Thursday, March 17, 2005
Criminal: I haven't been closely following the Terry Schiavo case, the brain-damaged Florida woman whose husband is pressing to have her feeding tube removed.
The way the media has reported this case, and therefore the perception of much of the public, has been skewed by a biased expert, a close-minded judge and an unwillingness to really do solid reporting.
Rev. Robert Johansen has a must-read piece over at National Review on the Schiavo case.
After reading Johansen's piece, I'm convinced that if the state of Florida had been responsible for Terry Schiavo's care, the media would be all over it.
Many people believe that Terri Schiavo has had “the best of care,” and that everything has been tried by way of rehabilitation. This belief is false. In fact, Terri has had no attempts at therapy or rehabilitation since 1992, and very little had been done up to that point. Terri has not even had the physical therapy most doctors would regard as normative for someone in her condition. The result is that Terri suffers from severe muscle contractures, which have caused her body to become contorted. Physical therapy could remedy this, but husband Michael has refused to provide it.
Terri has also suffered from what many professionals would regard as neglect. She had to have several teeth extracted last year because of severe decay. This decay was caused by a lack of basic dental hygiene, such as tooth-brushing. She also developed decubitus (skin) ulcers on her buttocks and thighs. These ulcers can be prevented by a simple regimen of regular turning: a basic nursing task that any certified nurse’s aide can perform. The presence of these easily preventable ulcers is a classic sign of neglect. Bob and Mary Schindler have repeatedly complained of Terri’s neglect, and have sought to remove Michael as guardian on that basis. Judge Greer was unmoved by those complaints as well.
Nursing homes are shut down and nurses go to jail when this sort of thing happens. But there is no outrage for Terri.
Add to this real questions over whether Terri really is a vegetable -- or in a "persistent vegatative state" -- and what appears to be happening is a rush to kill a woman.
In the course of my conversation with Dr. Morin, he made reference to the standard use of MRI and PET (Positron Emission Tomography) scans to diagnose the extent of brain injuries. He seemed to assume that these had been done for Terri. I stopped him and told him that these tests have never been done for her; that Michael had refused them.
There was a moment of dead silence.
“That’s criminal,” he said, and then asked, in a tone of utter incredulity: “How can he continue as guardian? People are deliberating over this woman’s life and death and there’s been no MRI or PET?” He drew a reasonable conclusion: “These people [Michael Schiavo, George Felos, and Judge Greer] don’t want the information.”
Dr. Morin explained that he would feel obligated to obtain the information in these tests before making a diagnosis with life and death consequences. I told him that CT (Computer-Aided Tomography) scans had been done, and were partly the basis for the finding of PVS. The doctor retorted, “Spare no expense, eh?” I asked him to explain the comment; he said that a CT scan is a much less expensive test than an MRI, but it “only gives you a tenth of the information an MRI does.” He added, “A CT scan is useful only in pretty severe cases, such as trauma, and also during the few days after an anoxic (lack of oxygen) brain injury. It’s useful in an emergency-room setting. But if the question is ischemic injury [brain damage caused by lack of blood/oxygen to part of the brain] you want an MRI and PET. For subsequent evaluation of brain injury, the CT is pretty useless unless there has been a massive stroke.”
So, we really don't know what Terri's status is, and the judge, with recent rulings that no testing of Terri may be done, isn't interested either.
Johansen also provides plenty of evidence that the doctor Terri's husband, Michael, has hired is more interested in killing people than treating them.
In cases where other doctors don’t see it, Dr. [Ronald] Cranford seems to have a knack for finding PVS. Cranford also diagnosed Robert Wendland as PVS. He did so in spite of the fact that Wendland could pick up specifically colored pegs or blocks and hand them to a therapy assistant on request. He did so in spite of the fact that Wendland could operate and maneuver an ordinary wheelchair with his left hand and foot, and an electric wheelchair with a joystick, of the kind that many disabled persons (most famously Dr. Stephen Hawking) use. Dr. Cranford dismissed these abilities as meaningless. Fortunately for Wendland, the California supreme court was not persuaded by Cranford’s assessment.
I wouldn't trust this guy if he said the sky was blue.
And it gets worse -- vegetables don't flinch.
In marked contrast, Dr. Cranford examined Terri on one occasion, for approximately 45 minutes. Another doctor for Michael Schiavo, Dr. Peter Bambikidis of the Cleveland Clinic Foundation in Ohio, examined Terri for about half an hour. When Dr. Bell learned of the cursory nature of these exams, he said: “You can’t do this. To make a diagnosis of PVS based on one examination is fallacious.” In Cranford’s examination, described by one witness as “brutal,” he discounted evidence under his own eyes of Terri’s responsiveness. At one point, Dr. Cranford struck Terri very hard on the forehead between her eyes. Terri recoiled and moaned, seemingly in pain. In his court testimony, Cranford dismissed the reaction and moan as a “reflex.”
"I asked Dr. Bell if he thought a moan uttered after a painful blow could be a reflex. "It's highly unlikely," he replied. He qualified his answer by noting that he had not actually seen the video of the exam, but he believes that the description of Terri's reaction is not consistent with a reflex. "A moan is not a reflex," Bell said. "A wince or grimace is not a reflex." "
By the very definition of Persistent Vegetative State, the patient must exhibit no “evidence of awareness of self or environment” or “ability to interact with others.” As one neurologist put it, if a patient shows “any response to the outside world, the patient isn’t in a PVS.” All it takes, according to Dr. Jones, is “only one examiner to discover the presence of higher brain function and the naysayers’ opinions are, by the very definition of PVS, null and void.”
If I'm ever in some tragic accident and my brain quits working, but my body doesn't know it, then there's no need for the empty shell to provide full employment for health care professionals. But don't starve me to death -- that's cruel. Instead chop out the organs and donate them to people whose brains are working. If that's not possible, force feed me Hostess Twinkies until all of my arteries clog up.
What's rather clear here, however, is that Terri Schiavo is not a vegetable. The real Terri is in there, somewhere, and if there is rehabilitative treatment that will help her, she should get it.
As a society, we should err on the side of life. That's not happening in this case.