Terri Schiavo's (Flat?) EEG

[kookbreaker]

Re: Re: Re: Re: To Rouser2:

Oh, well thank your for that profound input. You are, perhaps, her confessor?

Give us a reason we should find this woman credible. Her stories contradict everyone, including the Schindlers.

 

[HypnoPsi]

She didn't have a cerebral cortex, which is the part of your brain that makes you, you. People are arguing she might have had some consciousness. This isn't an arguement to keep her alive but an arguement to let her die. If somebody doesn't want to be kept in that state that is exactly what they are talking about. To be alive with some dim awareness or worse lots of awareness but a prisoner in your body. That is why people have living wills to start with to avoid just that state.

Even though I am strongly inclined to agree with those who think that Terri Shiavo was "gone" I am utterly astonished at the degree of scientific 'wrongness' being displayed by those who hold to the same position.

Let me make this completely clear: you assess cognitive functioning (self-awareness, information processing) by cognitive tests. You do not assess cognitive functioning by brain scans. Not CAT scans, not EEG's, not MRI's or X-Rays.

As you can all see from this page http://makeashorterlink.com/?G6D732DBA Terri Schiavo's brain had severely atrophied - but we cannot conclude from this alone that she definately was gone. A great deal of "self" seems to come from the (old) mid-brain, while the cerebral cortext seems to be involved in information processing. And some of Terri Schiavo's cerebral cortex was still there.

Every single one of you talking about the brain scans of Terri Schiavo should stop overemphasising it in terms of cognitive functioning.

A Clinical Neuropsychologist (or a Clinica Psychologist) would (should?) have run cognitive tests with Schiavo. This would have involved something as simple as hoding up a green card and asking if it's red, holding up a blue card and asking if it's blue, using a mirror and/or various family pictures in which Terri was and was not present. These simple tests - and only these simple tests - are how self-awareness and capacity for information processing are determined.

Sheesh!!!

Of course, there are other more complicated tests in clinical/neuropsychology and clinical/neuropsychologists have to be quite creative when it comes to producing a reliable mode of communication with brain damaged patients. However, the point is that cognitive psychology and neurology (although related) are still different sciences - with cognitive psychology being the all important piece of the jig-saw puzzle here.

I've hunted online and I can't (yet) find evidence of Terri being assessed thoroughly by a clinical/neuropsycholgist and/or the results of such a test. One hopes that she was tested. But if she wasn't then some very serious questions need to be asked.
_
HP

 

[HypnoPsi]

Re: To Rouser2:

Terri could NOT 'talk' with her parents, and she was unaware of her status or environment.

You don't know that.

Terri never communicated a willingness or a desire for eat or drink, even as she lay there starving & dehydrating to death. SURELY, someone of 'some' brain capacity would have done something to stop the process, IF they so wished!?!?

Not necessarily. People in comas cannot do this, yet some still recover.

It is quite clear that Terri's cerebral cortex was much atrophied, but it was not entirely gone - and "self" may be a product of the midbrain rather than the cerebral cortex.

Even though I lean towards the view that Terri was 'gone', the logic you are using here is inexcusable. Just because Terri did not respond does not mean she was choosing to die. How do you know what effects malnourishment and dehydration would have had upon her?

As Rouser2 has pointed out, at least one nurse has given a very interesting statement on this matter - containing things that I believe(?) Terri's parents and others backed up.

Either way, as per my previous message, only cognitive tests can establish self-awareness and the degree of information processing - not brain scans.
_
HP

 

[Rouser2]

Re: Re: Re: Re: Re: To Rouser2:

Give us a reason we should find this woman credible. Her stories contradict everyone, including the Schindlers.

Cite a reason why she would not be credible? She was a fully qualfied RN who risked her livelyhood by reporting suspicious actions which might have been homicidal.. What would you have done in such an instance? Not report it? Ignore it? Her suspicions were also consistent with the actions of MS in regards to Terri's urinary infection.

 

[Dancing David]

Ah, Dancing David, who, having absolutely no clue at all, prefers to denigrate the venue rather than address the facts. Nor did the alleged doctor lose his license for "fraud". But Scarboro did provide balance in interviewing the lead Cheerleadr of the Death To Terri Gang -- Dr.Ronald Cranfor, the man who calls himself Dr. Death, whose professed goal was not just to kill Terri, but over a million Alzheimers' patients. Who knows? You may be next.

You believe that Joe Csarborough is a source, then hurrah for you! The venue is what it is I dengrate not at all but point out his lack of balance. And quite rightly the doctor who didn't get niminated for the Nobel didn't loose his license, just the ability to use it for six months. For the perpetration of fraud.

And saying JS provides balance points out something about your world view.

Have you proven that terri Schiavo had a possibility that she might have revived? Or just that fact that her body was not totaly dead. If you argue that she might recover, that I think is foolish. If you argue that she was alive and that her life should be extended because she was alive, that I find to be a credible arguement.

(If you accord all life forms that benefit.)

 

[Dancing David]

Terri’s medical condition was systematically distorted and misrepresented. When I worked with her, she was alert and oriented. Terri spoke on a regular basis while in my presence, saying such things as “mommy,” and “help me.” “Help me” was, in fact, one of her most frequent utterances. I heard her say it hundreds of times. Terri would try to say the word “pain” when she was in discomfort, but it came out more like “pay.” She didn’t say the “n” sound very well. During her menses she would indicate her discomfort by saying “pay” and moving her arms toward her lower abdominal area. Other ways that she would indicate that she was in pain included pursing her lips, grimacing, thrashing in bed, curling her toes or moving her legs around. She would let you know when she had a bowel movement by flipping up the covers and pulling on her diaper.

Where is the scientific protocol here?

What frequency did these utterances and actions occur, what contexts and methods were used to determine that there occured at a higher rate during the times given by this nurse?

Of the same one that Rouser2 hold against the neurologists that they disagree with.

"It is an opinion and belief not a fact".

Well when Jesus raises Terri from the dead then we can ask her what she wanted.

 

[Rouser2]

Where is the scientific protocol here?
What frequency did these utterances and actions occur, what contexts and methods were used to determine that there occured at a higher rate during the times given by this nurse?

There is no "scientific protocol". Just the observations of a nurse, corroborated by other care-givers and family members. The question is, where is the scientific protocol that determined this patient PVS, and therefore elibigle for execution? And what use would it be, when representative studies show a possible error rate between 37 and 75 percent?

 

[HypnoPsi]

Where is the scientific protocol here? What frequency did these utterances and actions occur, what contexts and methods were used to determine that there occured at a higher rate during the times given by this nurse?

That's the central question here.

Without knowing the results of any fair and comprehensive cognitive tests that were done nobody should be saying that she definately was cognisant or that she definately wasn't congnisant.

Trying to determine congnisance from brain scans is like trying to determine blood pressure from pulse rate alone - unreliable.

I can say this: considering the criteria for PVS listed at: http://makeashorterlink.com/?C248142FA it seems that Terri Schiavo was displaying behaviours which would rule out PVS. Particularly in the the "swab test" video located at http://www.terrisfight.org/ There also seem to be other signs of cognisance in the other videos.

Is skepticism not about testing claims and asking questions? While both the videos and brain scans are inconclusive they demonstrate quite clearly that Terri should have been assessed cognitively by a Clinical/Neuropsycholgist who would have extensive knowledge of cognitive tests for self-awareness and ability to process sensory information.

I don't want to jump to the conclusion that such testing wasn't ever carried out with Terri, but if this was done one would expect it to have been made public knowledge by either side and the results fully explained (due to the enormous public interest in this case).
_
HP

 

[Rouser2]

Originally posted by HypnoPsi [/i]
That's the central question here.

>>Is skepticism not about testing claims and asking questions? While both the videos and brain scans are inconclusive they demonstrate quite clearly that Terri should have been assessed cognitively by a Clinical/Neuropsycholgist who would have extensive knowledge of cognitive tests for self-awareness and ability to process sensory information.


The reliance on a medical "expert" with a different credential maybe just as fallacious. In testing cognition, the testor can only judge via a patient's response. But a patient may have complete cognition and be unable to make any resoponse. This is now called "Locked-In Syndrome." Some patients diagnosed PVS have come out of it, and reported they understood everything going on around them, but could not communicate response. They were "locked in".

"What is Locked-In Syndrome?
Locked-in syndrome is a rare neurological disorder characterized by complete paralysis of voluntary muscles in all parts of the body except for those that control eye movement. It may result from traumatic brain injury, diseases of the circulatory system, diseases that destroy the myelin sheath surrounding nerve cells, or medication overdose. Individuals with locked-in syndrome are conscious and can think and reason, but are unable to speak or move. The disorder leaves individuals completely mute and paralyzed. Communication may be possible with blinking eye movments"
http://www.ninds.nih.gov/disorders/lockedinsyndrome/lockedinsyndrome.htm

* * *


" A case is presented involving a nursing home patient who suffered a stroke that left him unable to speak or move, and thus unable to communicate his wishes except through eye movement. Steffen ponders several questions related to whether this patient should be given life-prolonging treatment, including whether he is competent to give or withhold consent, how a guardian could justify a third-party consent or refusal, and whether the attending physician could write a "do not resuscitate" order without the approval of the patient's guardian. He concludes intuitively that life-sustaining therapy should not be given in view of the patient's quality of life and the burden of his illness. Franklin disagrees, contending that it is unfair to withhold life-sustaining therapy because a patient cannot communicate and that there is an increasing number of cases on record of patients with locked-in syndrome who have recovered or have learned to communicate through Morse code or computers."

from Pub Med, Natinoal library of Medicine

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=4066303&dopt=Abstract

* * *

Locked in Syndrome, i recovered
This article submitted by Michael Hulbert on 5/22/99.
Email Address: michael hulbert

"I am a young man aged 28. In 1994 I sustained LIS, now, May 1999, I can say I have recovered to near normal. From only been able to move my eye lids, I can now walk and have managed to secure a good job. Im very interested in working with others who may have LIS, and, more so with Medical researches who may try and discover how I recovered from a neurological point of view."

http://neuro-www.mgh.harvard.edu/forum_2/GeneralNeurologyF/5.22.9910.55AMLockedinSyn.html

 

[Roadtoad]

That's the central question here.

Without knowing the results of any fair and comprehensive cognitive tests that were done nobody should be saying that she definately was cognisant or that she definately wasn't congnisant.

Trying to determine congnisance from brain scans is like trying to determine blood pressure from pulse rate alone - unreliable.

I can say this: considering the criteria for PVS listed at: http://makeashorterlink.com/?C248142FA it seems that Terri Schiavo was displaying behaviours which would rule out PVS. Particularly in the the "swab test" video located at http://www.terrisfight.org/ There also seem to be other signs of cognisance in the other videos.

Is skepticism not about testing claims and asking questions? While both the videos and brain scans are inconclusive they demonstrate quite clearly that Terri should have been assessed cognitively by a Clinical/Neuropsycholgist who would have extensive knowledge of cognitive tests for self-awareness and ability to process sensory information.

I don't want to jump to the conclusion that such testing wasn't ever carried out with Terri, but if this was done one would expect it to have been made public knowledge by either side and the results fully explained (due to the enormous public interest in this case).
_
HP

What I have a problem with here, HP, is, given my experience in television and radio, it's very easy, particularly with digital equipment, to fake the "evidence," (if, indeed it can be called that), and the fact that a great deal of information is blocked due to privacy rights.

If, in fact, the cognitive tests are as relatively easy as you say, (and I'm no psychologist or psychiatrist, so I can't say that, yes, it is or no, it isn't), it would seem to me that this would be one of the very first tests undertaken, if for no other reason, than simply to rule one way or another if there was any chance of hope.

Forgive me for reverting to form here, but I'm willing to admit to being wrong, provided we've evidence to the contrary. The fact that we do not, however, see this evidence of these tests indicates nothing other than the fact that we have not been told what took place, or even if anything took place.

I would tend to agree, however, if you are correct, that these are tests which should have been administered. That they were or were not, I can't say. The sites I've checked on don't show one way or another.

 

[Dancing David]

There is no "scientific protocol". Just the observations of a nurse, corroborated by other care-givers and family members. The question is, where is the scientific protocol that determined this patient PVS, and therefore elibigle for execution? And what use would it be, when representative studies show a possible error rate between 37 and 75 percent?

But still just an sewries of opinions that could be extremely biased and fraught with potential for error. Terri might have made those sounds and waved her hands when she did not feel anything at all. They may just be random enents unrelated to any potential consciousness.

I am not sure what procedures are used to determine the 'awareness' of someone in a coma or demented state.

 

[Roadtoad]

But still just an sewries of opinions that could be extremely biased and fraught with potential for error. Terri might have made those sounds and waved her hands when she did not feel anything at all. They may just be random enents unrelated to any potential consciousness.

I am not sure what procedures are used to determine the 'awareness' of someone in a coma or demented state.

Found some information on this in the Oxford Companion to the Mind. Fascinating stuff, actually. And, unfortunately, David, you're right. There's lots of potential for error, since much of it is subjective, and based on observation which can be interpreted a number of ways.

Hypno Psi's test is mentioned, (and hence, that's the info I'm going by), but much of what is tested requires (1.) a mind that has intact cognitive ability, (Terri did not have that); (2.) a means of response, though there's some question as to whether coherence was required for the test. One might assume that if some response were possible, regardless of its coherence, one might assume nearly everyone would have seen that as some chance for recovery.

But I would also point out that we have little in the way of video which, as near as I can tell, indicates a pattern, which would tell me clearly that, yes, a horrific mistake was made. One or two instances do not make a pattern which would suggest that Terri Schiavo was capable of anything more than dying.

When I learn a little more, I'll have a better handle on it. Right now, my position, based on what I've been reading over the past day or so, remains the same. It was hard decision, but as near as I can tell, it seems to have been the right one.

 

[csense]

...but much of what is tested requires (1.) a mind that has intact cognitive ability, (Terri did not have that)

This presupposes a conclusion, as to the very thing that you are testing for, which suggests a biological correlation, rather than a behavioral correlation.

If you conlude, as you have done above, that Terri did not have that, then you are basing your conclusion that the cerebral cortex is the causal determinant of consciousness, and this is exactly what the vast majority of neurologists have done in this case. Observation of behavior, therefore, is irrelevant from this perspective since such behavior which would suggest awareness at any level, would contradict a perceived truth.

Ironically, since the discussion is about consciousness and awareness, this would amount to cognitive dissonance, and regardless of how intelligent and knowledgeable these neurologists seem to be from our perspective, they are not immune to CD. In fact, I would say they are more likely to be predisposed towards it.

 

[Roadtoad]

This presupposes a conclusion, as to the very thing that you are testing for, which suggests a biological correlation, rather than a behavioral correlation.

If you conlude, as you have done above, that Terri did not have that, then you are basing your conclusion that the cerebral cortex is the causal determinant of consciousness, and this is exactly what the vast majority of neurologists have done in this case. Observation of behavior, therefore, is irrelevant from this perspective since such behavior which would suggest awareness at any level, would contradict a perceived truth.

Ironically, since the discussion is about consciousness and awareness, this would amount to cognitive dissonance, and regardless of how intelligent and knowledgeable these neurologists seem to be from our perspective, they are not immune to CD. In fact, I would say they are more likely to be predisposed towards it.

I had to read your post twice. Much of this is uncharted territory for me, so I'm a little slow right now on this.

My problem is a lack of knowledge, which I've freely admitted to. (You learn nothing if you claim to have what you ain't got.) Hypno Psi has suggested tests which would, it would seem, give some rational data which might help in assessing the state of Terri's mind. However, if I'm reading you correctly, this would, if we assume the Cortex is the causal determinant of conciousness, (to use your term), then what we seem to be heading towards is a sort of circular logic. Am I reading you right?

 

[materia3]

You might like to read the folllowing article on line from Science and Consciousness Review:

http://www.sci-con.org/articles/20040901.html

 

[Roadtoad]

You might like to read the folllowing article on line from Science and Consciousness Review:

http://www.sci-con.org/articles/20040901.html

I enjoyed that, and I'd like to read more. If we're dealing with a dynamic structure, then it would suggest to me that none of this is particularly cut and dried. It does tell me what I've always believed, that we need to be damn careful before we declare someone to be incompetent/incoherent/brain dead.

To date, though, I've yet to see where the decision regarding Terri was a wrong one. Maybe if Rouser2 were interested in a debate or discussion, perhaps there might be, but that would require admitting that facts are to be the deciding factor, rather than emotion.

 

[Bikewer]

Right after the lady's death, they had a couple of neuroscientists on NPR's Science Friday show. One, who was also a physician, said that the diagnosis of PVS is always made over a period of time, and includes a variety of tests and observations.

He, like others in the medical community I've seen or heard interviewed, said that past six months, there is no such thing as a "persistant" state; invariably they are permanent after that period.

 

[csense]

...past six months, there is no such thing as a "persistant" state; invariably they are permanent after that period.

There is nothing about the passage of time which would mandate or predict permanency of a behavioral condition, without also mandating or predicting an observable change in the physical condition, or system. To conclude otherwise would be indistinguishable from making this assumption initially, six months earlier, in the absence of empirical scientific evidence that the state must necessarily remain invariable...and in chich case, Terri Schiavo's condition wouldn't be subject to debate, since it would be an indisputable cold hard scientific fact, and nothing less.

 

[King of the Americas]

To Rouser2:

So she said ONE time 'something' that sounded like "Help me." to ONE nurse, who may or may NOT have a shred of credibility...?

I would have to ask for you to also submit the context in which this statement was made, and if you could have repeated the occurance.

For all we knw Terri could have been trying to ask the nurse to "help her remove her feeding tube.", because at the time she uttered those words she was most certainly being fed...

But I think the more imporant issue here was consciencenous and where it begins and ends. Terri couldn't blink once for yes and twice for no. There was no consistant behavior partern, that one could decipher as a clear choice of one stimuli or another. Like it or not no one was able to get Terri to perform or answer questions with grunts or flops with any kind of consistancy.

Terri couldn't interact with and was largely unaware of her environment.

In order to live, all that she would have needed to do was look longingly at the pitcher of water in the room. She decided to do otherwise. Given her condition, I can't say I blame her.

I can't help but wonder when Terri said the words you mentioned, and moreover wonder why she didn't repeat this feat at the hands of starvation & dehydration? I mean if she could say "Help me.", why wouldn't she do so if she KNEW she was alive, and WOULD die unless the feding tube was reinstalled.

Your stance sir, demands that you contradict yourself. One minute you say Terri was like a patient 'locked-in', then the next argument she is speaking clearly. I mean in your head was Terri able to speak and think clearly, as you or I, or was she merely of a diminished capacity? On a sliding scale, where did Terri land, if a normal person was like an 8 or a 9, the general downs sydrome afflicted individual a 6 or a 7, while a closed head injury patient who can answer 'some' questions with eye blinking sometimes as a 1 or 2.

It seems to me that the most inconsistant thing in this post has been your understanding & presentation of what exactly Terri was capable of.

 

[varwoche]

Re: Re: To Rouser2:

There are a few things in this life that I am absolutely certain of. I am certain that 2 plus 2 equals 4 (despite the new, newer math), that if you jump from a tall building, you are likely to go "splat," and the Terri Schiavo was the victim of a court ordred homicide, murder, execution.

It makes little sense for the thread to continue beyond this post. To his credit, Rouser2 has for all practical purposes proclaimed that he's a blind zealot, and that black is the same color as light grey (both being non-white afterall). Once a zealot fesses up, there's not much more to discuss unless one enjoys slamming one's head into walls.