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.

[FITZ]

The ones that opine there is some living cortex tissue left and the ones that don't, both have no surefire way to tell without opening up the cranium and looking, which would be out of the question.

Normally in a brain injury, the whole brain is still there --- just parts of it have become inactive from lack of oxygen which destroyed the function of the neurons --- but they neurons don't go anywhere. If her brain is actually physically gone ---- then where did it go? There is a blood-brain barrier --- so it's unlikely the brain got absorbed into the blood stream. Brain tissue doesn't just poof and disappear into thin air.

[Budge]

On www.terrisfight.org under "downloads" you will find this info. Because of the difficulty reading the PDF document, I posted it HERE. Read and follow the directions below first.

Under the photo is a link: "Get Origional Uploaded Photo" click that.

Once the larger photo loads and it still isn't large enough to read, move your mouse totally off of the photo, then back on. A short "menu bar" will appear in the top left corner of the photo, and in the bottom right corner an "enlarge icon" will appear. When you click on the "enlarge icon" you may have to move the photo around using the scrooll bars on the right side, and possibly the bottom.

To exit that photo simply click your browsers "Back icon."

[secretagent]

Doctors aren't suppose to make specific predictions on functions. Any doctor, or in this case, Alleged Expert, that makes specific predictions are negligent.

Please expand your comment a bit. The court held an evidentiary hearing to assess Terri's chances for recovering "increased cognitive function".

"On the issue that caused this court to reverse in our last decision, whether new treatment exists which offers such promise of increased cognitive function in Mrs.Schiavo's cerebral cortex that she herself would elect to undergo this treatment andwould reverse the prior decision to withdraw life-prolonging procedures, the parents presented little testimony."

I don't see the point of the doctor's opinions, at the evidentiary hearing, unless they hazard predictions of the liklihood of "increased cognitive function".

[FITZ]

Many terminal patients "turn their faces to the wall and refuse to eat."

I know one thing that happens quite commonly with real terminal patients ---- those actually in the process of dying from something like cancer. They're given pain killers and their doctor will tell them --- "Take one of two of these pills for pain, if you take six or more you'll probably go to sleep and never wake up." Then at some point the patient does take 6 or more and never wakes up ---- no one really knows if the patient forgot and took too many or if the patient made a conscious choice to go to sleep forever. Of course this is in a conscious person and one so terminal they're having to live on pain killers.

[The Old Hoosier]

Again, it's a very simple question about whether a third party can decide you die. That's all this is, "legal guardian" or no.

If you are unable to make the decision yourself, can someone else make it for you in the absence of any Living Will or other such document?

It sets an extremely scary precedent. It won't be long before "legal guardians" decide Grandpa's a goner when he gets a little bit out of it.

[yesnettv]

You were not replied to because they get thousands of e-mails a day and can't answer all of them. Duh!

[The Old Hoosier]

Low quality of life is never a reason to starve someone to death. Never.

[The Old Hoosier]

Christ was pretty nasty to those money-changers.

[secretagent]

"There is a blood-brain barrier --- so it's unlikely the brain got absorbed into the blood stream. Brain tissue doesn't just poof and disappear into thin air."

Acute contusions show hemorrhagic necrosis and brain swelling. Gradually, macrophages pick up necrotic brain tissue and blood. Eventually, the contusion evolves into a yellowish plaque.

http://www.akronchildrens.org/neuropathology/CHAPTER_FOUR.html

Now to google "macrophages".

[Lessismore]

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

OTOH, suppose she has cognition.

Suppose that she can't see, can't speak, can't hear, can't move, but her damaged nerve endings are communicating to her brain that she is in a burning lake of sulfur.

[PleaseNoMore]

Your post nailed it. Michael Schiavo changed HIS mind.

[Robert A Cook PE]

The HINO has not allowed ANYBODY/ANY DOCTOR to independently examine TS in ANY FORM.

Why?

(He doesn't want her to recover from her trauma - because he wants her dead, and he absolutely needs to control what information the media gets ... and gives.)

[FITZ]

Acute contusions show hemorrhagic necrosis and brain swelling

I know about macrophages and how that might work with contusions and hemorrhagic necrosis ---- but that didn't seem to be Terri's diagnosis --- or did she have contusions from certain head injuries? I read somewhere it was insufficient circulation to the brain which damaged neurons.

[I still care]

Thanks for the info.

[Robert A Cook PE]

becasue, TS DOESN'T WANT TO DIE.

(Oh, she does want to die? Who says so? ....

The HINO who wants to kill her?)

[Robert A Cook PE]

HIS doctors.

Not the family's doctors.

Who are you going to believe: The HINO's experts who want her dead?

[Calpernia]

Dr. Webber submitted an affidavit disputing the diagnosis of persistent vegetative state and therapies that offer good opportunity of improvement.

Dr. William Hammesfahr claimed that vasodilation therapy and hyberbaric therapy "could help her improve."

Dr. Webber was denied the opportunity to examine Terri. Therefore he cannot speak on specifics of Terri.

Dr. Hammesfahr was asked to testify on "specifics" that would be improved.

So the parents didn't present little testimony. The courts didn't allow room for Dr. Webber's evidence and Dr. Hammesfahr was asked to predict how Terri's theray would leave her in the end.

If this isn't the response you were looking for, please be more clear on your question.

[epow]

So is Terri Schiavo still alive?

Of course she's alive, she breathes on her own and her heart beats regularly without external electrical stimulation. Her digestive system works and her blood circulates at the direction of her living brain. That doesn't happen when people are dead. It isn't too hard to tell if someone is dead or alive as long as you don't have a vested interest in their being dead.

Question, if Mrs. Schiavo has no concious knowledge of her condition or her suroundings as the pro-euthanasiacs claim, why do they want her dead? If she is not aware of anything and has no sensations in her body as they claim, IOW if she is just a vegetable, how can she be suffering or even mildly uncomfortable? Why are they so anxious to see her distressed parents and siblings grieving over her death as soon as possible? As long as life is in her body her family has some degree of hope to help assuage their grief. Maybe the money Mr. Schiavo stands to gain at her death explains why he apparently wants her dead, but what motivates those other people who have nothing to gain by her death?

Most Christians and Orthodox Jews believe only God has the right to say when a person dies, so that explains their desire to have her live until natural death overtakes her. But what drives non-believers to so passionately want her killed? The Judeo/Christian religions celebrate life as a gift from God, what kind of perverted religion or philosophy celebrates death?

[secretagent]

Anoxic/Ischemic Injury: If the neuron is deprived of oxygen or glucose for more than 5 to 7 minutes, it dies. This is manifest as the cytoplasm becoming pink and homogeneous (eosinophilic) and the nucleus becoming dark and shrunken (pyknotic), with eventually the cell disappearing entirely.

http://www.uvm.edu/~jkessler/NP/neuropbr.htm

Cranford referred to Terri's "anoxic/ischemic" trauma. Loss of oxygen ("anoxic") causes the neuron to die.

I thought she had a 10 minute loss of circulation from a heart attack, causing the anoxia.

[litany_of_lies]

There MAY stil be a "there there," we just don't know, and Mikey won't let us find out.

If we follow the author's advice, anyone who wants to off a borderline PVS person just needs to stall for 3-6 months, say it's too late for therapy to do any good anyway, and get permission to do the deed.

I sense that the medical community and their bean-counting friends in the government and at the HMOs is beginning to organize against Terri and those in similar cases. If the Schindlers get hold of her and Terri recovers coherence, it will set their entire "right to die" and "futile care" agenda on its ear. This is beginning to look like the MOAB (Mother of All Battles) for the pro-life movement.

(I'm a recovering bean-counter, so I understand what happens when the bean-counting mentality takes over common sense and humanity)