to torture people to death because they are seriously injured.

If they want to kill her just do it. Why the torture of long drawn out starvation? It is a fig leaf to hide their nakedness.

[EllaMinnow]

A BUMP for clarity. Thank you, ambrose.

[Gringo1]

These bloodthirsty freaks are nasty.


Your christ-like attributes are in the hall closet, go get them back.

[T'wit]

Better a damaged brain than this writer's dead soul.

[TheAngryClam]

BTTT

[Gringo1]

Double bump.

You cannot face the "lets make her suffer for another 13 years" crowd with firm medical FACT, they prefer to operate only on emotion(they become liberals when it comes to interfering with the lives of others it seems).

[MarMema]

posturing in response to noxious or other external stimuli.

In watching the short video clips and the much longer one that was circulating here for a time, I have yet to see even the slightest glimpse of posturing in Terri.

[onyx]

Thos looks to be the moost comprehensive compilation of facts posted thus far.

BTTT for reading after my nap.

[Lokibob]

My thoughts exactly. Starvation is a hell of a way to kill somebody.

We treat death row prisoners more humanely then they want to treat Terri.

[incindiary]

"Better a damaged brain than this writer's dead soul."

Hear hear!

[ChemistCat]

Thanks for the ping.

My mother and I are bitterly divided over this. :-( I know her heart is in the right place. She sees this as a "right to die" hill to die on.

I see it as right-to-kill. I cannot get her to see the evidence. For her it is a one-way issue and anything that contradicts her position must be false.

I can see both sides. If Terri had a living will that said what Michael claims she said, I would fight for her right to die just as hard as I've fought for her to receive food and drink. I just do not believe a Catholic girl would want it, and I think Michael shouldn't be her guardian because he's moved on to make another family, and has misused money he swore to a jury he'd spend on her rehab. There are assistive communicative technologies that have never been tried--because he has refused to allow her to even TRY them. And I think everybody has a human right to clean teeth!

My mom is afraid that my support for Terri's parents means that I will ignore her own living will, which explicitly says she doesn't want food or water if she's in a similar state.

Well, I wouldn't let my mom go without pain meds or cleaned teeth. No way, no how, and I'd do everything in my power to let her communicate any change of mind.

This is very painful, and we are just not discussing it anymore.

[TrebleRebel]

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.

[MarMema]

Cranford only has one opinion in any case he sees. It is always 100% predictable. Therefore he is wrong on occasion, but it is rarely reported. This is from a link on my FR page.

"Dr. Ronald Cranford, the euthanasia advocate who hopes to help Pete Busalacchi take care of Christine when she is brought to Minnesota, had a similar case in 1979. Sgt. David Mack was shot in the line of duty as a policeman, and Cranford diagnosed him as "definitely...in a persistent vegetative state...never [to] regain cognitive, sapient functioning...never [to] be aware of his condition." Twenty months after the shooting Mack woke up, and eventually regained nearly all his mental ability. When asked by a reporter how he felt, he spelled out on his letterboard, "Speechless!"

[TheAngryClam]

However, most of the shrill "Save Terri" types here refuse to understand what her condition means, and think there's still a "there" there.

[HiTech RedNeck]

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

[ambrose]

Thos looks to be the moost comprehensive compilation of facts posted thus far.

Are we still allowed to post facts?

[Dog Gone]

I don't think this story is going to have a happy ending for the hundreds of Freepers who been actively supporting Terri and her parents.

I suspect that the recent law sparing her will be ruled unconstitutional, but even if it isn't, she's not going to ever get better. Perhaps I'm wrong on both counts, but I think there is a lot of hoping going on that has led to some false expectations.

[HiTech RedNeck]

Well maybe angry clams aren't there either.