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Monday, March 21, 2005

Terri Schiavo's brain

There has been some controvery about whether sufficient medical technology has been utilized to determine if she is a vegatable or not. This post should, in my opinion, pretty much settle that debate:

There is no way any qualified brain doctor or scientist could look at this image and suggest that significant recovery of function is possible. The fact that we could have all this discussion on the subject is a triumph of politics over science. Tragic for Terri Schiavo, and really for us all.
Click through to see an image of Terri's brain compared to a normal brain. (source for the images can be found here.) This is convincing to me.


Blogger The probligo said...

In ordinary terms, Dave, you would be right. In this instance you may well also be right.

BUT... (isn't there always one?)

The problem is really one of the ability of technology to keep people alive well past the time when nature would have them die.

The decline of the mental capacity of a person with Alzheimers is truly a reflection of this continuum from "life" to "death" of the personality.

What makes the problem stand out is that there is still no scientific means of reliably determining the death of the "person" as distinct from the death of the "body".

The problem I have with the interpretation of medical evidence of the nature you have linked to comes from a tv doco last year about a five year old lass born with ancephaly (essentially "no brain").

At birth the scan showed that she had not a lot more than brain stem tissue. The prognosis was that she would not live past some months.

At the age of five she had gained sight and hearing, and her speech was developing. Intellectually she was judged as equivalent to a four year old.

A brain scan at that time showed that her brain volume had increased - to about 15% of normal.

I have concerns about the Schiavo case - regarding the technology being used; the fact that the ability to keep people alive has far outstripped our ability to judge the quality of that life; and the fact that there are - as yet - no agreed ethics to control the influence of third parties over the rights of the patient.

There was a case in point in NZ recently - a 23 year old woman who "died" after a car smash. Nothing unusual in that except that she was four months pregnant. So she was kept "alive" until her babe was delivered, and then the machines were turned off and she died some hours later. Right or wrong? I am not going to judge. But what was the quality of the extended life?

I am concerned.

How do you judge the rights of spending NZD2 million (USD1.4 mill) keeping an eight y-o boy alive? He suffers from extreme haemophilia. The cost is "a conservative estimate". What quality of life has he had?

How much has Terri Schiavo cost over the past fifteen years? Who paid for that? For what quality of life?

My father died of a common and very rapid cancer. He had the option of all the medical technology; he refused. After we had talked him out of "sailing to Chile", he lived a comfortable 9 months supported by the family and intensive palliative care. I can say fairly certainly that he was glad to go.

The biggest pity, the biggest shame, the biggest concern; that Terri Schiavo has become the subject of public opinion and political "interest".

Neither of these should EVER, in my opinion, weigh on the rights of the individual.

3/21/2005 04:13:00 PM  
Blogger Dave Justus said...

I am no fan of nature, I think keeping ourselves from death is, in balance, a very good thing.

But quality of life does matter, it is a personal decision. When the person themselves can't make that decision it becomes a lot harder.

The point of this post though, was whether Terri needed an MRI or some other test to determine her condition or if the CAT scan was good enough. I am convinced that an MRI wouldn't reveal anything relevant.

3/21/2005 04:18:00 PM  
Anonymous Michael C said...

Whether it could or could not help we just do not know. The key is that when Michael Schiavo had the chance to allow additional testing he denied her treatment. He denied her simple antibiotics to fight infection. Why? This raises concern of his competentancy as her guardian. I simply believe that we as a society should error on the side of life rather than death. Michael Schiavo is erroring on the side of death. Terri early on had the ability to walk on parralel bars and talk a minute bit. Even now she has the ability to swallow water and to make sounds when people enter the room. She is brain damaged not brain dead.

posted here

3/22/2005 04:31:00 AM  
Blogger Dave Justus said...


I assume it is because he believes that she would want to die. That is the whole point of the controversy after all. Why on earth would anyone try to get a feeding tube removed but still have anti-biotics administered to fight infection.

Err on the side of life has a nice ring to it, but there must be a limit to how far we must go to avoid error and I believe their must be a place for personal choice.

I could be convinced I think, that Michael Schiavo should error on the side of life. It is a steeper test to convince me that our government should intervene and remove his choice made on his wife's behalf. Shouldn't we sometimes err on the side of freedom?

3/22/2005 07:42:00 AM  
Blogger Mystic Knight said...

Ah but what of the freedom for Terri?

Basically your saying her husband has the freedom to kill her because he is her [cough] guardian.

What of her freedom as basically a handicapped person being held prisoner by her husband and treated worse then we would treat prisoners?

I believe the words are "life, liberty, and the pursuit of happiness".

Life and freedom should go hand-in-hand.

3/22/2005 09:24:00 AM  
Blogger Mystic Knight said...

Sorry for the continued post, but I forgot why I began my response. :)

I would like to see a series of brain images showing various degrees of retardation and handicapped people. I have no clue what I am looking at with those images, and they both seemed to be lighted differently.

I'm no brain surgeon, but I have seen comparrison CT scans on the Discovery Channel when they are discussing mentally handicapped folks, and there is a variety of things they look for.

My point? These images in and of themselves indicate to me (someone who knows nothing about such things) that yes there looks like a problem is present. Am I knowledgeable to understand them enough to argue a defense? Uh, no... :)

I won't argue various degrees of handicapped brain scans, because of this I know naught.

3/22/2005 09:36:00 AM  
Blogger Dave Justus said...

The Freedom I am talking about is Terri's freedom.

I remain convinced that she expressed to her husband and others (although not apparently her parents) that she would not want to be kept alive in such a situation. That is what the court cases have found.

I certainly am not able to evaluate brain images, but the post I linked to still seems persuasive to me.

I would postulate that if two experts disagree in a situation like this, I would be more inclined to believe the one that said she was a vegatable than one who said it was inconclusive or she still had mental functions. As I have said many times, the issue is heavily emotionally charged and someone opposed to ending her life would be more likely to exaggerate her chances than someone who was not as emotionally connected. I think those who passionately think she should die are few and far between.

3/22/2005 10:37:00 AM  
Blogger Cubicle said...

" would postulate that if two experts disagree in a situation like this, I would be more inclined to believe the one that said she was a vegatable than one who said it was inconclusive or she still had mental functions. "

I would go the other way. That is what erring on the side of life means to me.

secondly, read this article about just WHO said she has mental functions or the test are inconclusive


3/22/2005 11:16:00 AM  
Blogger Mystic Knight said...

"I would postulate that if two experts disagree in a situation like this, I would be more inclined to believe the one that said she was a vegatable than one who said it was inconclusive or she still had mental functions." - Dave Justus

"I have been lucky, that my condition has progressed more slowly than is often the case. But it shows that one need not lose hope." - Stephen Hawking (source)

The disability is different, but the statement applies...

3/22/2005 12:22:00 PM  
Blogger Random Gemini said...

Stephen Hawking.. I wondered how long it would be before someone entered him into this equation.

Stephen Hawking's situation is almost entirely the polar opposite of Terri Schiavo's and to use him here as an example, when his situation absolutely does not apply, borders on the offensive.

Yes, I do believe that one should not give up hope. But hope is not what is at issue here in all reality. What is at issue, is Michael Schiavo's right to choose for his wife. If her parents wanted to have that right, they shouldn't have allowed her to get married, or they should have told her to get a living will. Under Florida law.. Michael Schiavo, like him or not, has the right to choose for Terri, her parents do not. Terri has no cognitive function and cannot make that choice for herself. In that situation, in most states, power of attourney goes to the spouse. That means, all your stuff, decisions about your medical care and weather or not the plug will be pulled on your life should you become unable to make those choices of your own will default to your spouse.

The law is very clear on this. Very clear. You may not like it, you may disagree, but you have no right to infringe upon someone else's right to choose. There is absolutely no law on the books that allows one person to infringe upon the rights of another. All the rights belong to Michael Schiavo and I am absolutely disgusted that no one who believes in "her right to live" has bothered to respect Michael Schiavo's right to let his wife die.

3/22/2005 10:01:00 PM  
Blogger Andrew Watkins said...

Random Gemini is absolutely right. All the examples of Michael Schiavo refusing his wife medical treatment (be it painkillers, or the MRI, which Tom DeLay has villified him for, and was the whole subject of this post) are being used to portray him as "erring on the side of death". The rhetoric and the emotions in this case have overlooked two important facts: A) Michael Schiavo, according to several judges of different persuasions, is acting according to the way his wife wanted. She wanted him to err on the side of life. B) Even if it were ambigious what her intentions were, which, again, courts have repeatedly found no ambigiuty, in that situation, the law says that a husband has the right to speak for his wife. There is absolutely no legal basis for anything Terri's parents have done after their FIRST appeals process.

3/24/2005 02:44:00 PM  

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