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Some thoughts occasioned by the tenth anniversary of the death of Terri Schiavo.
Mark–Brain dead is DEAD!!! But, of course, you wouldn’t know.
Terry Schiavo was alive, and there was a chance of recovery. People have come out of persistent vegetative states, and what you call “brain dead,” is not actually dead, and it never was, nor has it ever been. Dead is when a person’s entire body stops functioning and dies, not when they are in a vegetative state.
Tweck is right. TS was not brain DEAD, or even brain dead. She was diagnosed as being in a PVS, which basically describes an ongoing lack of awareness or consciousness. Brain scans confirmed that her brain had mostly liquified, and the possibility of any meaningful recovery was admittedly remote at best, but she was still very much a live human being, and as such should have been entitled to basic food and water until natural death.
And of course you would? There are those who hold a dead soul is dead, DEAD if you prefer, but let us pray they are wrong, Mz. Cha.
The key & obvious thing about the murder of Terri Schiavo is that her parents & siblings loved her, & that the husband who arranged her murder did not.
The latter triumphed to be sure, partly because in l’Usa, if I may borrow from Mr. Gogol, there are lots of dead souls, but mostly due to an oligarchy determined to kill the ones still alive, to the end of being able to kill whom’er they will.
Terri wasn’t brain dead, however.
“She was, to put it plainly, sentenced to death by thirst for the crime of being weak and expensive and inconvenient.”
William Hammesfahr, who was the primary neurologist for the parents, was promoting his own vasodilator therapy – a quack therapy with no evidence of efficacy. He offered a number of dubious opinions in this case, but most importantly that his therapy could help Terri Schiavo. The other physician who gave official testimony for the parents’ side (That Schiavo could recover) was Dr. William Maxfield. Like Hammesfahr, he also has a dubious treatment to sell – hyperbaric oxygen. Also of note Dr. Maxfield is a radiologist – not a neurologist. I find it extremely telling that the two physicians who ultimately stood for the position that Terri was not in a PVS had something dubious to sell.
There was another physician of note, a neurologist and recognized expert, who publicly offered his opinion in the case – Dr. William P. Cheshire. He stated that he believed Schiavo exhibited signs of consciousness. His opinions were largely criticized, however, in that they were based largely on his “feelings” about Schiavo, rather than objective exam findings, and he also came to the case on record as having strong conservative religious views on the topic.
The autopsy showed that Terri Schiavo had diffuse watershed infarcts of her brain – this means that the borderlands between adjacent arteries, where perfusion pressure is the lowest, experienced the most profound loss of oxygen and therefore damage. This is consistent with her history of cardiac arrest and diffuse anoxic-ischemic injury. The cortex was everywhere very thin, but worse in the occipital lobes. Microscopically her brain showed great variability. The worst areas showed a near complete loss of neurons – the cells primarily responsible for brain function. The better parts showed “relative” preservation, but still had loss of some types of neurons and infarction of some layers of the cortex, as well as overall atrophy.
In other words – her brain showed severe chronic damage, grossly and microscopically. The brain seen on autopsy was probably incompatible with any detectable consciousness and would have had no hope of meaningful recovery. Any other opinion is pure pseudoscience.
Of note the damage was worst in the occipital lobes responsible for vision. It is therefore also clear that Terri Schiavo was blind. This is further and independent evidence that any reports of her fixing her gaze on people or recognizing her family by sight must have been false.
What your write is accurate. Yes, the evidence of any type of consciousness or awareness was exceedingly weak, as was any evidence of a prospect of recovery of such. But TS was not brain dead, or any other type of dead in any scientific or clinical sense. Everything you write is basically an argument of equating consciousness or awareness with a human’s ontological humanity. You are basically saying if a person has no conscious awareness and no realistic prospect of such, then they should be “deemed” dead. As a matter of morality Catholics reject this precisely because one’s ontological status as a human being (i.e., a child of God) is not a function of awareness or consciousness as such, but simply a function of being scientifically and genetically human. Under natural law we owe our fellow human beings who cannot care for themselves ordinary care, which normally should include food and water.
Given that she was eating and drinking by mouth after her injury, until Michael stopped that and had the feeding tube inserted, she had at least some function. But that doesn’t matter anyway; we would recognize cruelty of the worst sort if we starved and dehydrated an animal to death, and there’s no excuse for murdering any human so horribly (not that a “kinder” murder would be any real improvement).
ETA: the reason she had a tube was not inability to eat, but that Michael cited fears she would get aspiration pneumonia or choke. Shortly after, he switched her nursing home (so as to no longer have her in the care of staff who had seen her abilities) and began court arguments that the tube he’d insisted on was medical treatment and should be discontinued.
The autopsy was performed only after she had been dehydrated to death, so it is certainly possible that a substantial amount of that damage was due to the dehydration. The obvious way to learn how death by dehydration affects the brain is to dehydrate brain healthy people and see what the effects of that kind of death is. Since we haven’t quite reached that level of depravity in this country yet, we’ll probably have to wait 5 or 10 years to find out. In the meantime, there’s no way to determine how much of what was wrong with Terri’s brain was due to her original injury and how much to her judicial murder.
For patients who are at the end of life, death normally occurs within three to 14 days after artificial nutrition and hydration is stopped (the time varies depending on how debilitated the patient was when treatment was discontinued). Reports based on the observation of unconscious patients indicate that the process is quite peaceful, and no evidence exists that they are aware of the process. Conscious patients who are elderly or neurologically impaired usually will slip quickly into a coma (a sleep-like state that is inherently free of pain) and become similarly unaware.
Observations by those who have had a great deal of experience caring for people who are dying, such as hospice workers, have noticed that patients who are not tube fed seem more comfortable than those who are. Caregivers also have observed that symptoms such as nausea, vomiting, abdominal pain, incontinence, congestion, shortness of breath, among others, decreased when artificial nutrition and hydration were discontinued, making the patient more comfortable. Medical observation has found no indications that patients who have suffered massive brain damage causing permanent unconsciousness experience any pain when artificial nutrition and hydration is stopped.
Reports from conscious dying patients indicate that they increasingly experience a lack of appetite and thirst. In fact, it is common for competent hospice patients and those suffering acute illness to refuse food and water. Dry mouth is the only commonly reported symptom, and it can be managed without resort to tubes.
Artificial nutrition and hydration is largely a 20th century technology. Historically, coma was nature’s way of relieving the suffering of people who were dying. However, the provision of artificial nutrition and hydration may prevent the development of this natural anesthesia in some cases.
This is true of people who are *dying* but not at all true of people who are not near the end of life yet are denied food and water anyway. Terri was not dying; she was healthy but brain-damaged. There are plenty of disabled people who live for years, quite happily, receiving nutrition via tube and Terri had been, and should have continued to be, one of these.
Tell it to Terri and her brother who witnessed her horrible death.