Terri Schiavo's autopsy was released today
Of all the articles I've seen, this St. Petersburg Times Tampa Bay article seems to be the most factual and unbiased summary of the report.
I am amazed at the number of articles claiming the autopsy "proves" or "backs up" this or that--especially when the report itself doesn't say any such thing.
For example, the PVS diagnosis.
The autopsy report simply doesn't and can't prove whether Terri Schiavo was in a vegetative state as opposed to a minimally conscious or other profoundly disabled state, despite what many news articles are saying. As Examiner Thogmartin reasserts in the report, PVS is a clinical diagnosis and not something that can be proven or disproven by doing an autopsy.
We already knew that the autopsy was going to show profound brain damage and that dead neurons weren't going to grow back. That's no surprise.
But that still doesn't tell us how much consciousness or awareness she did or didn't have, or whether she would have been able to experience some level of improvement in her existing brain cells with the right therapies or not. It was beyond the scope of an autopsy to make that kind of judgement, and it seems somewhat irresponsible to me for a medical examiner to make a strong statement one way or the other regarding that fact based on an autopsy.
The autopsy certainly doesn't tell us whether it made any difference to her when she was provided with music and other stimulation, treatment for symptoms of pain, basic care and therapy, etc. versus when she was denied these things. Although I think it unlikely that her basic condition would have changed with therapy, I certainly think it's possible that she was at least on some level aware of and affected by the way she was (or was not) treated.
It is interesting to me that it mentioned Terri's brain weighed half what a normal brain would weigh. Yes, that's extreme damage but it's also not the same as "no brain" or a "completely liquified brain" as Atty. Felos and several doctors were claiming. I'd be very interested to know how that compares with a profoundly disabled but aware brain, the brain of someone with hydrocephalus or in a minimally conscious state, and also how dehydration might affect that.
What confuses me is how Thogmartin can claim to know from the autopsy that Terri Schiavo was unable to swallow (especially given that we have much evidence she was able to swallow at least her own saliva) and that he says she was blind. If she was blind, why did all but one or two of the doctors who examined her say that she showed at least some level of visual tracking? Is visual tracking something that can take place with blindness? Also, how would blindness affect the evaluations of her responses in making a diagnosis?
It is interesting to note that the examiner found no evidence consistent with a spine or neck injury, bulemia, or heart attack. The cause of her original collapse still remains completely unknown.
I haven't been able to get the pdf format of the actual report to load for me, so if anyone finds it in text format please let me know.
I am amazed at the number of articles claiming the autopsy "proves" or "backs up" this or that--especially when the report itself doesn't say any such thing.
For example, the PVS diagnosis.
The autopsy report simply doesn't and can't prove whether Terri Schiavo was in a vegetative state as opposed to a minimally conscious or other profoundly disabled state, despite what many news articles are saying. As Examiner Thogmartin reasserts in the report, PVS is a clinical diagnosis and not something that can be proven or disproven by doing an autopsy.
We already knew that the autopsy was going to show profound brain damage and that dead neurons weren't going to grow back. That's no surprise.
But that still doesn't tell us how much consciousness or awareness she did or didn't have, or whether she would have been able to experience some level of improvement in her existing brain cells with the right therapies or not. It was beyond the scope of an autopsy to make that kind of judgement, and it seems somewhat irresponsible to me for a medical examiner to make a strong statement one way or the other regarding that fact based on an autopsy.
The autopsy certainly doesn't tell us whether it made any difference to her when she was provided with music and other stimulation, treatment for symptoms of pain, basic care and therapy, etc. versus when she was denied these things. Although I think it unlikely that her basic condition would have changed with therapy, I certainly think it's possible that she was at least on some level aware of and affected by the way she was (or was not) treated.
It is interesting to me that it mentioned Terri's brain weighed half what a normal brain would weigh. Yes, that's extreme damage but it's also not the same as "no brain" or a "completely liquified brain" as Atty. Felos and several doctors were claiming. I'd be very interested to know how that compares with a profoundly disabled but aware brain, the brain of someone with hydrocephalus or in a minimally conscious state, and also how dehydration might affect that.
What confuses me is how Thogmartin can claim to know from the autopsy that Terri Schiavo was unable to swallow (especially given that we have much evidence she was able to swallow at least her own saliva) and that he says she was blind. If she was blind, why did all but one or two of the doctors who examined her say that she showed at least some level of visual tracking? Is visual tracking something that can take place with blindness? Also, how would blindness affect the evaluations of her responses in making a diagnosis?
It is interesting to note that the examiner found no evidence consistent with a spine or neck injury, bulemia, or heart attack. The cause of her original collapse still remains completely unknown.
I haven't been able to get the pdf format of the actual report to load for me, so if anyone finds it in text format please let me know.
Copyright 2009. All rights reserved.
Posted by purple_kangaroo at 2:24 PM[Permanent link]
2 Comments:
I find the general response to the blindness rather puzzling honestly.
Hours upon hours of video tape where she did not track anything, the parts where her dad harshly tells her to stop playing games and follow the balloon. Even the choice cut bits and pieces her parents released were debunked rather convincingly.
If she was blind that would account for all of that, but rather the finding is just dismissed as a fallacy by one side.
And the other side is using it to point and say that she never responded at all.
Being blind implies not being able to respond to visual stimuli so the lack of (consistent) response which in part was used to push PVS and dismiss minimally conscious completely drops away.
Maybe I'm missing something obvious here.
Other than that I think the minimally conscious arguement was really only a legal maneuver and not actually true. Since Michael won the "what would she have wanted" part of the trial, the only real avenue they had left was to create doubt about her condition. On the other side, Michael needed the PVS diagnosis because minimally conscious would not allow removal of the feeding tube.
It was in neither side's best interest to be accurate and 100% truthful about her condition.
Overall I think the autopsy does more harm than good really. Everyone's back to bickering, name calling and assigning blame.
Part of the real issues and problems are how to deal with people who are in a condition where they are no longer capable of expressing their wishes and if a wish should either be declared in writing, or determined to be an end of life desire, is the way it happened to Terri humane either for the person themself, or the rest of us who have to 'watch' or the question whether keeping someone alive against their wishes is any more justified.
Interesting points, vanessa. Thanks for sharing your thoughts. I think you're right that the real issues go beyond what Terri's state was to how we handle situations where a person is not able to express their wishes . . . and particularly how and why we make a determination that a life is not worth living. Those are the real issues.
Blindness or not, PVS or MCS, all those things are interesting to discuss. But they don't change the basic issues here.
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