Many of you are probably aware of the Terri Schiavo case which was in the news in 2005. Terri was in a persistent vegetative state, according to her doctors. Persistent vegetative state, or PVS, is a condition in which severe brain damage and coma have progressed to the point where the patient is awake, and often experiences a normal sleep-wake cycle, but shows no genuine signs of awareness. The state is said to be persistent if it continues for more than thirty days. Victims of persistent vegetative state often cry, moan, scream, swallow, or smile spontaneously without any external stimuli, but these behaviors are generally thought not to be a result of consciousness.
Terri Schiavo had collapsed in 1990 from cardiac and respiratory arrest. The collapse was believed to have been brought on by an eating disorder, although this has not been verified. According to the statement Terri’s husband Michael Schiavo made on Larry King Live, seventy minutes elapsed before he called for emergency medical care. No explanation has been given for the delay.
Terri’s brain was severely damaged, leaving her in a coma. She eventually emerged from the coma, but showed no normal evidence of consciousness, leading to her PVS diagnosis. As a result of her condition, Terri had to be institutionalized, and was dependent on a feeding tube. Terri’s husband, Michael Schiavo, filed suit in 1993 against Terri’s OB-GYN for malpractice, claiming that the doctor had failed to diagnose and treat Terri’s bulimia. He was awarded $600,000 for this suit, and Terri was awarded $1.5 million, to pay for her future rehabilitation and care.
Despite this, in just a few short months after receiving the money for this lawsuit, Michael Schiavo chose to stop all of his wife’s therapy. He issued a Do Not Resuscitate order at the same time. Michael Schiavo began a relationship with another woman, by the name of Jodi Centonze, during his wife’s interment. He remained married to Terri, since divorcing her would mean relinquishing guardianship. He claimed that Terri had stated that she would not want to live in a persistent vegetative state, and that he wanted to ensure that her wishes to die would be carried out.
In 1998 Michael Schiavo began proceedings in a Florida court to remove Terri’s feeding tube. The court decided that Terri would not wish to continue living as she was, and ordered her feeding tube removed. A battle ensued. Michael Schiavo maintained his insistence that Terri would not want to live in a persistent vegetative state. Eighteen witnesses gave testimony in 2000, and Judge George Greer found their testimony “credible and reliable.”
Terri’s parents, Robert and Mary Schindler, argued that Terri experienced consciousness. Several videos were placed on the internet. I watched these segments, and I felt they very clearly showed Terri reacting with pleasure to her mother’s arrival. She seemed very aware of her mother’s presence, but unable to adequately respond.
The Schindlers disputed Terri’s diagnosis of persistent vegetative state, and asked that she be reexamined. In 2002, five doctors examined Terri and new scans of her brain were taken. The scans showed clear signs of hydrocephalus, or water on the brain. A significant amount of the central area of Terri’s brain had simply turned liquid. Three of the doctors, two of whom had been chosen by Michael Schiavo and one which had been chosen by the court, supported the diagnosis of persistent vegetative state.
However, the two doctors which the Schindlers had chosen testified to the court that Terri was in a minimally conscious state. Minimally conscious patients exhibit deliberate or cognitively moderated behavior in such a way that it can be distinguished from totally unconscious or reflexive action. Six hours of video were produced as evidence. After viewing the tapes, Judge Greer ruled that “Terri does not consistently respond to her mother.”
On March 18, 2005, Terri’s feeding tube was removed. She died on March 31, 2005, aged 41, from dehydration and lack of nutrition.
Since Terri’s death, an autopsy has revealed that it was in fact possible for her to have known what was happening to her. The report given by the Medical Examiner for Pasco and Pinellas counties stated, “The frontal temporal and temporal poles and insular-cortex demonstrated relative preservation.” Her cortex was still functional, and the brain was “more normal” in the area that controls judgment, language, memory, and other higher cognitive skills. The most affected areas of Terri’s brain were the parts devoted to motor ability. This evidence supports the findings of the Schindler’s doctors, that Terri was minimally conscious, rather than in a persistent vegetative state.
Another case has come to light which supports this theory. In his report, A Quarter Brained Man!, Stefan Anitei reveals a 44 year old man who has been living a normal life despite the fact that the majority of his brain has turned to soup. Like Terri Schiavo, he has hydrocephalus in approximately 50% to 75% of his brain, based on a visual analysis by Lionel Feuillet, a neurologist from Marseille, France. The whole brain was reduced in size, including the frontal, parietal, temporal and occipital lobes. The reduction occurred on both sides of the brain in an almost symmetrical pattern.
The man scored 75 on an intelligence test. This is below average, but doesn’t qualify him as mentally retarded or disabled.
Despite the extreme reduction of his brain, this man was able to work as a civil servant, and manage his life as a husband and father of two children. He had suffered hydrocephalus since infancy. Dr. Feuillet stated that in some cases, the brain can adapt to extreme injury in the “pre- and post-natal period.” Pediatric brain specialist Max Muenke was amazed at cases such as these, where “the brain can deal with something which you think should not be compatible with life. If something happens very slowly over quite some time, maybe over decades, the different parts of the brain take up functions that would normally be done by the part that is pushed to the side.”
What’s really frightening here is that Terri’s brain was actually more intact than the brain of the Quarter Brained Man. Perhaps this man retained greater functionality since he suffered his condition since infancy, whereas Terri’s condition began in adulthood. Perhaps this man’s brain was able to adjust to gradual changes over time, whereas the suddenness of Terri’s injury allowed her no such luxury. Still, I feel strongly that this sheds new light on Terri’s condition.
The entire justification for the manner in which Terri was put to death was based on the PVS diagnosis. I don’t believe that the the actions taken against her were justified at all, even if the diagnosis was correct. It’s impossible to make a truly accurate diagnosis of PVS, and misdiagnosis is common. I don’t mean to justify the forcible killing of patients who could be said to be truly suffering from PVS. I believe that it’s murder, plain and simple, regardless of the legal definition. I believe that Terri’s tube removal was a horrible miscarriage of justice. If I lived to be a million years old, I would never support this ruling.
But these new findings make the manner of Terri’s death even more horrifying. If she was truly cognizant on some level, but merely unable to communicate properly, then it’s possible that she did experience her slow starvation and dehydration as slow torture. It’s possible, as the report stated, that she experienced and was aware of her impending death.
The point here is that we don’t understand the function of the human brain anywhere near as much as we think we do. To claim that we know it all is simple arrogance. The truth is that many people who are believed to be in a coma, persistent vegetative state, or minimally conscious may be experiencing higher brain functions. And they may experience these functions despite the fact that a significant amount of the brain has turned to fluid, or there appears to be no brain activity. We just don’t know.
The acts taken against Terri Schiavo were acts of prejudice, not acts of mercy. Michael Schiavo’s statements regarding Terri’s collapse have been consistently inconsistent. Allegations that her husband abused her, that he may have caused her collapse, and that he put her to death just to get her money, or because he just wanted her dead, have never been properly addressed. An absence of evidence is not proof that these things didn’t happen. It’s just means that Michael Schiavo is a very clever monster, and that he knows how to get away with murder.
It’s time for us to stop passing judgment on the brain-injured. It’s time for us to stop taking away their rights, and the rights of their families. Terri has lost her life, and her parents have lost their daughter. Who is going to be the next victim?
Uncredited, “Terri Schiavo.” Wikipedia. URL: (http://en.wikipedia.org/wiki/Terri_Schiavo)
Uncredited, “Terri’s Wish.” Terri Schindler Schiavo Foundation. URL: (http://www.terrisfight.org/mainlinks.php?tablesingle=main_terri_story&id;=6)
Uncredited, “Persistent Vegetative State.” Wikipedia. URL: (http://en.wikipedia.org/wiki/Persistent_vegetative_state)
Uncredited, “Minimally Conscious State.” Wikipedia. URL: (http://en.wikipedia.org/wiki/Minimally_conscious_state)
Stefan Anitei, “A Quarter Brained Man!” Softpedia. URL: (http://news.softpedia.com/news/A-Quarter-Brained-Man-60542.shtml)
Jon R. Thogmartin, M.D., “Report of Autopsy.” Blogs for Terri.com. URL: (http://www.blogsforterri.com/archives/5050439_autopsy%20report%20and%20supporting%20documents.pdf)
