The Schiavo Case: Bearing False Witness
Cathy Young | March 29, 2005, 7:31am
My take on the Terri Schiavo case.
I respect differing opinions on the issue of "sanctity of life" vs. "quality of life." I understand that there are legitimate concerns about ending the life of a profoundly disabled person on a third party's decision.
But as I said in the column, the level of hysteria, hate, and lies around this issue -- coming from the "pro-life" side -- is revolting.
The new material I've come across since writing the column confirms that opinion.
There is, for instance, this National Review article about Terri Schiavo's medical prognosis -- written by Rev. Robert Johansen, who is not a physician -- which claims that Schiavo never had an MRI. Well, it seems that she did have one in 1990 several month after her collapse, according to a report by one of the expert witnesses and to excerpts from Schiavo's medical records posted at a conservative pro-life website that strongly supports keeping Schiavo alive. ("7/24/1990 -- MRI Report Dr. Pinkston. profound atrophy w/ very atrophic appearing cortex. Mild white matter disease, anoxic/hypoxic injury.") The Rev. Johansen's claim that a leading expert witness for Michael Schiavo, Dr. Ronald Cranford, had earlier misdiagnosed a minimally conscious patient as being in a persistent vegetative state appears to be false as well.
There is also the fact that Dr. William Hammesfahr, the only one of the eight neurologists to examine Schiavo who asserted that she was not in a persistent vegetative state, has been touted (by Fox News' Sean Hannity, among others) as an outstanding physician who has been nominated for the Nobel Prize in Medicine. In fact, his "nomination" consists of a letter from his Congressman to the Nobel Committee stating that he deserves to be nominated for the "Nobel Peace Prize in Medicine" (the Committee was no doubt impressed). Dr. Hammesfahr is the practitioner of a questionable method of treatment for stroke survivors that is generally not recognized in the medical profession (in plain English, he may be a quack); he has been disciplined by the Florida Medical Board and has never published in legitimate peer-reviewed journals.
There is plenty to be said about the junk science in this case -- for instance, the 17 affidavits submitted in support of the parents' claim that Schiavo may not be vegetative by medical experts (who never examined Schiavo and based their conclusions on viewing short video clips). Interestingly, the affidavits have been removed from the Terrisfight.org site, but an extensive and persuasive critique of them can be found here. In the hysterical atmosphere that reigns among the "pro-Terri" blogs, any dubious claim spread like wildfire. A medical blog called CodeBlueBlog claims that the image of Schiavo's brain scan shows far less deterioration than most exerts have asserted, and that her bone scan shows signs of physical abuse. I haven't been able to find out much about the blogger, apparently a Florida-based radiologist named Dr. Thomas Boyle; I do know, however, that not long ago, he also claimed that the altered appearance of Ukrainian presidential candidate Victor Yushchenko was caused not by (later confirmed) poisoning with dioxin but by a combination of excessive drinking and rosacea covered with makeup. He has also claimed, on the basis of recent published photos of Bill Clinton after heart surgery, that the former President actually has cancer or AIDS. CodeBlueBlog sports a "2004 Medical Weblogs Awards: Best Clinical Sciences Weblog" blurb, but the awards seem to be decided by online votes from fewer than 200 readers on another medical site.
(By the way, it's also worth noting that according to the GAL report, at the 2000 trial over Terri Schiavo's guardianship her parents did not dispute that she was indeed in a persistent vegetative state.)
Worse yet, however, have been the outright slanders directed at Terri Schiavo's husband Michael. Schiavo's "supporters" have circulated an affidavit by a nurse who cared for Terri Schiavo for several months in 1995-96. Iyers claims that Michael was abusive toward his incapacitated wife and said things like "When is that bitch gonna die"; she also claims that her voluminous notes indicating that Terri was conscious, responsive, and trying to communicate were regularly deleted from Terri's charts, and that another nurse at the convalescent center who was on friendly terms with Michael Schiavo may have been killing patients. (No record exists of her ever making a police report, and she did not come forward with her story until 2003.) Not surprisingly, the much-maligned Judge Greer dismissed this bizarre statement as "not credible," which has not kept Iyer from being interviewed on CNN and Fox. Terri Schiavo's family and friends have appeared before the cameras as well to spout wild charges that Michael may have been an abuser and may have murdered Terri (odd how this never came up until the dispute over the feeding tube began).
I have to say that when I first started paying attention to this case I thought, like many other people, that there was something shady about Michael Schiavo and that, if nothing else, the guy was a creep. The more I've learned about the details, the more I've been sympathetic to this man. The two guardian ad litem reports are generally very positive about his role in caring for his stricken wife in the early years of her condition (even the first report, which concluded that Michael had too much of a financial conflict of interest to be a reliable witness to Terri's expressed desire not to be kept alive; more on that later). The worst that can be said about him, perhaps, is that when he testified at the malpractice trial on his claim for damages for the loss of his wife's consortium and her medical expenses, he wasn't entirely forthcoming about the fact that he had pretty much given up on prospects of viable treatment for Terri. It is worth noting, however, that in 1998 he offered to donate all of her estate (primarily the money left from the $750,000 portion of the award allocated to her medical care) to charity if the Schindlers withdrew their objections to the termination of artificial feeding and hydration for Terri. (Rather bafflingly, the terrisfight.org site, which reproduces this letter, lists as one of the "myths" about Terri the notion that "Michael Schiavo volunteered to donate the balance of the inheritance to charity." And why, pray, is it a myth? Because he only made this offer on the condition that "Terri's parents would agree to her death by starvation." The site also claims that "the proposal came after a court-appointed Guardian Ad Litem cited Schiavo's conflict of interest since he stood to inherit the balance of Terri's medical fund upon her death." But the letter from Michael Schiavo's attorney to the Schindlers' attorney is dated October 21, 1988, and the GAL report is dated December 29, 1988.)
Interesting, by the way, how the "pro-lifers" simultaneously charge that Michael just wants to get rid of Terri because she's a burden to him, and scream, "Why doesn't he just divorce her and let her parents care for her?" Well, if he did see her as nothing more than a burden, it would have been the easiest thing in the world to get a divorce and move on with his life. Maybe he won't divorce her because he does feel responsible for carrying out her wishes, and doesn't want to leave her in the hands of the delusional parents who would have her linger on in her living death. But there are, of course, other explanations. Here's a charming one from Eric Cohen in The Weekly Standard: "And while one would think that divorce was the obvious solution, this was more than Michael Schiavo apparently could bear, since it would require a definitive act of betrayal instead of a supposed demonstration of loyalty to Terri's wishes." (That's right: Michael Schiavo is willing to be vilified as a murderer rather than face the stigma of divorcing his disabled wife.) At American Digest, Gerald Vanderleun suggests that Michael Schiavo wants his wife dead because he wants to sell the book and movie rights. (Of course, it was the Schindlers who turned the case into a public circus, but ... oh, never mind.) This particularly odious sliming is dutifully linked by Michelle Malkin.
I could go on and on (I already have). I apologize for the length of this post, but I'm very angry right now, at the hysteria and the lies, at the collective insanity unfolding on the news. There are people claiming, and barely being challenged by interviewers, that Terri Schiavo is still trying to talk, smiling, and lifting her arms to "dance" in response to music. (If she were conscious and being slowly killed by hunger and thirst, would that be a likely response?) There's the preposterous story by the lawyer who claimed that she elicited the beginning of an "I want to live" from Terri -- which, of course, conveniently happened with no witnesses and no tape recorder, and which this lawyer waited to report for a week after the removal of Terri's feeding tube. For most of the people who are championing this cause, this is not about protecting Terri Schiavo's rights. I heard one of the protesters say on the news, "It's not what Terri would have wanted, it's what God wants." I don't think the religious right is our own homegrown Taliban, but maybe it's about as close to a Taliban as you can have in modern American society. These are people who really do want the state to enforce their vision of "what God wants." In the name of this cause, apparently, it's more than okay to forget that little Ten Commandments thing about bearing false witness.
chthus | March 29, 2005, 10:26am | #
Jon H,
One does not preclude the other. EEGs record congregate activity from a point outside the skull. It can show you that cortical activity has dropped by x overall, but has little specificity for localized activity. While an important test, it doesn't tell you everything an fMRI or PET scan would.
It seems that a lot of people have simplified this to black and white, cortex gone autonomic brainstem intact. That's not the case. The cortex is largely gone and the brainstem largely intact, but the damage that has occurred is not of a selective sort that only hurts cortex, or eliminates it completely.
I'm comfortable with letting her die based on the evidence from the neurological tests, electrical recordings and static brain imaging, as are many others. Having functional imaging evidence to go along with that would be beneficial in that it would convince even more people (though certainly not all). It would not be superfluous in that it would give us information that we couldn't get from the other tests, just as the EEG gives us something a neurological exam doesn't give us.
Had the courts ordered this type of functional imaging, it may very well have saved us a considerable amount of the appeals and court costs in this case. Should they order it in similar cases in the future, it would be a good idea. This is all I'm saying, not that an fMRI would magically change the game, simply that it would be best to go with all of the evidence available in these cases.
In a simplistic analogy, the MRI or CAT/CT scan is a photograph, the EEG is an audio recording and the neurological exam is an eye witness. The fMRI or PET scan would be a video recording. In trying the show that something happened, wouldn't it be better to have it than to not? If you are trying to show something didn't happen (purposeful, coordinated cortical activity in this case) isn't it even more so?
Angie | March 29, 2005, 12:43pm | #
I found this article to be very informative, and written in a thoughtful way, and I appreciate that. I have many questions though, that I believe change the direction of my thoughts on this issue.
1. If the body is sustaining itself through breathing, digesting, blood circulation, all organs working properly, then why is a simple inability to swallow, and insertion of a feeding tube, considered "artifical life"? This baffles me. She is living on her own. She just can't swallow. And even this is in question, since no one has been allowed to even attempt to feed her by mouth. And it is, by Florida law, illegal to withhold food or water by mouth from any living person. The very fact that Michael Schiavo will not allow anyone to attempt to feed her is criminal.
2. Why has Michael Schiavo not allowed cameras around Terri? This reeks of suspicion to me.
3. Why, when Michael Schiavo was sitting in front of a judge being awarded money for his "distress" and for Terri's care, did he not mention Terri's "wish" not to be kept on "life support"? Instead, he claims that he will care for Terri for the rest of his life. I find it very interesting that his tune changes so drastically shortly afterward.
4. Why, if death by starvation is so humane and painless, is Terri being administered morphine? Why, if she is at death's door, a living vegetable who wants to die, is it taking 12 days and counting for her to pass away? This is not a weak, crippled waste of a person. This is a determined, capable body who was no where near dying.
5. Why is Michael Schiavo, a man who is outwardly living with another woman and has fathered two children with her, allowed to remain Terri's sole guardian? That seems a tidge ridiculous to me.
6. Why has Michael Schiavo, over the last decade, ordered that Terri's teeth not be brushed, or other standard care? This is neglect, there is just no way around it. Why has she not been allowed outside for fresh air or company, or out of her room even? These are basic needs that any human should have access to.
7. Why has communion been denied her? This ties in with the feeding by mouth issue I imagine. But of course, if she can be fed by mouth and sustained, then she is viable, and many people will soon be guilty of premeditated murder.
These are questions that I do not have satisfactory answers for. We need to be careful when deciding who is worthy or not worthy of life. Especially those whose "wishes" have been made known in such a suspicious, contradictory and inconsistant way.
Angie
zeroentitlement | March 29, 2005, 2:30pm | #
Hey, Angie, I got some answers for you.
1. Terri was a bulimic. Were she cognizant, she'd probably be starving herself anyway, or upchucking anything that did pass her lips.
2. Do you allow news cameras into your family members' deathrooms?
3. God forbid someone in this Puritanical, self-flagellating, victim-wallow culture opts not to bond himself in slavery to a human houseplant for the best years of his life.
4. It isn't Terri's body that's toast. It's her brain. That's why she's taking the normal amount of time to die for someone not drinking or eating.
5. Again, how dare someone in this Puritanical blah-blah culture pursue a new life with a new partner, just because his bulimic, f'ed-up wife is now an immobile meatsack with the cognition and personality of a cauliflower. If he'd been a real American, he would have spent his days reading to her drooling form the inspirational tomes of Richard Bach, forsaking any wishes to have a family, and eschewing contact with all other women. Because Michael was married to her, dumbass. That's why he gets to make decisions for what's left of her.
6. You've caught him, all right! He was trying to force her to die from gingivitis! Speaking of fresh air and sunshine, why didn't the Schindlers keep her at their place and give her plenty of both? What's that you say? The Schindlers, champions of human life and dignity that they are, had her for three weeks, found her to be too much trouble to care for, and promptly wheeled her back into the hospice veggie bin?
7. She's had communion and last rites. Now, presumably, she won't burn in the fiery pits of hell. Without them, she certainly would have. Her God, apparently, does not suffer a helpless vegetable lightly.
Jon | March 29, 2005, 2:31pm | #
Dynamist: "Perhaps we might consider a kinship right of appeal in all cases of suspended treatment where no clear instructions by the afflicted are available?"
I have rarely seen my aunts, uncles, and cousins. Or even my oldest half-brother and half-sister. Most of them live in Seattle, while my immediate family has been in Connecticut for 35 years.
I've been to Seattle only three times in my 33 years of life.
Why should any of these people have any say in the matter, were I in a situation like Terry Schiavo?
Kinship does not magically impart knowledge of a person's wishes. Nor does it imply a willingness to carry out one's wishes, as seen with the Schindlers' determination to keep Terry alive no matter what she wanted.
Maybe some relative would disagree with my choice. Maybe they'd insist on keeping me alive, due to religious beliefs that I don't share. But you know what? If I'm allowed to die,
they'll get over it. The offense to them is not particularly important to me, compared to the offense to *me* of keeping me hooked up to tubes as a vegetable for decades. Sorry to hurt their feelings, but
it's not about them.
Mere kinship ought not to carry so much weight. Lots of people are estranged from their families. Many people have kooky relatives. Many families have diverse beliefs.
Lots of people develop beliefs and values of their own, separate from those of parents and siblings. But they're likely to marry someone who shares their own values and beliefs, and to have friends with those values and beliefs.
So it makes no sense to me that parents or siblings should trump others. Their emotional attachment isn't a good enough reason. It's not about them.
BillyRay | March 29, 2005, 4:33pm | #
Reader review of George J. Felos book, "Litigation As Spiritual Practice." at
Amazon. Felos is Michael Schiavo's lawyer. Shoot, he'd fit right in with 75 percent of the Reasonaniacs.
Felos the Grim Reaper?, November 10, 2003
Reviewer: A reader
This book contains bizarre stories about the author's fervent desire to end the lives of severely disabled or gravely sick patients. Estelle Browning's case set a precedent whereby Felos advances his "right to kill" agenda while making a tidy profit for himself as an author.
In this book, Felos claims he has the ability to psychically communicate with the souls of people in comas by SHOUTING at them, "DO YOU WANT TO DIE?? DO YOU WANT TO DIE??". In response, he hears voices in his head that he claims to be emmanating from the soul of the patient. Predictably, the answer Felos hears is "yes", which inspires him to take aggressive legal actions to dehydrate and starve a patient who has left no advance healtchare directives.
This book strikes me as being authored by a new age nutcase at best, and a dangerous man at worst. In this book, Felos claims that he visualized a plane crash during a flight on which he was a passenger, which actually caused the plane to begin to crash. He writes that God Himself spoke to Felos to warn him: "Be careful what you think. You are more powerful than you realize." I wonder if the FAA is aware of Mr. Felos' claims!
Felos is no simple legal advocate for Michael Schiavo in the Florida state courts where he is fighting for the death of Terri Schindler-Schiavo. He told the St. Petersburg Times he wants to write about this case too and his "spiritual journey" with Terri Schiavo. As Litigation as Spiritual Practice demonstrates, Mr. Felos is an egomaniacal visionary bent on death as the ultimate demonstration of his messianic powers. Judging from this book, Felos appears to be clinically delusional.
