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Terri Schiavo

It's long been recognised that the definition of persistent in relation to persistent vegetative state really needs to be concise. the existing definition of PVS is far too arbitrary.

That said, the five doctors who reported to the court (including the doctors engaged by Terri's parents) were in agreement that recovery is not a prospect in this particular instance due to the extensive destruction of her cerebral cortex.

Florida Supreme Court

With due respect Denise, I would suggest that very many people who regain consciousness after having been diagnosed as being in a PVS do not further recover enough to either enjoy a quality of life which is acceptable to them, to actively end their own lives if they wish, or to be able to make their own decisions about future medical treatment.

I'd be interested in seeing some statistics on how many people who have recovered from a PVS lasting 12 months or more are living independently and how many require around the clock care.
 
reprise said:
It's long been recognised that the definition of persistent in relation to persistent vegetative state really needs to be concise. the existing definition of PVS is far too arbitrary.

That said, the five doctors who reported to the court (including the doctors engaged by Terri's parents) were in agreement that recovery is not a prospect in this particular instance due to the extensive destruction of her cerebral cortex.

Florida Supreme Court

With due respect Denise, I would suggest that very many people who regain consciousness after having been diagnosed as being in a PVS do not further recover enough to either enjoy a quality of life which is acceptable to them, to actively end their own lives if they wish, or to be able to make their own decisions about future medical treatment.

I'd be interested in seeing some statistics on how many people who have recovered from a PVS lasting 12 months or more are living independently and how many require around the clock care.
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I guess I should have been clearer. Doctors make mistakes. Terri might be conscious. She might feel pain as she is dehydrated and starved to death. Do we want to allow this in our society? What was her crime? She made no written wish, all we have is hearsay.

Some people do want extraordinary measures to save their lives. I am not one them, but I do not consider a feeding tube an extraordinary measure. We do not know in this case. I think it's better to keep her alive. Her parents want her to be alive. They are willing to care for her. What kind of spiteful sob would take her from them? Edited my garbled response.
 
Denise said:
I guess I should have been clearer. Doctors make mistakes. Terri might be conscious. She might feel pain as she is dehydrated and starved to death. Do we want to allow this in our society? What was her crime? She made no written wish, all we have is hearsay.

Some people do want extraordinary measures to save their lives. I am not one of them, nor do I consider a feeding tube an extraordinary measure. We do not know in this case. I think it's better to keep her alive. Her parents want her to be alive. They are willing to care for her. What kind of spiteful sob would take her from them?
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I agree with you absolutely Denise that in respect of this particular case the husband's legal rights to make the decision should be set aside.

My own living will specifically states that under no circumstances are fluids and nutrition to be withdrawn in order to end my life should I enter a PVS or an irreversible coma. It also states that only palliative measures may be taken in terms of any acute infection I might suffer while in that state - pretty much ensuring that my death would occur due to an untreated, overwhelming infection. And I want lots of morphine whether or not I appear to be in pain or distress.

But that just reflects my life experience and my personal preferences.

I do wonder if the parents of Terri are in a position to assume the financial responsibility for her indefinite care - a need which may extend beyond their own lifetimes. I also wonder why they did not take action previously to have guardianship of their daughter transferred to them (something I would certainly have done when my son-in-law started a family with someone new).
 
Reprise, I don't know if you are aware of the state of health care in America. Most health care is funded by private companies for their employees. In other words, if you lose your job, you lose your healthcare. It's happened to me, and the state will take months to help. A person can only carry their spouse and children on their health care policy. A mother cannot put her grown child on her policy. They have been fighting for guardianship of their daughter. But if it happens, the state will have to take care of the costs. I think it would be better if she was made a ward of the state for now.
 
Assuming that Terri had health insurance at the time she collapsed, could her coverage have been maintained by continuing to pay the annual premiums? If so, could that not still continue to be done with her parents paying the premiums?

From what I know about the cost of medical care in the US, there is no way that the money which was awarded to her husband for her care would have covered the cost of her care for any significant period of time - suggesting that someone other than her husband has been meeting a substantial portion of the cost of her care for last 13 years.

It seems to me that there are other means by which Terri's husband can obtain the freedom to remarry and by which he can avoid legal liability for her continuing care than through passive euthanasia.

I agree that an independent guardian might be the best option at this point in time. While I don't necessarily believe that Terri's parents choice is the best one, I have very real concerns about her husband's failure to exercise his spousal right to withdraw care long before now.
 
reprise said:
Assuming that Terri had health insurance at the time she collapsed, could her coverage have been maintained by continuing to pay the annual premiums? If so, could that not still continue to be done with her parents paying the premiums?
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Maybe her husband still has a policy on her. I don't know. I don't think that her parents can now pay her premium. I'll have to look into it. Once it lapses the company does not have to carry her. I am assuming that the judgement took the place of her policy, in other words, once the judgement occurred her insurance company refused to pay for her care. When I was laid off I could have paid the premiums for my daughter and I. 700 dollars a month. Needless to say, I could not afford that. Interesting. If the husband still has a policy and it is paying, maybe most of the money is still there. Hm.
 
I can't help wondering how likely it is that if Terri was made a ward of the state the state will make the same decision as her husband has made.

This link on the website created by the Schindlers makes the sequence of financial events and court petitions a little clearer, if you can disregard the emotive language.
 
I don't think the state would make the same decision. I think it's heartbreaking that the parents request of 8 weeks of therapy to try to see if she could eat from her mouth was denied.
 
CNN has reported that her feeding tube has been removed. Apparently, Terri's parents are not allowed to visit her before her death. From their website
October 15, 2003 is the day the courts have ordered the withholding of nutrition and hydration from Terri Schiavo. It is also the Feast of St. Teresa - Terri's name-sake.
In a desperate effort to get the attention of someone who could stop this court-sanctioned death, the Schindler family has released a video of Terri that they took some 24 months ago, showing Terri laughing with her mother.

Because of this, Mr. Schiavo's attorneys have ordered that Terri may no longer have visitors. Not even her mother and father are allowed to see her or to even say goodbye to her.
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The quote is from terrisfight.org just so there is no confusion.
 
reprise said:
PVS and coma are not the same.

People who have entered PVS often exhibit instinctive behaviours which are controlled by the "primitive" or "reptilian" brain, but have lost all higher brain function.
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IIRC, there are many reflexes that are actually considered indicators of lack of brain function. For example, you probably have noticed that babies will grab a finger when you place it in their palm. That is reflex, as opposed to a concious grab. Adults who have lost brain control will also do this action. Another is the the Babinski response, which is (IIRC) a flexing of the toes when the foot is stroked. However, ThirdTwin or some other doctor-type person can provide more information.
 
The "no visiting" ruling is ridiculous, and I can't see any court validating it. I presume that funeral arrangements will also rest with Terri's husband unless her parents make applicationt ot he court to take possession of her body.

My partner was in a vegetative state three times before his death. On one of those occasions his swallowing reflex was still present, although awareness was not.

It's the details of this case which I find perplexing. Why does the husband want feeding withdrawn when Terri will almost certainly develop a lethal infection in the short to medium term future if prophylactic measures to prevent infection are withdrawn and a "no treatment" order is in place? She might not develop such an infection for another 6 months, but after 13 years is time really such a critical factor here?

Nor would Terri's ability to swallow food demonstrate awareness or her inability to do so conclusively establish lack of awareness, so I question why that particular test is the one for which Terri's parents were fighting.

I just find this case very, very sad and I can't say that I'm left with any respect for the parties involved.
 
I saw an interview with the husbands lawyer this morning and he said that the family could visit but had to be accompanied. The reason for this was to prevent them from making any more videos with no one else present.
 
SRW said:
I saw an interview with the husbands lawyer this morning and he said that the family could visit but had to be accompanied. The reason for this was to prevent them from making any more videos with no one else present.
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I don't believe that condition is unreasonable.

Is there any information on whether or not the doctors are going to sedate Terri?
 
http://www.philly.com/mld/inquirer/news/local/7014750.htm
Michael Schiavo's attorney, George Felos, described the tube removal as an easy medical procedure that consists of deflating an inflatable bulb that delivers water and nutrients through her abdomen. It will be conducted by doctors at Woodside Hospice, where she has been living, he said.

After the tube is removed, she will probably not receive medication such as morphine, Felos said. "It's my understanding from the medical literature and testimony... that this is a painless death," he said.
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SRW said:
I saw an interview with the husbands lawyer this morning and he said that the family could visit but had to be accompanied. The reason for this was to prevent them from making any more videos with no one else present.
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Why do they care if the family makes videos?
 
I can't imagine that US law would prevent the administration of large doses of morphine (or one of the sedative agents) in this particular case. The viewpoint of the doctors - however - is almost certainly that someone whose cerebral cortex has been destroyed is incapable of registering pain or other distress.

My personal viewpoint would be to give her the morphine anyway - it's certainly not going to do her any harm.
 
reprise said:
I can't imagine that US law would prevent the administration of large doses of morphine (or one of the sedative agents) in this particular case. The viewpoint of the doctors - however - is almost certainly that someone whose cerebral cortex has been destroyed is incapable of registering pain or other distress.

My personal viewpoint would be to give her the morphine anyway - it's certainly not going to do her any harm.
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And how much does modern science really know about the brain? Can we know for sure that she will not feel pain. To be honest, I feel she has some form of consciousness, even if it is at an infant level. There are doctor's on the side of her family who feel that she is aware.
 
reprise said:
I can't imagine that US law would prevent the administration of large doses of morphine (or one of the sedative agents) in this particular case. The viewpoint of the doctors - however - is almost certainly that someone whose cerebral cortex has been destroyed is incapable of registering pain or other distress.

My personal viewpoint would be to give her the morphine anyway - it's certainly not going to do her any harm.
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Reprise, are there cases like this in your country where the patient is starved or dehydrated to death?
 
Denise said:
Reprise, are there cases like this in your country where the patient is starved or dehydrated to death?
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Yes there are. I doubt that there's a country in the Western world where withholding of support isn't practised on a daily basis in neonatal intensive care units and in hospices.

Once my partner entered his final vegetative state, no further fluids or nutrition were given (they were not withdrawn in order to initiate death, however), only morphine.

Cases like Terri's - however - are extremely rare. Decisions about withdrawing care don't usually take over a decade to make.
 
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