Terry Schiavo case - how can she respond?

I didn’t say they proved anything. Please see my first post.

Did you watch the video clips?

The reason I keep asking this is because I’m curious to know what those of you who have actually watched the video clips think of them.

See post #17.

In combination with what doctors have said about them, and about Terri’s state, I think they do not refute the doctors’ statements that she is in a permanent vegetative state with no chance of recovery.

That said, I can understand how her parents could believe that she is aware and has hope for recovery. Love – especially a parent’s love for a child – is more powerful than reason.

I only want to point out that repeated EEG tests (to measure brain waves arising from the cerebral cortex, i.e. that part of the brain that distinguishes us from reptiles) have been FLAT. And on multiple occasions. There is NO cortical activity.

Please come up with a mechanism for meaningful responses in the absence of a functioning cerebral cortex (i.e. one that is both electrically silent and anatomically absent, shown by EEG’s and CT’s respectively).

Thanks, Sample the Dog, I read your post #17, but was looking for more than just one opinion. :smiley:

I am not a doctor, but from what I’ve read and watched, I don’t think Terri has any chance at recovery. I sympathise with her parents, but IMHO, I think it’s a very selfish thing they’re trying to do, though I understand fully why they’re doing it.

I don’t necessarily side with Schiavo, because I am not yet convinced that his intentions are honorable. I do believe him when he says that Terri would not have wanted to be kept alive this way. Who would?

However, if we really want Terri and others like her to be allowed to die without being kept alive artificially, shouldn’t we be providing a less horrible way to go than starvation and dehydration?

In one of Terri’s video clips she does grimace when a nurse sticks a Q-tip into her mouth and over her lips. If she can feel that, and that sensation creates discomfort, I cannot imagine - nor do I want to - what she was feeling for the first five days after her feeding tube was removed.

I think the humane thing to do would be to euthanize her, not make her suffer for a week or two more as her body shuts down. Fifteen years seems like enough already.

This whole thing has prompted me to fill out an advance directive, which I did this morning.

Having cared for and observed numerous patients with all levels of unconsciousness, including PVS, even the heavily edited sound bites do nothing to convince me she is in any way aware. The changes in facial expression are seen in most patients with little or no high brain function.
But put that aside for a moment. Just for arguments sake, lets pretend Teri had another aspect of PVS know as Locked in Syndrome, in which the patient is fully to partly cognisant, but unable to communicate in any way ( I’ve seen 2 in 40 years)
Wouldn’t that be an even worse way to live? If she were “in there” so to speak, wouldn’t keeping her alive be far worse than solitary confinment in prison?
Teri’s ability to think or not isn’t the real issue. The true issue is her quality of life. No matter how much care her mother lavishes on her, its still not a life. Why not give her peace?

Before anyone asks, the locked in patients do have different reactions. Even though its often very difficult to distinguish PVS from LIS it can be done. Also, LIS patients have cortical tissue, Teri doesn’t.

I think it’s been pointed out in other threads that there is a legal difference between doing nothing and actually performing euthanasia.

I agree with your feelings.
Unfortunately it appears that some politicians have seen a bandwagon to jump on, so it’s not clear when any reasonable debate will take place.

Yes, I think we should allow such euthanization if the person requests it, however …

If by “advance directive” you mean to instruct that you be euthanized it won’t do any good. As the law stands now and it would appear for some time into the future, an advance directive to euthanize wouldn’t be honored. It’s against the law and it looks like it will remain so.

By a votor inititative, Oregon passed a law permitting euthanization and the US Attorney General has stated that the federal Justice Department will prosecute any physician physician in Oregon who acts under that law for violating federal drug laws.

Despite our best efforts it seems that starvation and its effects are one of the ways in which we finally die. For example, many abdominal cancer patients are unable to eat, or if they do eat can’t retain the food. They get weaker and weaker and finally get pneumonia and suffocate from lack of oxygen to the brain cells. And such patients have sensations and can feel pain so large injections of morphine, Demerol or other pain relief medications are used and this also contributes to the terminal pneumonia because the person is relatively immobile and can’t clear their lungs.

Yes, I have watched them.

I think it is absolutely ludicrous that they are being used as evidence that Schiavo has any conciousness or cortical function. The “balloon” one is particularly ridiculous, since the balloon itself and Schiavo are almost never shown at the same time, so it’s impossible to see whether or not she is tracking it - and the comments of the doctor on the sound track suggest she is not. The clips don’t indicate a level of response any higher than that of an earthworm.

I speak with some experience on this. My first cousin has been in a persistent vegetative state for the last three years. He twitches, he moans, he rolls his eyes, he grimaces. It is very disconcerting. It is easy to convince yourself at first that he may be responding in some way, since his eyes may occasionally flicker in your direction when you are speaking, and he may grunt or moan just after you have said something. But if you sit with him over a period of hours, it becomes obvious that these apparent reactions are just random - his eyes are just as likely to fixiate on some other part of the room, and he makes sounds even when no one has spoken for some time.

I don’t think you can evaluate these clips without having spent some time with a person in a PVS.

It’s the only legal way to do it. Sadly.

No, David Simmons, I am aware of the legal status of euthanasia in this country. I just think it would be the most humane option in Terri’s case.

I filled out an advanced directive so that if something dreadful happens to me - as it did to Terri - there will be no question what my wishes are.

I wonder if Terri is getting morphine?

She is indeed on a morphine drip.

Why? To assuage doubters that she might not be in no pain, hedgeing bets in case she is in pain, or she is in pain?

Because it’s a standard of care in cases of cessation of nutrition? Kind of like swabbing the arm you’re about to lethally inject while carrying out a death sentence (used ONLY as an example of a similar carryover, not equating Schiavo’s current situation with being executed. I think it’s safe to say that my position on this situation is very clear if you’ve read any of the previous threads on this that I’ve participated in.)

Some things are sort of automatic. Like when my father had terminal cancer and complained that his room was too warm. I opened a window and my mother-in-law worried that he would catch a cold.

So it’s SOP? I was under the impression that it wasn’t for people with brain injuries who would lack pain sensing capabilities.

In this case they probably figure it can’t hurt.

I wonder if all those protesters know that many, many people are disconnected from feeding tubes and whatnot, every day. It’s sad, but Terri’s is not a special case aside from the legal fighting.

I think it’s SOP in such cases.

It is sort of like the old joke about the lecturer who was stricken on stage. As people worked on rescusitation a voice floated down from the balcony, “Give him chicken soup.”

This was ignored and the work continued but to no avail, he died.

As the rescusitators stood up the voice again came from above, “Give him chicken soup.”

“Lady,” was the reply, “The gentleman is dead, what good would it do?”

Back came, “What harm?”

Telling your parents and fiancee is a good start and something you should do regardless. However, while IANAL I think it would be wise for you to put your wishes down in writing. Certainly in Terri Schiavo’s case she had presumably expressed her wishes verbally (as was found in a court case exploring that question) yet there is still legal wrangling going on. Putting it all in writing seems relatively simple and inexpensive or even free. All you need is a pen and paper and some witnesses to sign the document.

That said laws do change from place to place. Certainly in the US laws differ from state-to-state. IIRC in Michigan you need to give someone durable power of attorney over you if you are unable to make medical decisions. Supposedly that person must follow your wishes as best they know them (ideally with written instructions). Again IANAL and doubtless laws in Canada are different as well but it should be a simple matter to see your wishes in this regard put in a legal form that will be honored by phsyicians, courts and your family if it ever comes to that. There are all sorts of places (such as this one ) that point you to appropriate resources. I assume such things exist for Canadians as well.

As always if you really want to see it done right retain an attorney who knows this stuff to guide you through it all.

Anyone who’s edited home movies can tell you that editing footage to give an appearance different from what actually happened is trivially easy.

It may not be for pain management purposes. When my mother was dying in the hospital, she was not in pain (her cancer had not progressed to that point). However, she was in significant respiratory distress, fighting to breathe. They put her on a morphine drip because that eased the struggle to breathe, so she could rest more comfortably. She was not on a high enough dose to actually suppress the breathing reflexes, and in fact her oxygen saturation improved because she wasn’t wasting energy fighting to breathe.

Nothing I’ve heard indicates that this is what’s going on in Terri Schiavo’s case, of course; I had not even heard that she was on morphine until this thread. Just mentioning it because of the non-pain usage of morphine.