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.
Sean | March 29, 2005, 7:41pm | #
If you're going to use the comments on the MRI reported on Empire Journal,shouldn't you include these notes from the same record?
Look carefully.
6/27/1990
Started to show some vocalization where she will say no and occasionally has had some
voluntary movement on command of eyes and mouth as reported by husband and mother. Ready for inpatient rehab program here at Bayfront.
She will close her eyes to any threatening response around her face and blink appropriately. Tracking is inconsistent. Verbal output reported by husband and other family members and therapists at College Harbor.
Goals are interdisciplinary intensive therapy, P.T., O.T., Speech and Language, psychology, social services, rehaf, Recreational Therapy. Goal to advance her level of awareness and consciousness.
7/12/1990
Responsive, eyes open to sensory stimulation in arm.
8/25/1990
Discharged from Bayfront Medical Center, pt did show some improvement in range of motion
1/29/1991
Noted increased alertness, turns head toward voice, turns head from tactile stimulation. Sucking and rooting response to olfactory stimulation. Spontaneously vocalized.
2/1/1991
Alert throughout treatment session, responds to pain, moaning, turns head from noxious stimulii.
2/11/1991
Swallowing improving, some possible following commands to voice.
2/20/1991
Pt has made significant gains since admission in all areas of range of motion. Have on one occasion when pt reclined, on command pt extended right knee, 4 X / 6 at random request. Appeared to follow command to turn her head while I had her on the mat the other day, but not (yet) consistant.
3/16/1991
Pt lifted head off pillow straining neck, look at something to her right. Pt making humming sounds for about 5 min.
3/11/1991
2 point increases in vocalization and eye-opening, motor response. Tactile increased 3 points. Overall her general responsiveness score increased slightly from 19 to 23. Remains at a Rancho level 2.
3/26/1991
Terri's side-rail on her bed found down after Michael left. When told about it, he replied that "that was their job."
4/25/1991
MS talking to her, she then lifted head off and away from chair. I asked her if she wanted to get up. She nodded. I asked her a minute later, she did the same motion.
April 1995 to July 1996
Michaels orders: no rehab, no range of motion, no nothing. Alert & oriented,
spoke regularly "Momma," "Mommy," "Help Me"
4/20/1998
Husband declined P.T. evaluation for treatment of contractures
7/9/2002 (Videotaped)
(Examination of Dr. Cranford on July 9, 2002) - After Terri�s mother enters the room,
Terri greets her by speaking the word �Hi,� and makes good eye movement toward her. Later Dr. Cranford touches Terri�s face much in the same manner as her mother typically does. Terri responds to this stimulation initially by smiling, but the smile is not sustained, and it is not equivalent to her response to her mother.
9/3/2002 (Videotaped)
Terri�s mother enters the room and addresses Terri.
Terri�s face goes from no expression (her typical baseline), to a smile with turned-up corners and eyes opening wider, indicative of recognition of her mother and a vocalization which appears to be specific to her mother (an appropriate vocal expressive gesture). Her eyes focused on her mother�s face with eye contact with her, indicative of cognitive recognition.
...
When raised even with her head, Terri gave a slight grimace of pain,
indicating sensorium between her conscious mind and that extremity. If the only reaction involved the extremity which was the source of the pain, it could be argued that this was a reflex, but
reacting through facial expression necessarily involves the conscious mind. Minimal pain response (possible peripheral nerve atrophy). During the manipulation, the doctor asked Terri to open her eyes, and then to look at her mother. She responded well with slow movements.
...
During a return visit from her mother,
Terri greeted her by speaking the word �Hi�. Dr. Hammesfahr introduced a balloon and asked her to look at it. Terri successfully accomplished this task. During eye examination,
Terri responded to being asked to open her eyes and had effective pupil dilation to light.
11/29/2002 (Audiotape)
At the beginning of the recording, Robert Schindler greets Terri and asks how she is. Terri responds, albeit with a slight delay, with a throaty sound. Mr. Schindler asks Terri if she can smile for him, to which
she responds by saying �yeah�. He then asks how she is doing, and Terri changes tone and inflection to a sound which is apparently specific to her father. Early in the recording Terri responds to a number of Mr. Schindler�s requests by saying the word �yeah,� including when he asks her to �say something to me,� when he asks �can you say hi,� and when he asks if something is hurting her.
...
Under normal circumstances, Terri would receive the complete range of therapies, including physical and occupational, recreational, cognitive and speech-language therapy, and her family would become more skillful in her care through involvement in her treatment, but here they have been deprived of those experiences.
Later in the recording there are several instances where Terri is apparently receiving no stimulation, and Terri remains quiet. This demonstrates that she does not vocalize randomly, as is also demonstrated by the several extended lengths of time during the Hammesfahr examination in which Terri remains quiet.
Cathy Young | March 30, 2005, 3:40am | #
A few comments in response to the posts here. First of all, thanks to everyone who liked my post. Now, on to the criticisms...
Bonar Law:
Once again there's the tacit assumption that all of the pro-feeding side are activists on behalf of traditionalist Christianity.
No, not all; but few would deny that this is where the main impetus comes from. I would add that some of the "disability rights" activists are pretty scary in their own right. It's a movement caught up identity politics similar to those of gender and race, except that the disability rights movement fashions a positive identity out of disability. At its most extreme, it bristles at the idea that disability is something to be "cured" because talk of a cure suggests that it's bad to be disabled. These were people who
slammed the
late Christopher
Reeve because, after being paralyzed from the neck down in a fall, he focused his efforts on finding a cure for spinal cord injuries and refused to embrace the activist dogma that even a severe disability wouldn't be much of a problem if the government just forced everyone to properly accommodate it. (This dogma, of course, goes far beyond the belief that a profoundly disabled person can still have a satisfying life.) Now, the movement's fanatical insistence that life is always worth living (which in the past has led it to oppose a conscious patient's right to voluntarily terminate life support) has led it to extend the concept of "life" to existence in a permanent vegetative state. A friend who was reading up on the case today asked me, genuinely nonplussed, what on earth the Schiavo case had to do with the disabled since she is not disabled but for all intents and purposes brain-dead. Good question.
The latest news, of course, is that the Rev. Jesse Jackson has glommed onto the case. When Randall Terry and Jesse Jackson are on the same side of an issue, I feel pretty comfortable being on the other side.
Billy Ray:
For example, The Rev. Johansen's claim that a leading expert witness for the parents, Dr. Ronald Cranford, had earlier misdiagnosed a minimally conscious patient as being in a persistent vegetative state appears to be false as well. Here's what Rev Robert Johansen wrote "But the star medical witness for Michael Schiavo, Dr. Ronald Cranford of the University of Minnesota". Dr. Cranford not only is an expert witness for Michael Schiavo, he's also a big proponet of Euthanasia.
Yes, you caught me, I made a typo. Of course Dr. Cranford was an expert witness for Michael Schiavo; I've corrected my post. Anyway, your comment is irrelevant to the point I made. The Rev Johansen claimed that Dr. Cranford once wrongly diagnosed a minimally conscious patient with PVS. He did not.
Tom Knapp:
Regarding the issue of Dr. William Hammersfahr, he was not disciplined for false advertising and providing substandard treatment because the administrative judge, Susan Kirkland, found that his treatment methods, while not accepted by the medical community, were protected by Florida law as a form of "alternative health care" (go
here for a copy of the judgment and scroll down to p. 39-40 of the document/p. 31-32 of the judge's "recommended order"). Dr. Hammesfahr's credibility is further undermined by the fact that he has knowing misrepresented himself as a Nobel Prize nominee, and that he has never been published in any legitimate medical journals.
Xlqr:
I'm pretty skeptical about that claim myself, but making an issue of the "convenient" absence of a tape recorder is inexcusable. If the Schindlers tried to bring a tape recorder into the hospice, they'd be arrested.
It was a lawyer, not the Schindlers. In any case: you may have a point about the tape recorder. However, the lawyer says that she begged Terri Schiavo to say "I want to live" and put an end to the whole dispute, and obtained a response. If she did resort to this desperate measure in the hope of eliciting a response, why would she do it when she was alone with Terri? As one of the other posters points out, it would have been easy enough to get a neutral witness. The story would have had more credibility if the lawyer claimed that this was a spontaneous utterance (though of course in that case, it would have been tough to make a case that "I waaaa" means "I want to live").
The issue of the MRI has been already addressed by other posters. (If the Rev. Johansen intended to say that Schiavo has never had an
fMRI, he should have said so.) I want to add another point. In all the years of litigation, the Schindlers and their attorney, as far as I know, have never requested an fMRI or a PET scan. The issue only came up recently as the 11th hour. Why? Probably because for years, they did not even dispute the PVS diagnosis; and later, they probably knew that if they asked for an fMRI and the results showed no brain activity whatsoever, it would seriously undermine their ability to object to the termination of artificial feeding.
Sean:
If you're going to use the comments on the MRI reported on Empire Journal,shouldn't you include these notes from the same record?
These notes are not an official medical case history. I'm not sure how they were compiled and what they are based on. I assume it's mostly medical information in the Schiavo legal case file.
The most startling claims in this chart, that Terri said "Momma," "Mommy," and "Help me," come from two nurses' affidavits that were filed years later and are totally lacking in credibility. (See the information on Carla Iyer in my post above.)
As for the rest, I assume it does come from contemporaneous medical records, but I notice that you chose your quotations very selectively. For instance, a mere two days after Dr. David Baras's very positive report, there was this:
6/29/1990 Neuro Consult Dr. Hernandez
Pt. is arousable and has roving eyes, altho I do not think she is following any commands. Moans, has moments of alertness. Pupils symmetrical and contents show a slight response. Assessment: PVS
The positive assessments all come from Dr. David Baras, who is the medical director of a rehabilitation center and, not surprisingly, sees potential for rehabilitation in Terri. (The other contemporaneous source of positive assessment is "MS Journal" -- not sure what that is.) As has been stated numerous times, PVS patients often have random vocalizations and movements that can be mistaken for voluntary ones.
Again, all the credible neurologists who have examined Terri Schiavo have concluded that she is not responsive.
CodeBlueBlog:
I have no medical expertise and will readily admit that I'm not qualified to debate you. I do, however, consider myself qualified to say that a medical expert who diagnoses someone with cancer or AIDS based on photographs in the news is not someone I'd consider trustworthy. And I have yet to see any proof that your opinion should count for more than those of the medical professionals who were directly involved with the case.
(By the way, I didn't merely "skim" your posts on Yushchenko, I followed the debate rather closely at the time.)
Incidentally, in the comments section of his post, CodeBlueBlog has made it clear that he would not support the removal of the feeding tube even with a PVS diagnosis ("I just have never understood how a physician can support removing food and water from an otherwise living patient").
Greg | March 30, 2005, 5:25pm | #
A particularly great post given that this topic challenges anyone to keep focus on reason and analysis rather then sheer emotion. However, the more that I've seen this story regretfully unfold before our collective eyes, the more I'm convinced no one wants to confront the 400 lb. gorilla in the living room. Plain and simple, I think the Schindler family is the epitome of "toxic parents". That might sound cruel to say, but I can't rationalize the events over the past few days any other way.
What makes me come to this conclusion? Here are my observations:
* Death threats have been made on Michael Schiavo, and yet this family issues no call for rationality. Instead, they stand by silent hoping that the mob mentality will prevail as long as the outcome is what THEY would wish.
* A report today on MSNBC stated that local police have been flooded with bogus 9-1-1 calls stating that "a murder is taking place at (Hospice's address)". And, again, no family statement is issued to tell these fanatics that they might actually be costing a life if a genuine 9-1-1 call isn't answered.
* Mary Schindler's impassioned plea yesterday to "Michael and Jodi" was completely contemptuous and ingenuine. In my opinion, her last minute plea is where this tragic story should have been centered many years ago. The plea could have been simple: "Relinquish your guardian duties; you've performed faithfully, admirably, and compassionately for all of these years and Terri would be thankful. We believe that Terri told you that she wouldn't want to live this way. However, we, as her parents, want to assume the responsibilities and wishes. We'll carry them out." Instead, the family resorted to character assasination, misrepresentation, and deceit to achieve an end THEY could live with.
* The underlying causes of Ms. Schiavo's underreported bulimia as a teen is likely attributal to familial issues. The photos of Terri Schiavo at her happiest are unbelievably radiant. It's very possible that those photos were taken by Michael. However, to my knowledge, the Schlinder's have never publicly acknowledged any culpability in the incremental steps leading her to illness. Instead, they now agree to an autopsy in the vain attempt to prove that foul play was involved.
It pains me to say these things without knowing the family, but in a way they've forced a nation to peer inside and look at their inner dynamics, and that's what I see.
Thomas L. Knapp | March 31, 2005, 4:27am | #
Cathy,
-----
Regarding the issue of Dr. William Hammersfahr, he was not disciplined for false advertising and providing substandard treatment because the administrative judge, Susan Kirkland, found that his treatment methods, while not accepted by the medical community, were protected by Florida law as a form of "alternative health care" .... Dr. Hammesfahr's credibility is further undermined by the fact that he has knowing misrepresented himself as a Nobel Prize nominee, and that he has never been published in any legitimate medical journals.
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I'm not particularly interested in debating the guy's credibility or lack thereof. It's pretty clear to me that he's a publicity hound whose methods and evaluations are at best dubious.
However, you seem to be alluding to an entirely different claim than a) you originally made or b) I alluded to. Above, you refer to a court decision. In the original article, you referred to Dr. Hammesfahr as having been "disciplined by the Florida Medical Board."
I have read the Board's findings of fact; their disinclination to discipline him for his treatment methods was very specifically outlined not as being based on any Florida law protecting "alternative medicine," or on any court decision, but rather on an overt finding that the treatments caused no harm and seemed, in some cases, to result in improvement for the patient. The board did not endorse the treatment, and there was of course no reference to whether or not it might be relevant to Terri Schiavo's condition, but ...
The substance and entirety of the _Florida Medical Board's_ decision (as opposed to a court proceeding of which I was unaware) to discipline the doctor was that a patient accused him of not providing some services he charged for, and that the board found the allegation to have merit. Assuming that the board's finding was correct, and that it was not a simple oversight but rather an intentional bilking of a patient, it is, of course, reprehensible ... but it says nothing about his qualifications to evaluate or treat patients.
But enough of the unpleasant doctor. I agree with you that all too many people (myself included) have had a tendency to get downright mean in this whole debate, and that that's unfortunate. Thanks for attempting to inject some civility.
Regards,
Tom Knapp
Rich (not wealthy) | March 31, 2005, 10:55am | #
After all this is over and done, will we as a society really have learned anything?
As a Christian I am saddened by the position of many of the "Pro Lifers" who also claim to be christians. They seem to enjoy picking and choosing from God's word to fit their agenda convieniently forgetting other parts that would contradict them. Terri Schiavo's parents are to be commended for loving their daughter, how ever when she married her husband their direct involvement ended. As her husband, Michael should have the final "say" in this and the parents, courts, govenment, should never have gotten involved.
When we marry we leave our parents and join as one with our spouses; to depend on one another in all things; but being Catholic I'm sure the Schindlers already are aware of this. It's ok for them to have concerns and emotions as it would be unnatural if they didn't, but they have over stepped their boundries. They must respect the sanctity of Michael and Terrie's marriage and stay out of it. If they are going to bring their faith into this situation then they must bring all of it or none of it, picking and choosing isn't an option. Jesus says be either hot or cold, but the luke warm is spit out, (yes it's a poor paraphrasing - best I can do on spur of the moment)luke warm = fence sitting (picking and choosing). The Schindlers seem to do a lot of this in their actions, they want what ever fits their cause best at the moment. The word selfish comes to mind.
Michael Schiavo on the other hand is at least staying the course, good or bad, hot or cold, taking whatever comes as it comes even to the point of being reviled. He is sticking by her through all, to see that her wishes are carried out. That is what a "spouse" is supposed to do.
Who else would know intimately what her wishes are regarding a situation such as this? Well, because society has become so jaded to marriage; IE: there are no good marriages any more, every one abuses, cheats, etc. we just have a hard time believing that this could be true. Well it is true, there are good marriages out there (I said good not prefect). No marriage is pefect as they are works in progress, I think Michael is doing what is right by his wife. I do believe she made it known to him her wishes regarding this kind of a situation. My wife and I have disscussed this also (long before we ever heard of Terri Schiavo) but we also have made legal arraingments to cover it.
To end this rant, two things...
1. It may sound funny to some, but I see God already having her soul and looking down at us and sadly shaking His head at our foolishness.
2. It at least has woke me up to the fact that not all things/people/parties are what they claim to be...
Oh yeah, I used to call my self a Republican.
BFM | March 31, 2005, 9:03pm | #
Regarding CodeBlueBlogMD's response,
All this talk of CT's, MRI's, fMRI's is beside the point (god, we love our technology). PVS is and will always be a CLINICAL diagnosis, made by bedside clinicians. You can put all sorts of pretty pictures on the screen, but spend some time examining the patient if you want to make a diagnosis.
Mr BlueMD is right, you can't tell PVS by the CT. You can, however, get a general idea of how much cerebral cortex is left. Whether that patient has PVS, advanced Alzheimers, or some other process is beyond the scope of the radiologist.
Regargding his "bet"; sure he can randomly throw up some really bad CT scans.... such as the one he has one his site under the headline "not that bad" [if you have spent ANY time with CT's you will laugh at his assesment], and many of those CTs may not of patients with PVS (a relative rare condition to be in, thankfully). HOWEVER, they will not be NASA rocket scientists either. More likely than not they will be in an advanced demented state, lucky if they know their own name or able to feed themselve or get out of bed. But they proabably don't have PVS....
Side question: In how many of his MORE THAN 10000 CT SCANS READ has CodeBlueBlogMD examined the patient that went with the CT scan. Probable answer: none. Radiologists stay in there dark rooms.
Most of you can probably see through the sillines, and are not intimidated by credentials (the louder they spout their own credentials, the more you wonder why they need to, no?).
BFM
Pepina | April 3, 2005, 2:47pm | #
People. People. People. Her condition is/was irrelevant. (The "crime" of parody: there are only two people in the world who understand the mystic of the human brain...and they disagree.)
He said, she said, they said is blather. "She was a 'vegtable;' end her suffering..." - you can't have it both ways, my friends, carrots do not, in any circumstance, 'suffer.' But, that, in itself, isn't really, truly a deal maker... anyway.
Hey, I don't know. Maybe Mikey is a holy picture. Maybe there was 'no greater love.' Hell, who knows - you don't and I certainly don't know. Isn't important, anyway.
So then what, if anything, is important. I am so glad you asked.... value. Her life, whatever that life may have been, had value to her parents. It should have meant something. It didn't. Damn shame.
(Note: 'Value to your parents,'I just talked to a kid who was on the verge of tears... his 'parents' were not going to be able to attend his wedding - they were in the 'finals' of a bridge tournament and they were so, so very sorry...) Guess, with us, the way we are, it all couldn't have ended any other way.
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