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MsSilvie -> RE: Terri Schiavo (4/2/2005 6:19:20 PM)
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ORIGINAL: CTclay
Ms. Silvie, thank-you for that reply. You made some very good points, and you helped me think about this more.
I looked up some things I'd seen before, and did a bit more searching that helped me with some aspects of this case, some of which I quote below. I don't accept any one point that I've read anywhere as conclusive evidence in this issue.
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No one but her parents or people her parents picked as spokespersons argue that there is any chance, much less a good chance, that she would ever improve. Again, I agree that it's very premature to make this kind of decision in a few months. This was 7 years. And at was 15 years before anything happened. In 15 years, someone isn't going to recover spontaneously.
From what I've found, basically, Terri was given a lot of help in the first three to four years -- from early '90, when she collapsed, to sometime before late '93, when Michael basically wanted nothing more done. After that, no rehabilitation has been done and there are questions about the quality of care she received, just to maintain her regularly in good health. In '98, he petitioned the court to allow him to remove the feeding tube.
Again, that is not a sign that someone is being neglected. How long is reasonable to try to rehabilitate someone? If there is no sign of improvement over several years, this would confirm the diagnosis of persistent vegetative state. I've also not seen ANYTHING that implies she was not given excellent support at any time. She never had bed sores, and a comment from someone who worked in one of the care facilities she was at said "He may be a bastard, but if I was sick like that, I wish he was my husband."
http://www.bulletin.ninemsn.com.au/bulletin/site/articleIDs/8444CCC81C798276CA256FD20002ECA9
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I've never heard anyone that has said, yes, I would want to live like that, unable to interact with my family and loved ones, unable to communicate, and totally dependant on others. What I find frightening is that so many people seem to not have a problem saying that they think someone else should have to live at that level.
I think some experts say she might have been able to interact with people on some level, with therapy. Some think she was doing that.
Some do, most don't. The ones that don't tend to be ones that were not brought in by the parents or the parents sponsors.
If all you had to look at was the parents very selective video clips, then yes, I think anyone reasonable would say, "That doesn't seem consistent with the diagnosis, I think this should be reviewed more carefully." That is absolutely not the same thing as saying, "She's not vegetative". A number of people the parents contacted did nothing more than review the video, they never got any closer to Terri to examine her than that. To me, that's politics, not a good medical diagnosis.
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At what point have you done enough physical testing? You can't determine if someone is in a vegetative state from any kind of scan. The diagnosis is made based on an examination of the patient and the history. The scan simply is physical proof in this case that there is a whole lot of atrophy. Any other form of scan will show the same thing. [snip]
I've never seen anyone argue that the scans in question don't show significant brain damage. This will show up in an autopsy. That, on it's own, is not enough to prove someone was in a persistent vegetative state. The patient gets the diagnosis, not the scan or the autopsy result. I think the autopsy is, in part at least, an attempt to show that there is nothing to support the accusations of abuse that a lot of people are making.
I've read that proper testing is a necessary element in diagnosing PVS. Here are some things I've read that shed some more light on testing and on the rest of the case:
((lots of snippage, for space reasons))
National Review is not a source of unbiased info.
A good blog analysis of that article can be found here
http://www.amptoons.com/blog/archives/2005/03/26/lies-about-terri-schiavo-in-the-national-review/
The site indicates some sources stating that she did have an MRI. As part of experimental therapy, she had an electrode implanted in her brain that most likely makes additional MRI testing impossible. A fact conveniently omitted by people who insist that more should have been done.
There were neurological exams performed a number of times.
http://abstractappeal.com/schiavo/WolfsonReport.pdf
In late Autumn of 1990, following months of therapy and testing, formal diagnoses of persistent vegetative state with no evidence of improvement, Michael took Theresa to California, where she received an experimental thalamic stimulator implant in her brain. Michael remained in California caring for Theresa during a period of several months and returned to Florida with her in January of 1991. Theresa was transferred to the Mediplex Rehabilitation Center in Brandon, where she received 24 hour skilled care, physical, occupational, speech and recreational therapies.
Despite aggressive therapies, physician and other clinical assessments consistently revealed no functional abilities, only reflexive, rather than cognitive movements, random eye opening, no communication system and little change cognitively or functionally. On 19 July 1991 Theresa was transferred to the Sable Palms skilled care facility. Periodic neurological exams, regular and aggressive physical, occupational and speech therapy continued through 1994.
Again, there is not a scan that can be done to determine if someone is vegetative. People can have some horrible looking scans, and still be walking around fairly functional. People can have obvious neurological problems that do not show up on any kind of scan. In this case, the scan confirms that there is very obvious brain damage. It is one fact that has to be considered along with all the others. That diagnosis is made examining the patient, not a scan, not a 5 minute video. Her court appointed guardian at law:
http://www.msnbc.msn.com/id/6210240/
WOLFSON : There are several physicians across the country who have expressed that very opinion (that perhaps Mrs. Schiavo is not in a persistent vegetative state -ed) I'm not familiar with what he did nor when he did it, nor how he did it. I understand from what you just said that he did not actually evaluate nor examine Terri. People are going to have different opinions.
And honest people are going to differ about their opinions. The fact is we're dealing with 15 years worth of medical evidence and legal evidence that were admitted through the Florida judicial system, based on laws that were created by the legislature, rules of evidence in the Florida courts, rules of civil procedure and the guardianship law in particular, which over 15 years evolved with very carefully designed bipartisan political and religious cooperation.
And you're either going to believe the facts that have been accepted by the courts, using the standards of competent evidence and clear and convincing evidence, or you're not.
And that is about what it boils down to. You can either believe that the system examined this case very carefully, and made the best decision based on clear and convincing evidence, or you're not. It's a tragedy all around. No one wanted to see this woman die, regardless of what some groups would have you believe. But no one wanted to see her body forced to keep living, when there was no hope of her coming back.
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