Full disclosure: I am very close with the Schindler family. (Terri’s siblings and mother. Her father Bob died last year, his health destroyed by grief over what happened to his beloved daughter.) They are as good and decent as people get. I know the lawyer who represented them for most of the case. She’s honest and true. I know Fr. Frank Pavone. Agree or disagree with his strong pro life positions, he has integrity. I have talked with several people who spent a lot of time with Terri Schiavo. All told me she could react, particularly, that she could hear and respond to loving talk (as in the famous photo of her smiling broadly as she is greeted by her mother or her opening her eyes wide on request, as shown in the photo sequence to the left).
But she had been diagnosed as PVS and the courts refused to allow that determination to be shaken during the ordeal. (The family made a mistake by stipulating to it during the original trial. But that was because of costs and a naive disbelief that a court would order a human being to be dehydrated to death.) Indeed, when it was clear that Terri would be lying in bed for a year pending appeals, the family begged Judge Greer to permit sophisticated brain scanning that had never been used on her before. It couldn’t have hurt her, and it might have shown something. But stubbornly, he refused. I will go to my grave believing the judge knew what he didn’t want to know.
Now, a “surprising” new study has found that many supposedly PVS patients have reactive brains. From the story:
Many of the patients were labeled with the same grim diagnosis: “vegetative state.” Their head injuries, teams of specialists had concluded, condemned them to a netherworld — alive yet utterly devoid of any awareness of the world around them. But an international team of scientists decided to try a bold experiment using the latest technology to peek inside the minds of 54 patients to see whether, in fact, they were conscious. One by one, the men and women were placed inside advanced brain scanners as technicians gave them careful instructions: Imagine you are playing tennis. Imagine you are exploring your home, room by room. For most, the scanner showed nothing. But, shockingly, for one, then another, and another, and yet two more, the scans flashed exactly like any healthy conscious person’s would. These patients, the images clearly indicated, were living silently in their bodies, their minds apparently active. One man could even flawlessly answer detailed yes-or-no questions about his life before his trauma by activating different parts of his brain. “It was incredible.”…
“This should change the way we think about these patients,” said Nicholas D. Schiff, an associate professor of neurology and neuroscience at Weill Cornell Medical College in New York City. “I think it’s going to have very broad implications.”
But it won’t. The bioethics mainstream has rejected the equality/sanctity of humanlife for the so-called quality of life ethic. It began with the odios advocacy of Joseph Fletcher in the Hasting’s Center Report back in 1972, claiming that the inability to communicate meant that one had lost humanhood (now called personhood). Thus today, not only unconscious but conscious patients are dehydrated to death in all fifty states and it is shrugged off as medical ethics.
Back to Terri: As happens every time stories like this come up, the reporter hastened to assure readers that Terri’s case was somehow “different:”
The research inevitably raised questions about patients such as Terri Schiavo, a Florida woman in a persistent vegetative state whose family dispute over whether to discontinue her care ignited a national debate over the right-to-die issue that led to congressional intervention in 2005. Schiavo’s brother, Bobby Schindler, said the new study highlights the limits of medicine to provide an accurate diagnosis. “I wish this could have been used on my sister to see what could have been done to help her,” Schindler said in a telephone interview. But Owen, Schiff and other experts stressed that the research does not indicate that many patients in vegetative states are necessarily aware or have any hope of recovery. Many, like Schiavo, have suffered much greater danger to their brains for far longer than the patients in the study. “In some cases, the damage to the brain is so severe that it is simply inconceivable they could produce any responses,” Owen said.
Perhaps, but thanks to Judge Greer’s intransigence, we will never know what her brain scan would have shown. And don’t bring up the autopsy: The report said her brain was consistent with either a PVS or minimally consciousness, and moreover, that such decisions are clinical, not subject to being decided upon autopsy.
But this is the point. Conscious or unconscious, people should not have to earn the right to receive basic sustenance. What we did to Terri Schiavo was a blight on the legal system and bioethics. Pretending otherwise won’t make that stain go away.
February 4th, 2010 | 1:35 pm
I notice that the end of the article brings up whether we can use the technology to ask, “Do you want to die?”
February 4th, 2010 | 2:07 pm
What? Again?
February 4th, 2010 | 2:11 pm
Any human being with functioning organ systems (like Terri Schiavo, Rom Houben, etc, etc) will have functioning parts of their brain. (until we develop artificial brains and/or control devices) Consciousness is irrelevant to certain functioning parts of the brain. These scans are also subject to interpretation and/or the physician giving them.
There is no scientific definition of “human” or “personhood” (not to be confused with Homo sapien sapiens). It is beyond the abilities of science. It is folly to look to science to answer whether Schiavo was “human” or not.
February 4th, 2010 | 2:30 pm
There is a definition of human. It is biological. There isn’t of person, because that is philosophical.
February 4th, 2010 | 2:51 pm
Gee, David, I thought only cnservatives were anti-science.
February 4th, 2010 | 3:03 pm
Gee, David, I thought it was conservatives who were anti-science.
Besides, you are reiterating Wesley’s point: It is IMPOSSIBLE at this point to know fully what consciousness is in these patients.
Before we even get to the philosophical question of how consciousness and personhood are linked, you have the problem of determining a basic thing like awareness and thought.
So, how can we use “interpreted” data as the basis for treating or ending a life?
February 4th, 2010 | 3:23 pm
Drs. Owen and Schiff find their own scan results “incredible” under the circumstances of some of their subjects, while insisting that it is “inconceivable” that other subjects’ scans would show any response.
They’re surprised by what they unexpectedly find, then assure us that they will not be surprised again.
Which is it ?!
All the Schindlers ever wanted for Terri were the same humane opportunities afforded others in her circumstances, so unbelievably cruelly denied her by a “perfect storm” of corruption and political expediency.
One oft-repeated aspect of her case that always infuriates me is the dismissal of tests or therapies that might have helped her earlier, except that she was in her condition for “so long … ”
Firemen walk away from a smouldering flame in, say, the kitchen – telling us there’s nothing more to be done about it [or obeying a judge's restraining order against doing any more about it] – only to return hours later to the entire house engulfed in more fire than they can possibly extinquish.
February 4th, 2010 | 4:18 pm
[...] Secondhand Smoke, Wesley J. Smith rightly reflects again on the case of Terri Schiavo. I think that the possibility — and in the light of this study, a probability — that [...]
February 4th, 2010 | 6:10 pm
Why don’t we just ask George Felos? That dude can SOUL TALK!
But, seriously. The more time passes and the more technology advances, the more apparent it is that PVS is a trash diagnosis to begin with. It definitely isn’t a good reason to starve someone to death.
Come to think of it, there actually is no good reason for starving anyone to death. It’s just barbaric.
February 4th, 2010 | 8:28 pm
Performing a fMRI would have required brain surgery first to remove the experimental interthalamic stimulators (for such a debilitated patient, likely too risky to be considered an ethical procedure)
The authors of this study noted there were no responses in patients like Schiavo where the brain damage was caused by anoxia.
February 4th, 2010 | 8:58 pm
We’ve noted that. The PET scan requested by the Schindlers, however, would not. And that was the kind of test that found Ron Houbens was awake and aware. Nice try Bill, but no cigar.
February 4th, 2010 | 9:23 pm
“…Houbens was awake and aware.” Since the only proof we have of that is the big toe-operated ouija board, how can you make that statement with such certainty? Haven’t you noticed that his eyes remained closed while his “facilitator” helped him “communicate” with the world? Now that’s a neat trick. Maybe he can also do one of those Luke Skywalker stunts and use the Force to move himself around.
February 4th, 2010 | 9:32 pm
History Writer: If you are going to be snarky, at least be original. Caplan used the Oija Board reference. He is awake and aware by his answering yes or no questions with his foot and his brain tests. The controversy of facilitated communication isn’t part of that. Even Caplan acknowledges he isn’t PVS.
February 5th, 2010 | 1:34 am
Food and water is not an extraordinary means of sustaining life. I would have sent in Pattons third army to defend Terry Schiavo!!!!
February 5th, 2010 | 8:46 am
Terri was starved to death. No question. I hope this new technology moves forward to stop this insane starvation in all of our states. I wonder if Judge Greer has a living will? And if so, I wonder what HIS states…
February 5th, 2010 | 10:37 am
Terri Schiavo was starved to death. No better treatment than the Nazis gave the Jews and Christians they wished to exterminate. Her death took a lot longer. Those who perpetrated this horrific evil on her will pay for it one way or the other. We do not kill innocents without grave consequences. Her husband made sure she did not regain enough ability to tell the truth of what happened the day she was injured. We live in a world where no one thinks of ultimate consequences any more. Many will be surprised and horrified when they close their eyes for the last time and awaken to TRUTH.
February 5th, 2010 | 2:39 pm
Annie:
You wrote of Terri Schiavo: “Her husband made sure she did not regain enough ability to tell the truth of what happened the day she was injured.”
Now that’s really interesting, since the record shows that Mrs. Schiavo lost consciousness for a sufficient time to sustain irreversible brain damage, as a direct result of the dietary regimen she followed.
That was the basis of the winning malpractice suit brought by Michael Schiavo against her physician.
Of course we shouldn’t discount the possibility that YOU know “the “truth of what happened,” so why not tell us all about it? Was it some sinister act on her husband’s part that caused Terri’s brain damage, which he then compounded in some as yet undetermined way “to keep her from telling”? Did you pick this up your inside information from some unimpeachable source like a supermarket tabloid, or Concerned Women for America? Please don’t hold out on us. We’re all dying to hear all the dark secrets about Michael Schiavo that you’re privy to.
February 5th, 2010 | 2:55 pm
I think it is important here to state that there is no evidence that M. Schiavo abused Terri or caused her injury. The police were called by the emergency response team at the time of her collapse, but based on her age. There were no marks indicating choking or any other assault-type injury. It is important also, to understand that the family and M. Schiavo worked together for years after the injury, and indeed, that he lived with them for awhile. The dispute began after the malpractice suit was completed.
Despite comments from M. Schiavo about her alleged bulimia, the cause of Terri’s cardiac arrest remains unknown.
February 5th, 2010 | 4:08 pm
DEEPTOAD and everyone else here who’s on the same page: WELL SAID.
HW: You really don’t know what you’re talking about.
Far too much respect and deference is given to doctors and “the medical establishment” (including even by you, Wesley), doctors, hospitals, lawyers, judges, and family members (I refer to Michael Schiavo here, not the Schiavos) can be, well, you know whats, medicine lacks necessary humility today, society puts far too much faith in it, the law had no place being involved in things like this, and there is good reason why courts and legislatures refused to ratify “living wills” for decades. People who sign such documents don’t realize they’ve been rooked, and no one can know, really, what they’ll want once they’re in a situation they’ve never been in before.
I’m very sorry to hear of Mr. Schiavo’s passing, and the reason for it. Perhaps his illness was the reason why those who tried to reach the Terry Schiavo Foundation did not hear back when we were trying to save my mother’s life in 2008. I was just wondering how the Schiavos are doing the other day. The thing is, it’s not just the Schiavos, it wasn’t just my mother, or other cases that have gone to court, where it’s impossible to fight them in such circumstances as well it would be possible to fight otherwise — and in fact issues of life and death don’t belong in court in the first place, unless it’s a matter of capital punishment — it happens more often than the public realizes. God Bless the Schiavo family. I can imagine the tete a tete Mr. Schiavo, his daughter, my mother, and a whole lot of other people are having on the other side right now. We all can. I have no doubt it’s taking place.
February 5th, 2010 | 4:12 pm
OOPS!!!! I meant SCHINDLER, not SCHIAVO! I conflated the name Terri was known by to the public with that of her real family — the people who loved her, and who are RIGHT — in my head. I apologize.
February 5th, 2010 | 5:31 pm
Forced feeding like MRA’a, brain scans and the like are all modern day medical procedures. To insist that the caretaker only use forced feeding as a moral requirement without the need of other modern procedures would be wrong and would result in a large guilt trip on the caretaker. When does the use of modern medical procedures be an absolute necessity decided by what moral law? Secondly, there needs to take in account of the caretaker inability to provide for care.
February 5th, 2010 | 6:07 pm
Wesley: You’ve got it backwards. Bioethics is a blight. This happened in a world in which “bioethics” exist. “Bioethics” CAUSED it. As for the legal system, this isn’t a blight on it, either. The legal system had no business even entertaining it, and the blight is the society and legal system which allowed the legal system to be involved in it. Either killing anyone who can be considered in any way to be alive is illegal, period, or we can’t have a society, period. And as I’ve made clear here before, it’s not because I give a damn about the little foetuses with the visible arms and legs, and it’s not because of any religious belief; in fact I think religion getting into this has only made things worse. It doesn’t take religion, a rocket scientist, doctors, or the law and the courts to say — or opine — that alive is better than dead. It just is.
February 5th, 2010 | 6:10 pm
And since medicine, doctors, the law, the courts, and society can’t grasp that simple fact and proceed accordingly with humility, THEY are the blight. What happened to Terri and to my mother and has happened to many other is just the symptom.
February 5th, 2010 | 6:40 pm
WAIT A MINUTE — The PRESIDENT of the UNITED STATES wanted someone to live, and it didn’t stop matters cold? Don’t give me that baloney about even the president isn’t above the law, the legal system, blah, blah, blah. What the ****?! Now we’ve got a president cut from the opposite cloth. Thank God for the tea parties. Not to mention George Bush.
February 5th, 2010 | 7:05 pm
I am very sory about this woman no one has the right to starve to death someone on the excuse that he or she ain’t functioning well .but if in this world some have this power I AM WAITING for GOD ALMIGHTY to show them what starvation is to show them what its like to starve from seeing the beauty of his face .this world passes for everyone we’ll meet in the next for justice .
February 5th, 2010 | 7:10 pm
Well I took a look at Terri’s birth date, Michael Schiavo’s. and a few significant times in the whole saga. Hands down, there are guilty parties here, and they aren’t the Schindler family.
February 5th, 2010 | 8:40 pm
Wesley: There’s also no evidence that Terri said she wouldn’t want to live in such circumstances (who even has such conversations at that age in the first place?), only Michael Schiavo’s claim that she said it. It’s hard to fight for the someone’s life when one keeps running into the hearsay problem EXCEPT when the person whose life is at stake and can’t speak for herself is being “quoted.” ASIDE from which, no matter what someone says before it happens, they don’t know how it will be and what they will really want if it actually does happen until, God forbid, it does happen. “On information and belief,” the pathology showed that she hadn’t been bulimic, and while I’m all in favor of medmal (the tort reform people have it backwards) cases, I think this one was bogus to start with. One look at Michael Schiavo tells you all you need to know, and a look at his planets, and at her planets, and the planets the day she collapsed, confirms it. I saw immediately how strong her heart was, and only later read what the pathologist said, including that her heart was very strong. Among other things. Not to let her brother into the room to say goodbye? Come on. Read the interviews with Schiavo. He’s a lot worse than no better than he should be. As for ANYONE who uses the phrase “death with dignity…” That’s an indication they’re trash right there. And yes I’m including the doctors who say it in that characterization. Well this is what to expect in a world in which Obama could have been elected president.
February 6th, 2010 | 12:00 am
Half of this statement is inaccurate:
“…the family begged Judge Greer to permit sophisticated brain scanning that had never been used on her before.” – Wesley Smith
As you have been previously informed It is clearly in the record that a SPECT scan was performed and a SPECT scan is on the same level as fMRI or PET scans in terms of the indications it provides of brain activity. SPECT is a “sophisticated brain scan” in so far as it deals with revealing details of FUNCTION and functioning (or the potential for it…) versus say a simple x-ray which deals with revealing structural details.
It is obviously and transparently deceptive to ignore that the SPECT was performed.
Terri had multiple isoelectric EEGs, as well as a SPECT scan that showed no metabolic activity in the cerebral cortex. Not to mention her multiple CT scans which clearly demonstrated hydrocephalus ex-vacuo.
The reason it is an oft repeated phrase that Terri Schiavo isn’t comparable to patients such as Rom Houben is that no doctor has suggested that hydrocephalus ex-vacuo is an aspect of Rom Houbens condition and it has never been indicated that ANY of the other patients being discussed in recent medical journal cases or press releases had the demonstrable hydrocephalus ex-vacuo of Mrs Schiavo.
But getting back to medical scans and the SPECT scan performed on Mrs Schiavo:
PET scans look at glucose uptake and metabolism — the ability of cells to turn fuel into energy. In order for a cell to function, it has to — at the very least — be able to burn biofuel to produce energy. This is what a PET scan looks at.
SPECT is a bit more specific. It looks at cells’ abilty to power a specific cell membrane pump that maintains polarization. It doesn’t just look at glucose metabolism, therefore. It looks at the capacity of cells to harness the energy to do work. Being able to power this cell membrane pump is crucial for cell survival and function.
EEG isn’t a form of “medical imaging” but as far as neurological testing EEG testing looks at a neuron’s ability to generate electrical signals via depolarization and repolarization of the cell membrane. This is how neurons communicate with one another, and it is essential for the proper functioning of neurons.
You know what the microscopic studies at autopsy revealed. While PVS or MCS is a clinical diagnosis the microscopic studies revealed why the EEG test results and the SPECT weren’t very helpful to the Schindlers.
Test results don’t detract from the humanity of Mrs Schiavo nor do they make a statement about the value of her life. The test results were only one aspect and one part of the information relied upon by the courts.
There were also the reports of objective observers such as Dr Jay Wolfson and Richard Pearse. Also the results of the Florida DCF investigations- an agency which, if anything, would have been biased toward the governors position.
February 6th, 2010 | 11:28 am
“It doesn’t take religion, a rocket scientist, doctors, or the law and the courts to say — or opine — that alive is better than dead. It just is.”
Profound! I wonder if you’d have said that if you were interned at, say, Buchenwald.
February 6th, 2010 | 11:52 am
I forget was the key element in the murder of Terri Schiavo her alleged statement to her husband, as related by him alone or was it based on the abscence of brain activity or was it both. As I remember her parents were ready, able and willing, no insisting that they would take care of her til the end of her natural life. Why would anyone have a problem with that.Why would a judge accept uncorraborated testimony from the husband who had moved on with his life and possibly had motives beyond the welfare of Terri when there was a non fatal alternative. Even assuming that Terri had made the alleged statement does anyone think that what she intended was to be starved for 14 days until she died.I think the uncontestable answer is no. I mean why were’nt those who intended her death,since it was about mercy, ha, given a gun. It would have been quicker and made it clearer what they were about. She was given less consideration then someone on trial for murder where the standard for conviction is beyond a reasonable doubt. If I had a target set up in my back yard that I was shooting at and a friend said wait a second I think I saw someone run behind the target would it be acceptable for me to continue to fire when any doubt existed that he might be right. The courts had an agenda, I wonder what it was. Oh about the findings in this study, as long as quality of life is the new trump card it will make no difference at worst and at best will just add one more step to a foregone conclusion.
February 6th, 2010 | 11:57 am
What amazes me is that people are so stupid that they don’t seem to realize that, for one thing, everyone, and every situation, is different, and, for another thing, that these diagnostic tests are man-made and not capable of determining everything that is necessary to be determined in a given situation. People who knew her and nurses who cared for her saw indications of awareness and that wasn’t enough? Doctors and social service people were to be believed instead, and it was to be decided by courts and judge? The President who was keeping us safe from terrorism and the governor of the state, who was on to the corruption of the social service crowd, were not to be heeded? There is something wrong with vivisection, there is something wrong with ANYONE who would ever pull a plug or endorse same, and there is something seriously wrong all over, which is why we’ve got the world we’ve got. Which non-human animals didn’t make, mind you.
February 6th, 2010 | 1:31 pm
HW: I haven’t BEEN interned at, say, Buchenwald. Have you? Do you know anyone who came out of, say, Buchenwald alive and wishes they’d died there? Which might be understandable, but the point is, one doesn’t know until and unless it’s happened to one, and that’s exactly what I’ve been trying to get through your head about “living wills.” Life IS better than death. At least for sane people. Even people who commit suicide out of honor realize they’re giving up something of value.
WESLEY: I just looked online and saw the reports of Mr. Schindler’s death dated August 29, 2009. My mother was murdered on August 29, 2009, and the final decision to murder her was made on August 28, 2009. Michael Schiavo, his hippie lawyer (sorry don’t mean to insult hippies) and the court et al. involved murdered Terri’s father just as they did her. God bless the Schindler family.
February 6th, 2010 | 1:43 pm
Further, it occurs to me that every year, the President of the United States pardons a turkey at Thanksgiving. Bill Clinton raised an uproar by pardoning Marc Rich and some other people, he and Hillary of the health care reform agenda made off with some furniture they weren’t supposed to have tooken in the course of his vaudevillian exit from the White House, and Eric Holder is now in charge of the justice department, but God forbid George Bush and his brother Jeb should have been allowed to save Terri’s life, or Obama should be impeached for the high crime and misdemeanor of disrespect for the life of the elderly, let alone potential citizens and even fully-formed foetuses not to mention his overall subversive agenda. I say there’s a case for it. I also say that in a world where The West Wing could be on television (how could Martin Sheen have done that? and consider what else is on television), detracting from the dignity and solemnity of the office, and some of the goofballs we’ve had in it even could have gotten elected, no wonder there’s a culture of death. It’s a matter of standards. I only hope you aren’t going to blame the animal rights movement for the turkey being pardoned but humans being legally put to death, Wesley.
February 7th, 2010 | 11:13 pm
Ianthe: I seriously suggest you get a hold of Black’s Law Dictionary and look up the definition of “murder.” You just might become a little less inclined to cheapen the term by tossing it around so casually and misusing it so often.
February 9th, 2010 | 9:20 pm
HW: I only have an inkling of what Ianthe has experienced when she speaks of her mother, but unless the same has happened to yours I would back WAY off from telling her to look it up in a dictionary!
About Buchenwald — I don’t know what I’d say. I make no such assumptions, and neither should you. What I do know is that there are more than a few people in this world whom one imagines would have reason to prefer death, and are actually quite glad to be alive.
February 9th, 2010 | 10:38 pm
Wesley-I disagree about evidence for abuse. Michael Schiavo indicated repeatedly that he was a violent person, and this was attested to by his former girlfriend and by one of Terri’s friends who noticed bruises on her arms. Bobbi Schindler also said that she went to him in tears over wanting a divorce from Michael but felt that she couldn’t because of being Catholic. Moreover, there was a bone scan done at the time of her collapse indicating fractures over a period of time.
Of course, you know the Schindler’s better, so perhaps you have inside info on these matters that contradicts this understanding.
February 12th, 2010 | 9:01 pm
what can i say. terri is a precious innocent defenseless young lady who was murdered by our country. she now resides in heaven. and we criticize nazi germany and stalin russia. we are worse. certainly JESUS is the antidote for the american insanity. there will be a better day.
February 12th, 2010 | 9:02 pm
Bone scans are not used to determine the presence or absence of fractures. X-rays perform that task specifically since they specifically visualize the variations in density of bone.
The doctor performing the bone scan (a year after Mrs Schiavos collapse) was deposed and explained that the bone scan test was ordered to determine why there seemed to be abnormal resistance and swelling in Mrs Schiavos knee joint during rehab sessions. The doctors deposition discredited the Schindlers and their bizarre claims. The bone scan and the Schindlers claims surrounding it was a subject discussed at length in the autopsy report.
A bone scan (Radionuclide bone scan) is a form of medical imaging used to visualize whether there is disease causing abnormal turnover activity.
For this test, the patient receives an injection of radioactive material called technetium diphosphonate. The amount of radioactivity used is very low and causes no long-term effects. This substance is attracted to diseased bone cells throughout the entire skeleton. Areas of diseased bone will be seen on the bone scan image as dense, gray to black areas, called “hot spots.” These areas may suggest metastatic cancer is present, but arthritis, infection, heterotopic ossification or other bone diseases can also cause a similar pattern.
Mrs Schiavo was diagnosed as suffering from heterotopic ossification.
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