Sunday, March 20, 2005

MORE ON TERRI SCHIAVO. As I expected, my post yesterday engendered some fairly intense reaction on the part of Media Log readers, most of whom seem to think I've suddenly allied myself with the likes of Tom DeLay, who is cynically trying to make people forget about his alleged ethics violations by pandering to the religious right.

Please. It amazes me that most liberals (there are exceptions, most notably Senator Tom Harkin) seem untroubled by what's going on in Florida - just as Globe columnist Jeff Jacoby is amazed that his fellow conservatives don't seem to care about the widespread torture being used by US forces against suspected terrorists. (Click here and here.)

One of my correspondents wrote, "It's time to encourage public officials and the media to start using their brains, as in honor medical opinion and trust the legal system." Well, I don't endorse Congress's grandstanding efforts to force the Schiavo case into the federal courts. But "trust the legal system"? You've got to be kidding. I trust the legal system when it appears to be trustworthy, which is to say sometimes.

As for honoring medical opinion, I honor it as the best efforts of very smart, well-intentioned people to understand what's going on. But we all know that medical opinion changes pretty radically over time. Years ago, many disabled infants were institutionalized, even starved to death. Today they often become productive members of society. And yes, I realize this isn't a particularly good analogy to Terry Schiavo.

Anyway, let me close with a couple of links. Because I am the first to acknowledge that I don't really understand Terri Schiavo's current condition (an aside to my critics: neither do you), I found this piece by Benedict Carey, in today's New York Times, to be useful and fascinating. He writes:

Especially when a patient's eyes open on emergence from a coma, Dr. [Joseph] Fins said, family members are likely to assume that this is evidence of recovery. In fact, he said, it can augur poorly for the patient. When the eyes open but there is no quick return to mental responsiveness, it suggests that the primitive brain stem is reasserting itself, without engaging the higher brain: the cortex and other parts that are involved in thought and emotion.

And here is the link to Not Dead Yet, a radical disability-rights group for which I have a great deal of respect. Not Dead Yet opposes assisted suicide and euthanasia from an entirely different perspective from that of, say, Randall Terry, the anti-abortion-rights extremist who has unfortunately allied himself with Terri Schiavo's parents.

Here's an excerpt worth pondering from Not Dead Yet's website:

Legalized medical killing is not a new human right, it's a new professional immunity. It would allow health professionals to decide which of us are "eligible" for this service, and exempt them from accountability for their decisions. Killing is not just another medical treatment option, and it must not be made any part of routine health care. In these days of cost cutting and managed care, we don't trust the health care system, and neither should you.

I recognize that the Schiavo case has been going on for years, and it may well be that enough is enough. Mrs. Media Log pointed out to me yesterday that it was suspicious that Barbara Weller, the lawyer who claims Terri Schiavo reacted with great emotion when asked if she wanted to live, apparently did not videotape it. (Although I still say that Judge Greer ought to visit Schiavo's room and ask her himself.)

But this remains an extraordinarily difficult case, and I remain unsure that letting Terri Schiavo die is the right thing to do.

6 comments:

Anonymous said...

As I understand it, Terry Schaivo is not in a coma - she is in a vegetative state, which unlike a coma, has no case, ever, of a recovery. Furthermore I have to wonder about all this press and congressional grandstanding when both the press and congress little Sun Hudson's feeding tube - by the hospital staff no less. At least the Houston Chronicle covered it: http://www.chron.com/cs/CDA/ssistory.mpl/front/3087387Oh. I get it - it was a black child. Who gives a f - right? Gee, I detect a pattern, if I recall right, around the time that Laci Peterson was found missing, a young black pregnant woman was found in Richmond, CA. I wonder if the press will get itself in a frenzy to cover that story. Or Congress will pass a law against killing pregnant women. Puhleeze.

Dan Kennedy said...

Sun Hudson had a genetic condition known as thanataphoric dwarfism, which is always fatal. See:

http://www.vh.org/pediatric/provider/radiology/PAP/MSDiseases/DwarfThanat.html

Still, it seems pretty cold that the hospital pulled the plug. He would have died soon enough without the cost-cutting medical industry having to hurry things along.

Gee ... where was Tom DeLay?

Stealth said...

George Bush signed that law, too.

Dan, you can trust your eyes all you want, but so can Judge Greer. You've seen edited clips. He has seen the full things:

http://news.tbo.com/news/MGBQ67CTI6E.html

I've watched neither, because I think it's morbid and none of my business.

You may also want to check out the Court of Appeals opinion from 2001 at http://abstractappeal.com/schiavo/2dcaorder01-01.txt

Some relevant excerpts:

"The evidence is overwhelming that Theresa is in a permanent or persistent vegetative state. It is important to understand that a persistent vegetative state is not simply a coma. She is not asleep. She has cycles of apparent wakefulness and apparent sleep without any cognition or awareness. As she breathes, she often makes moaning sounds. Theresa has severe contractures of her hands, elbows, knees, and feet.

Over the span of this last decade, Theresa's brain has deteriorated because of the lack of oxygen it suffered at the time of the heart attack. By mid 1996, the CAT scans of her brain showed a severely abnormal structure. At this point, much of her cerebral cortex is simply gone and has been replaced by cerebral spinal fluid. Medicine cannot cure this condition. Unless an act of God, a true miracle, were to recreate her brain, Theresa will always remain in an unconscious, reflexive state, totally dependent upon others to feed her and care for her most private needs."

"In the final analysis, the difficult question that faced the trial court was whether Theresa Marie Schindler Schiavo, not after a few weeks in a coma, but after ten years in a persistent vegetative state that has robbed her of most of her cerebrum and all but the most instinctive of neurological functions, with no hope of a medical cure but with sufficient money and strength of body to live indefinitely, would choose to continue the constant nursing care and the supporting tubes in hopes that a miracle would somehow recreate her missing brain tissue, or whether she would wish to permit a natural death process to take its course and for her family members and loved ones to be free to continue their lives. After due consideration, we conclude that the trial judge had clear and convincing evidence to answer this question as he did."

"Clear and convincing" is a higher standard than the usual "preponderous of the evidence" usually used in civil trial. It also happens to be the one compelled by NY Times v. Sullivan, which I know you are familiar with.

That affirmation was unanimous, by the way. The entire Florida judiciary has reviewed and affirmed this up and down, repeatedly. Undermine that, and we undermine our entire system.

Anonymous said...

If you haven't heard, Dan, a private GOP memo has surfaced, claiming that Republicans will cleanup in the midterm elections because of their involvement in this case. Ugh. A link to the story can be found on
http://drtucker.blogs.friendster.com/my_blog/2005/03/private_gop_mem.html

Drusca said...

Speaking of euthanasia, there was a touching piece in the Times yesterday about infant euthanasia:

http://www.nytimes.com/2005/03/19/international/europe/19verhagen.html
http://www.iht.com/articles/2005/03/18/news/doctor.html

Anonymous said...

Dan, I'm surprised at your shoot-from-the hip approach to this. Our mainstream media suffers from a preponderance of know-it-alls feigning expertise on subjects about which they know nothing --from economics to Islam.

Too many people think if they read-up a bit on a complex issue --like the Schiavo case-- it makes them sufficiently informed to offer meaningful judgements.

Dan, your assuption that one could gain any meaningful (as in accurate) insight about a person's brain function just by watching them on a couple of video clips and reading related news coverage is simple-minded.

Your assumption that facial movements by a person in a permanent vegetative state result from the same brain activity (and consciousness) as a healthy person, shows that you know nothing about neuro-science (nor would I expect you to).

A brain missing it's cerebral cortex cannot process thoughts and responses any more than an arm missing a hand can move its fingers. It isn't there and it isn't growing back.

But if you're going to offer "reality-based" commentary more authoritative than cheap blogger "insta-punditry," you should at least bother to read some of the 15-years' worth of legal opinions and scientific testimony on this case.

Beyond the clear fact that only her husband has and should have the legal right to decide this matter, many professional and lay people have observed and examined Mrs. Schiavo in person for days and years. They have concluded that she is in a permanent vegetative state; are you honestly saying your judgement is more accurate after seeing a couple edited video clips?

-Nelson, Roslindale