MERGED: Terri Schiavo

[TiaraGurl]

The following was on yahoo-just wanted to post it in the interest of more information.


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 (news - web sites).

"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."

 

[U2Kitten]

Sue

 

[nbcrusader]

This is a different situation.

What many are striving for is a principled way to deal with irriversable conditions that require ongoing, persistent care. It may be easy to say "let this one die". But it should be based on principles that, when consistently applied, produce results that are just.

 

[Maeve]

Hi Sue4u2,

I am so sorry to hear of your loss. And as a mother, I completely agree with you. I could never pull a feeding tube from my child. Your son was very blessed to have you as his mom.....

Terri was denied any kind of medical treatment by her husband for the past fifteen years. Michael wouldn't even let her have an aspirin, for a fever or an antiboitic for infection. No dental care. No outside stimulas of any kind. She wasn't even allowed to leave her room. There are therapies that can be used to help those who are comotose. And sometimes these patients can even recover.

She was also placed in a Hospice Center to die, while her husband collected 1.5 U.S. million dollars.

And finally, dehydration is a horrible death and I believed that this woman truly suffers. Here is what happens. The throat and tongue swells, hallucinations, pain, bleeding, kidney failure and finally the heart stops. And if you think that this isn't suffering, try going for just one day, without water or fluids of any kind. This poor woman can't even ask for something to drink.

 

[Maeve]

The Supreme Court has just ruled that they will not intervine in Terri's behalf. Her feeding tube will not be reinserted.

Very sad news for Terri's family. Please pray for them......

 

[melon]

Terri was denied any kind of medical treatment by her husband for the past fifteen years. Michael wouldn't even let her have an aspirin, for a fever or an antiboitic for infection. No dental care. No outside stimulas of any kind. She wasn't even allowed to leave her room. There are therapies that can be used to help those who are comotose. And sometimes these patients can even recover.

We have addressed this before in this thread. You can't leave your room when your brain literally disintegrates. She has a brain stem. That's it. Some brain damaged patients do recover, yes. However, not all brain damaged patients are alike. Her cerebral cortex, where her ability to be conscious, the ability to think, the ability to have memories, the ability to feel pain, the ability to dream, etc.--that's all gone. It died. It disintegrated. You don't need aspirin or painkillers when you are physically incapable of feeling pain. There's just spinal fluid there now where her brain used to be. When you have no brain, essentially, you cannot recover. She is not an ordinary "comatose" patient. She is, without a reasonable doubt, in a persistent vegetative state and for a reason.

Secondly, if she had an untreated infection, she'd have died from it already, so I tend to doubt that even occurred.

She was also placed in a Hospice Center to die, while her husband collected 1.5 U.S. million dollars.

She was placed in a Hospice center in 1998, I believe. Eight years after she was in the hospital and where Michael believed, on the examination by doctors, that she would never get better. This was after MRIs revealed that her brain had literally disintegrated. Again, you cannot recover if your brain literally does not exist anymore.

And finally, dehydration is a horrible death and I believed that this woman truly suffers. Here is what happens. The throat and tongue swells, hallucinations, pain, bleeding, kidney failure and finally the heart stops. And if you think that this isn't suffering, try going for just one day, without water or fluids of any kind. This poor woman can't even ask for something to drink.

I believe that "deep" addressed this appropriately, so I won't repeat it. Basically, minimal food and liquid intake, like experienced in concentration camps, is painful. A complete cessation of all food and water is not. Terminally ill patients will often consciously refuse all food and water and they die a very peaceful death, contrary to what people would think. The body responds appropriately. However, that's besides the point. She is incapable of feeling pain, because that part of the brain is gone.

There is a reason that every court case has sided with the husband. Contrary to what her parents might say, Terri is the most studied person in her case ever. She's had probably dozens of doctors. She's had several brain scans. She's had 7 years worth of court cases. No one else has ever been given this amount of attention, and patients are unplugged all the time in the U.S. It happens. If we didn't have life support at all in this country, she would have died 15 years ago. That's the consequence of having the technology available.

It is sad all around, but there is no easy answer to this specific case. There never will be.

Melon

 

[Irvine511]

"Here's the question I ask of these right-to-lifers, including Vatican bishops: as we enter into Holy Week and we proclaim that death is not triumphant and that with the power of resurrection and the glory of Easter we have the triumph of Christ over death, what are they talking about by presenting death as an unmitigated evil? It doesn’t fit Christian context. Richard McCormick, who was the great Catholic moral theologian of the last 25 years, wrote a brilliant article in the Journal of the American Medical Association in 1974 called "To Save or Let Die." He said there are two great heresies in our age (and heresy is a strong word in theology — these are false doctrines). One is that life is an absolute good and the other is that death is an absolute evil. We believe that life was created and is a good, but a limited good. Therefore the obligation to sustain it is a limited one. The parameters that mark off those limits are your capacities to function as a human." - Jesuit theologian Rev John J. Paris




this is not respect for life, but its fetishization.

 

[namkcuR]

Media. Politik. Life. Death.

Congress has moved ridiculously fast in the last five or six days to get this bill passed in order to essentially create federal legal grounds to have the feeding tube re-inserted. And boy has it gotten this story all over the news.

There has probably been more coverage of this story in the last week than than there has been of Africa in the last year, if not a longer length of time. Coverage of a story that revolves around a woman whose sad situation is being politicized by a bunch of politicians who all have their own agendas and don't give a flying fuck about Terri Schiavo. It's all about promoting pro-life.

To go on a tangent, I find it infuriating how these conservatives label you a hypocrite if you favor life in one issue but not in another. You know what I'm talking about. And when they do that, it is they who are the hypocrites. I mean, they can pass bills like this as much as they want, but at the end of the day, there's nothing pro-life about legally killing criminals - but that doesn't make them hypocrites now does it? Of course not. Fucking simple-minded politicians. Annoys the hell out of me.

Back to the topic...Congress doesn't care about Terri Schiavo. Jeb Bush doesn't care about Terri Schiavo. The state government of Florida doesn't care about Terri Schiavo. George W. Bush doesn't care about Terri Schiavo. They care about CNN, MSNBC, Fox News, CNBC, etc etc etc talking all week about how these are conservatives and how conservatives are pro-life. That is the sad truth to this. There is a woman who is not alive, not yet dead. Her husband, as suspicious as he looks and sounds, sees the medical evidence leading to the conclusion that she isn't coming back. Her parents cannot let her go. And the smile she doesn't know she's smiling has become a national hot topic thanks to Congress.

So fucking sad there are no words. But aside from Terri herself, if this case has shown me anything else, it's how fucking scared we, as a society, are of our own goddamn shadow when it comes to EVEN opening an intelligent dialog about euthenasia. And that's not a dig at either political side, it's a dig at both. One side is holier than thou on their soapbox and the other side is too scared of losing votes to open their mouths against the holier-than-thou-ness. Which is maddening because Congress would be wiser and more productive to discuss euthenasia openly than to waste their time conjuring up pointless bills like 'Terri's Bill' or whatever it was called, so that if more cases like this happen in the future where we don't know what the patient wanted, we can at least let them go peacefully instead of starving them.

So, basically, what we have is this: Woman is brain-dead. Her parents can't let her go. Her husband wants to get rid of her. Politicians who don't care about her are using her as a rope in an utterly meaningless political tug-of-war. And the media is making a circus out of all of this, a circus that revolves around a woman in a situation for which nothing can be done. Meanwhile, millions are still dying in Africa to something that is preventable. However, politicians don't have anything to gain from that so fuck trying to help those people, that's what Congress says.

It's a fucked up world we live in.

Forgive my cynicism.

 

[WinnieThePoo]

this judge is a good man

 

[The Sneak]

I am not for keeping her alive for any religious or political motive. I'm for keeping her alive because letting her starve is something that it's illegal to do to an animal. Remember, this isn't a case of pull the plug and she stops breathing. She will slowly waste away over 2 weeks. That's cruelty.

I am for keeping her alive because it's the wishes of the parents and siblings, and there is no proof of what she would have wanted. And yes, I think the husband is an asshole who's trying to get rid of her.

 

[jay canseco]

Originally posted by namkcuR
Forgive my cynicism. [/B]

I thought you were being realistic. Cynicism doesn't exist anymore.

 

[Irvine511]

I am not for keeping her alive for any religious or political motive. I'm for keeping her alive because letting her starve is something that it's illegal to do to an animal. Remember, this isn't a case of pull the plug and she stops breathing. She will slowly waste away over 2 weeks. That's cruelty.

I am for keeping her alive because it's the wishes of the parents and siblings, and there is no proof of what she would have wanted. And yes, I think the husband is an asshole who's trying to get rid of her.

as has been stated repeatedly in this thread: refusing a terminal patient food and water is not inhumane; in fact, it is a very human, natural way for someone to die. so long as pain is monitored by doctors, the patient feels no pain. terminally ill cancer patients often choose this method instead of allowing the cancer to kill them, and these are people of sound and conscious mind.

this is not cruel. this is not starving a healthy person against their will.

 

[Moonlit_Angel]

I am not for keeping her alive for any religious or political motive. I'm for keeping her alive because letting her starve is something that it's illegal to do to an animal. Remember, this isn't a case of pull the plug and she stops breathing. She will slowly waste away over 2 weeks. That's cruelty.

And yet again, she will not feel anything.

Besides that, she's been essentially wasting away for 15 years as it is. I can't imagine this is any crueler an option.

What good exactly would keeping her in this state do, for her or for anyone else?

Originally posted by The Sneak
I am for keeping her alive because it's the wishes of the parents and siblings, and there is no proof of what she would have wanted. And yes, I think the husband is an asshole who's trying to get rid of her.

If her husband is indeed a jerk, that totally sucks, as that's not the way to be acting in such tough times as these.

But what the motives of the parents or of the husband are would be, in my opinion, irrelevant in this case. The only thing that matters to me is the fact that she is not going to come out of this, she will not get better. So to keep her alive when that is plain to see just doesn't make sense to me.

Angela

 

[jay canseco]

I apologize for this, but are you sure your opinion is relevant? Is mine?

Are any of the rational arguements that hinge on cruelty relevant? Remember she is braindead. Whatever religious relevance that may have. Whatever rational relevence that may have.

Is one religious viewpoint more relevant than another?

Is any religious viewpoint more relevant than any rational viewpoint? Is it the other way around?

Is religion relevant at all. It can't in any case be rationally defended. We do allow that choice in the Constitution however.

 

[DaveC]

Time to pick this one apart...this is my favorite part of FYM. Picking stupid articles apart.

1. Ms. Schiavo is not terminally ill. She has lived in her current condition for 15 years. This is not about end-of-life decision-making. The question is whether she should be killed by starvation and dehydration.

Correct. She is not terminally ill.

2. Ms. Schiavo is not dependent on life support. Her lungs, kidneys, heart, and digestive systems work fine. Just as she uses a wheelchair for mobility, she uses a tube for eating and drinking. Feeding Ms. Schiavo is not difficult, painful, or in any way heroic. Feeding tubes are a very simple piece of adaptive equipment, and the fact that Ms. Schiavo eats through a tube should have nothing to do with whether she should live or die.

Also somewhat correct. Although I would argue that if someone cannot eat or drink normally, that a feeding tube is life support. Quite frankly, she will die without it.

3. This is not a case about a patient's right to refuse treatment. I don't see eating and drinking as "treatment," but even if they are, everyone agrees that Ms. Schiavo is presently incapable of articulating a decision to refuse treatment. The question is who should make the decision for her, and whether that substitute decision-maker should be authorized to kill her by starvation and dehydration.

Close enough.

4. There is a genuine dispute as to Ms. Schiavo's awareness and consciousness. But if we assume that those who would authorize her death are correct, Ms. Schiavo is completely unaware of her situation and therefore incapable of suffering physically or emotionally. Her death thus can't be justified for relieving her suffering.

Here's where this article takes a sharp left turn towards Stupidville, USA. There is no true dispute to Terri's consciousness because, quite simply, it's a physical impossibility for her to have consciousness and awareness without a cerebral cortex. Ask any first year neuroscience student, and they'll tell you the same thing. So it's true there is no physical suffering, but if you believe in any way that the soul exists, then the soul would be trapped in a lifeless body, which would be justification for relief of suffering.

5. There is a genuine dispute as to what Ms. Schiavo believed and expressed about life with severe disability before she herself became incapacitated; certainly, she never stated her preferences in an advance directive like a living will. If we assume that Ms. Schiavo is aware and conscious, it is possible that, like most people who live with severe disability for as long as she has, she has abandoned her preconceived fears of the life she is now living. We have no idea whether she wishes to be bound by things she might have said when she was living a very different life. If we assume she is unaware and unconscious, we can't justify her death as her preference. She has no preference.

But the first point in this bit is totally moot. She is not aware of a damn thing. You could probably put a bullet into her leg and you might get reflexive movement and a reflexive moan, but that's about it. SHE HAS NO TRUE BRAIN. People need to realize that; she can't physically do anything except react reflexively because the centers for control are all dead, gone, disappeared, and unless they manage to figure out how to do a brain transplant, she ain't getting that back.

6. Ms. Schiavo, like all people, incapacitated or not, has a federal constitutional right not to be deprived of her life without due process of law.

Another moot point. Due process was MORE than followed here, as it seems damn near every court with even the remotest bit of jurisdiction on this case has ruled. It's a damn lot more than most people who get feeding tubes removed get.

7. In addition to the rights all people enjoy, Ms. Schiavo has a statutory right under the Americans With Disabilities Act not to be treated differently because of her disability. Obviously, Florida law would not allow a husband to kill a nondisabled wife by starvation and dehydration; killing is not ordinarily considered a private family concern or a matter of choice. It is Ms. Schiavo's disability that makes her killing different in the eyes of the Florida courts. Because the state is overtly drawing lines based on disability, it has the burden under the ADA of justifying those lines.

Oh, don't start with this "discrimination" bullshit. There's a difference between someone in a wheelchair with full brain function and someone who's just a lump of skin, bones, and organs.

8. In other contexts, federal courts are available to make sure state courts respect federally protected rights. This review is critical not only to the parties directly involved, but to the integrity of our legal system. Although review will very often be a futile last-ditch effort—as with most death-penalty habeas petitions—federalism requires that the federal government, not the states, have the last word. When the issue is the scope of a guardian's authority, it is necessary to allow other people, in this case other family members, standing to file a legal challenge.

I will assume this article was written before the Federal court and Supreme Court had their hearings on the issue.

9. The whole society has a stake in making sure state courts are not tainted by prejudices, myths, and unfounded fears—like the unthinking horror in mainstream society that transforms feeding tubes into fetish objects, emblematic of broader, deeper fears of disability that sometimes slide from fear to disgust and from disgust to hatred. While we should not assume that disability prejudice tainted the Florida courts, we cannot reasonably assume that it did not.

This is quite possibly the dumbest thing I've ever heard. A feeding tube is a piece of medical equipment. No more, no less. I don't think that society as a whole has a deep fear of disability based on the fact that a vegetative lady has a feeding tube in her. Jesus, talk about your logic leaps. This author is clearly grasping at straws here.

10. Despite the unseemly Palm Sunday pontificating in Congress, the legislation enabling Ms. Schiavo's parents to sue did not take sides in the so-called culture wars. It did not dictate that Ms. Schiavo be fed. It simply created a procedure whereby the federal courts could decide whether Ms. Schiavo's federally protected rights have been violated.

In the Senate, a key supporter of a federal remedy was Iowa Sen. Tom Harkin, a progressive Democrat and longtime friend of labor and civil rights, including disability rights. Harkin told reporters, "There are a lot of people in the shadows, all over this country, who are incapacitated because of a disability, and many times there is no one to speak for them, and it is hard to determine what their wishes really are or were. So I think there ought to be a broader type of a proceeding that would apply to people in similar circumstances who are incapacitated."

I hope against hope that I will never be one of those people in the shadows, that I will always, one way or another, be able to make my wishes known. I hope that I will not outlive my usefulness or my capacity (at least occasionally) to amuse the people around me. But if it happens otherwise, I hope whoever is appointed to speak for me will be subject to legal constraints. Even if my guardian thinks I'd be better off dead—even if I think so myself—I hope to live and die in a world that recognizes that killing, even of people with the most severe disabilities, is a matter of more than private concern.

Clearly, Congress's Palm Sunday legislation was not the "broader type of proceeding" Harkin and I want. It does not define when and how federal court review will be available to all of those in the shadows, but rather provides a procedure for one case only. To create a general system of review, applicable whenever life-and-death decisions intersect with disability rights, will require a reasoned, informed debate unlike what we've had until now. It will take time. But in the Schiavo case, time is running out.

This case has already been debated to death (no pun intended). Every single judicial hearing has resulted in one result: that Michael Schiavo has every right to remove her feeding tube. Congress getting in on this is absolutely ridiculous and hell, there should be a law against it in my opinion.

The Supreme Court has rejected hearing the case, rightfully so. There is no further recourse to the law for the Schindlers. Now can we please, please, PLEASE, just let Terri Schiavo die in peace?

 

[nbcrusader]

And yet again, she will not feel anything.

Often repeated, but how to you monitor such "lack of pain" with a person who could not express a feeling of pain.

 

[Se7en]

DaveC

 

[Se7en]

Often repeated, but how to you monitor such "lack of pain" with a person who could not express a feeling of pain.

from what i understand the part of her brain necessary to interpret pain is gone.

 

[BVS]

Often repeated, but how to you monitor such "lack of pain" with a person who could not express a feeling of pain.

Science...

 

[MrsSpringsteen]

I've seen doctors on various TV channels say THEY don't know if she will feel/is feeling pain or not, so I don't know how anyone else can say for sure. Some doctors think they know it all, I trust doctors and people who admit they don't.

She will die soon, so all I have left to say is my deepest sympathies to her family.

 

[Irvine511]

Often repeated, but how to you monitor such "lack of pain" with a person who could not express a feeling of pain.

those who can register pain, like cancer patients, are drugged up to the point where they feel no pain from the dehydration.

in Terri's case, i'm not the doctor, but any trained physician should know how to do this without her feeling any pain regardless of her ability to express it or not.

 

[DaveC]

from what i understand the part of her brain necessary to interpret pain is gone.

Thank you.

And yes, you're right. Pain receptors are in the cerebral cortex.

Brain stem itself is solely reflexive and involuntary activity (which is why she can breathe and her heart keeps beating) and merely transports impulses from the cortex to the rest of the body.

I'm in an office with a 3rd-year neuroscience student, in case anyone doubts that.

 

[Irvine511]

it shocks me that people think of doctors as barbarians.

they know what they are doing. it's not like this hasn't happened before. in fact, the medical aspect of the case is the LEAST interesting/contraversial part of it. the right wing has pounced on starvation because it sounds cruel to people who don't know any better or have a clue about what goes into palliative care.

 

[jay canseco]

Is the soul located in the brain?

I've seen some pour souls trapped working at Wal-Mart.

 

[DaveC]

What the hell are you talking about?

 

[Macfistowannabe]

I think it's odd that people consistently point the finger at religion, consistently point the finger at conservatives, and consistently label her "braindead." Yet I pulled a Google search "schiavo braindead" and NOTHING credible and unbiased came as a result. About all the "religion vs logic" is a matter of complete opinion. And the conservative bashing gets me too. "You don't love Terri, her husband did, ..." And you know this for a fact? And you love her enough to starve her to death? Take in to account, many do not see this issue as right vs left, but right or wrong. Some would agree that starvation is a viable option, while others like myself don't see it that way. Seemingly any "conservative" opinion is blamed on religion. Quite odd.

 

[starsgoblue]

What I find sad about this whole thing is certain groups of people have jumped on this situation to make like their 'posterchild' case for their agenda. (and when I say groups of people I am not refering to any posters in this thread)

My feelings on this whole thing are not black and white. I don't think it can be. There is alot of factors here that do make it a very difficult, and at times a volitale, predicament.

 

[Macfistowannabe]

Science...

And how has science monitored such "lack of pain" with a person who could not express a feeling of pain?

 

[BVS]

And how has science monitored such "lack of pain" with a person who could not express a feeling of pain?

Well lack of cerebral cortex = lack of pain. If you don't have the part of the brain that processes pain then you have no pain. Science has made this pretty clear.

 

[jay canseco]

What the hell are you talking about?

Apologies if that was for me. I was first referring to combining of rational arguments with concerns of the soul.

The second sentence was not clear, but about releasing the soul when trapped. It has to be a decision for each individual to make based or their religious beliefs. Every religion has it's own truths.