richard
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Florida governor signs law to overturn court decision and keep vegetative woman alive
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Oct 27 02:28 UTC 2003 |
There is a case making headlines down in Florida, where a woman has
been in a vegetative state since suffering a heart attack in 1990, and
the Courts gave permission for her next of kin, her husband, to consent
for the removal of her feeding tube. The courts agreed with the
doctors that this woman has no chance of recovery, that there was
massive loss of oxygen to the brain when she had her heart attack, and
that CAT scans show the brain has greatly reduced in size. Her feeding
tube was taken out and her body was to be allowed to die peacefully.
But enter the conservative Florida legislature, which-- acting on
behalf of this woman's parents-- tailored a bill specifically for her
case that would take away the husband's right to act as her guardian.
Florida governor Jeb Bush signed this bill, and the woman's feeding
tube was reinserted.
This article was in today's New York Times:
In Feeding-Tube Case, Many Neurologists Back Courts
By DONALD G. McNEIL Jr.
Published: October 26, 2003
The New York Times
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Brain
t the center of the court battle over the immobile body of Terri
Schiavo, the 39-year-old Florida woman kept alive by a feeding tube, is
a videotape made by her parents. It lasts only minutes but has been
played so many times on television and the Internet that it all but
defines her.
On the tape, Mrs. Schiavo, propped up in bed, is greeted and kissed by
her mother. She is not in the deep, unresponsive sleep of a coma. Her
eyes are open, and she blinks rapidly but fairly normally. She seems to
follow her mother's movements, but her mother's face is too close for
that to be clear. Her jaw is slack and her mouth hangs open, but at
moments its corners appear to turn up in a faint smile.
To many supporters of Mrs. Schiavo's parents, who say she should be
kept alive on a feeding tube, the tape demonstrates that she can still
think and react. But many leading neurologists say that it means no
such thing, that the appearances of brain-damaged patients can be very
misleading.
Florida courts have ruled, after hearing from several experts who
examined her, that Mrs. Schiavo has been in a "persistent vegetative
state" an official diagnosis of the American Academy of Neurology
since her brain was deprived of oxygen when she suffered a heart attack
13 years ago. Her feeding tube was removed on Oct. 15, but it was
reinserted six days later after the Florida Legislature gave Gov. Jeb
Bush the authority to override the courts.
Patients in vegetative states may have open eyes, periods of waking and
sleeping and some reflexes, like gagging, jerking a limb away from pain
or reacting to light or noise. They may make noises or faces and even
say words.
But they do not, according to academy criteria, show self-awareness,
comprehend language or expressions, or interact with others.
A vegetative state "is the ironic combination of wakefulness without
awareness," said Dr. James L. Bernat, a Dartmouth Medical School
neurologist and past chairman of the academy's ethics committee.
Mrs. Schiavo's parents and the conservative Christian groups working to
keep her on the feeding tube insist that she is in a "minimally
conscious state" another official diagnosis. They note that on the
videotape, her eyes appear to follow a silver balloon waved before them.
Her father, Bob Schindler, visited her on Thursday night and said later
that she had made the sound "unh-unh," as if to say no, when he kissed
her, and "unh-unh" again when he asked her if she wanted him to kiss
her. He described that as a sign that she could hear and answer
questions.
In 2001, Dr. Richard Neubauer, director of the Ocean Hyperbaric
Neurologic Center in Florida, said in an affidavit that said he found
Mrs. Schiavo "not in a vegetative state" and "at least semi-responsive
to her environment." He was seeking to treat her by putting her in an
oxygen-rich pressure chamber.
A famous case of "minimally conscious," said Dr. Michael P. McQuillen,
a professor of neurology at the University of Rochester, was that of a
woman who appeared vegetative but, on overhearing her sister on the
phone making funeral arrangements for a favorite uncle, began to cry.
Mrs. Schiavo is fed by tube and incapable of making decisions for
herself. She cannot swallow, though her parents argue that with help
she might be able to relearn swallowing so she could be spoon-fed.
Early in Mrs. Schiavo's illness, her husband, Michael, sent her to
California to have a nerve stimulator implanted, one neurologist said,
but he later came to believe she would never recover.
Vegetative states become persistent, according to the neurology
academy's criteria, after about three months, after which it is highly
unlikely that they will end. Patients like Mrs. Schiavo whose brains
have been starved of oxygen do worse than patients who suffer head
trauma, neurologists say.
"Thirteen years is plenty long enough to tell," said Dr. Bernat, who
said he had not examined Mrs. Schiavo or seen any videotapes. "Assuming
she is in a vegetative state, I can say with medical certainty that
there is no realistic hope that she'll recover."
Dr. Bernat was part of a large medical panel that in 1994 assessed
thousands of patients' records and found that up to 35,000 Americans
were in persistent vegetative states.
Mrs. Schiavo's parents and a Web site, terrisfight.org, have
cited "miracle recoveries" by people who supposedly woke up, speaking
and moving, after years in comas.
Dr. Bernat said his 1994 panel looked into more than 70 "alleged late
recoverers" and found that "there wasn't a single one that was
verified, so I'm very skeptical."
Dr. Ron Cranford, a Minneapolis neurologist who was Dr. Bernat's
predecessor on the academy ethics committee, examined Mrs. Schiavo as
part of the original trial and testified in favor of her husband's
request to discontinue feeding.
He was adamant that she would never get better, and he says he is
furious about the popular videotape.
"She's vegetative, she's flat-out vegetative, there's never been a
shred of doubt that she's vegetative, and nothing's going to change
that," Dr. Cranford said in a telephone interview. "This has been a
massive propaganda campaign, which has been very successful because it
deludes the public into thinking she's really there."
Her eyes do not steadily track objects, he said, and when she appears
to look at her mother or a camera for a moment, it is merely rapid eye
movement.
More important, he said, "the CAT scans indicate a massive shrinkage of
her brain, with its higher centers completely destroyed, which
indicates irreversibility."
The Schiavo case is the kind of family fight that doctors treating
brain-damaged patients say they dread. "In a case like this, you're
between a rock and a hard place," said Dr. McQuillen of the University
of Rochester.
He added that keeping Mrs. Schiavo alive artificially could be a burden
on her.
For many terminally ill patients, he pointed out, "food is an abslute
burden it increases secretions and makes them uncomfortable."
The woman's parents have put up a website to make their case that she
should be kept alive, that she is responsive to them:
http://www.terrisfight.org/
What do you think?
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richard
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response 1 of 107:
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Oct 27 02:39 UTC 2003 |
This case really upsets me. I don't think the Florida legislature or
Governor Bush had any business interceding in this matter. This woman
is brain dead, she is vegetative, and her brain is now greatly reduced
in size. What she was, her memories, her personality, is gone. Her
husband is her next of kin, and if the doctors, many doctors, have told
him there is no hope of recovery, and that force feeding her body ad
infinitum won't change things, I think he has/had every right to ask
for her tube to be removed.
The parents seem to be particularly spiteful of the husband, because he
got another girlfriend a few years ago and had a child with her. I
don't think this is relevant. This woman has been in a vegetative
state since 1990. After years went by, it becomes obvious that there
is no hope. He had the right to go on with his life. If I was this
woman, I would not want my body kept alive when there is no hope of my
recovery. I would want my loved ones to get on with their lives. the
parents see their little girl, and she's alive and breathing. But what
they see is on the outside. On the inside she's dead. She died a long
time ago. Their daughter died when her brain died. Her body is what
is still alive. And these conservative legislators, who drafted this
emergency legislation, and Bush who signed it, seem to be reacting out
of their religious beliefs, that only God should take a life and that
the husband is an adulterer.
I think the parents need to let their daughter go, and they need to
respect that when she when she had her heart attack, and ended up in
that hospital bed thirteen years ago in a coma, she was happily
married, and her HUSBAND, not them, is the next of kin. And if he
said, "my wife wouldn't want her body kept alive", they ought to
respect that and not say he's lying.
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