Dispatches from the Creation Wars

Official Report on Terri Schiavo

This is worth reading, for those who aren’t completely sick of this entire situation. It’s a PDF file of the entire report of the Guardian Ad Litem that Jeb Bush appointed to investigate the entire situation and recommend what the state should do in 2003. Amid the flurry of vicious charges that have been leveled against Michael Schiavo, this report points out a great many things worth knowing. It notes, for example, that for the first several years that Terri was in a vegetative state, Michael held out hope that she would recover, despite all evidence to the contrary, and that he was so attentive to her care that he was described as “a nursing home administrator’s nightmare”. It points out that in the infamous situation where he denied care when she got a urinary tract infection, this was done in consultation with her doctors, who had finally convinced him that there was no hope of recovery and that it was more humane to allow her to die naturally. It also notes that Terri’s parents were also convinced for many years that she was in a persistent vegitative state and would never recover, but they refused to allow her to die naturally despite that, and it’s only recently that they have begun denying that she was in PVS or even denying that there is such a thing. The guardian ad litem also says bluntly:

Of Michael Schiavo, there is the incorrect perception that he has refused to relinquish his guardianship because of financial interests, and more recently, because of allegations that he actually abused Theresa and seeks to hide this. There is no evidence in the record to substantiate any of these perceptions or allegations.

I don’t blame Terri’s parents for not wanting to give up hope, or for not wanting to have her taken out of their life even in the state she is in now. But I think they have allowed that highly emotional desire to create paranoid fantasies in their head and to begin a campaign of villification. The report also notes, for instance, that they were very close with Michael until he became convinced that there was no hope of recovery and that therefore she should be allowed to die naturally. It even notes that they had encouraged Michael to get on with his life and encouraged him to begin dating, and that he had introduced them to the woman he subsequently became involved with in the beginning.

The other thing that really must be said is that Michael is right, and the doctors are right, there is no hope of recovery here. Ever. Period. Under any circumstances. And anyone who claims otherwise is either delusional or deceitful. Amp posted one of the catscan slices from her the other day on his blog, along with comments from a neurophysiologist. Lynn, for those who don’t know, is a radiologist. In her residency, she examined Terri Schiavo and she saw not only that catscan slice but the entire file of test results and scans up to about 2 years ago. She said that the neurophysiologist’s reading of that catscan is correct, that a sizable portion of her brain has necrotized and been replaced by spinal fluid, and that the myriad of tests that have been done are all extremely conclusive that she will never, ever regain consciousness or function. The parts of her brain that control higher functions simply do not exist anymore.

Comments

  1. #1 Ben
    March 23, 2005

    Anyone here a lawyer? Would he have a case if he wanted to sue some of these right-wing radio guys who are calling him a murderer?

  2. #2 Donny
    March 24, 2005

    I believe Michael Schiavo has a very good defamation case. He is not a “public figure” as defined in the law, and these talk radio hosts are leveling demonstrably false charges in obvious bad faith.

  3. #3 Mike
    March 24, 2005

    The parts of her brain that control higher functions simply do not exist anymore.

    Has anyone claimed (I haven’t heard anyone say this) that she may have lost her “higher functions” but can still feel the pain of hunger and thirst? Is she incapable of feeling these sensations? Just wondering…

  4. #4 Mark Paris
    March 24, 2005

    It is truly a sad case. I can understand why the parents don’t want to let go. It’s hard to accept the death of a loved one. We made a decision about my father, who had suffered a brain injury after falling from his bed (in the hospital, no less). He was on life support (not just a feeding tube). The decision was hard, but we made it that night, in a very short time. Facts are facts, no less so than for their painfulness. Terry Schiavo would have been allowed to die years ago, just like hundreds of other people in similar conditions, but for the glare of the public spotlight.

    Please deliver me from these sanctimonious fools.

  5. #5 Ed Brayton
    March 24, 2005

    Has anyone claimed (I haven’t heard anyone say this) that she may have lost her “higher functions” but can still feel the pain of hunger and thirst? Is she incapable of feeling these sensations? Just wondering…

    If they’ve made that claim, it’s not supported by any medical understanding. Frankly, I would much rather they not just pull out the feeding tube and let her starve, even if she can’t feel anything. I’d rather they just administered a lethal injection so she would die quickly. But the same people who are screaming about how cruel starvation is also go apeshit over allowing active euthenasia.

  6. #6 Ed Brayton
    March 24, 2005

    I believe Michael Schiavo has a very good defamation case. He is not a “public figure” as defined in the law, and these talk radio hosts are leveling demonstrably false charges in obvious bad faith.

    He’d still have a very difficult time winning such a case. The libel and slander laws in the US are notoriously difficult to make stick because they are so stringent. He would have to show that they passed on information they knew was false with the intent to defame him. Proving that someone knew a given claim was false is difficult to do, as is proving ill intent.

  7. #7 ruidh
    March 24, 2005

    Has anyone claimed (I haven’t heard anyone say this) that she may have lost her “higher functions” but can still feel the pain of hunger and thirst? Is she incapable of feeling these sensations? Just wondering…

    The perception of pain, thirst and hunger involves several parts of the brain. The sensory impressions from the nerve endings are mapped onto the surface of the cerebral cortex. So, at that level, it appears that the first level of pain reception is still present. From the MRIs I’ve seen, the surface of the cortex seems to still be present. Deeper layers of the cortex involve the awareness of pain. It is these deeper levels which are severely damaged in Mrs. Schiavo. I don’t know that she can be said to be aware of anything. In her case, it is the entire perception of self, volition and awareness of surroundings which seems to have been lost. In one very true sense, she isn’t there anymore, so it matters little to her what we do to her meat.

    Of course, our sense of respect for her demands that we treat her body with respect. I just happen to believe that proper respect includes allowing her body to die now that she has been long departed.

  8. #8 Jim Anderson
    March 24, 2005

    Ed,

    I find it interesting that you omitted this passage, right below the one you quoted:

    Until and unless there is objective, fresh, mutually agreed upon closure regarding measurable and well accepted scientific bases for deducing Theresa’s clinical state, Theresa will not be done justice. There must at least be a degree of trust with respect to a process that the factions competing for Theresa’s best interest can agree. To benefit Theresa, and in the overall interests of justice, good science, and public policy, there needs to be a fresh, clean-hands start.

    Has such a recommendation been carried out in the meantime?

  9. #9 Social Scientist
    March 24, 2005

    ruidh–

    My understanding is that her EEG is flat. Wouldn’t this indicate that her remaining cortical neurons, while still more or less structurally intact, aren’t performing any signalling? I have also heard that her thalamus is entirely gone. That would cut all sensory input to the cortex by itself, and explain the nonexistent EEG.

  10. #10 Lynn
    March 24, 2005

    Terri’s EEG was flat 15 yrs ago, and still is today. That can’t ever change.

  11. #11 CPT_Doom
    March 24, 2005

    Has anyone claimed (I haven’t heard anyone say this) that she may have lost her “higher functions” but can still feel the pain of hunger and thirst? Is she incapable of feeling these sensations? Just wondering…

    If they’ve made that claim, it’s not supported by any medical understanding. Frankly, I would much rather they not just pull out the feeding tube and let her starve, even if she can’t feel anything. I’d rather they just administered a lethal injection so she would die quickly. But the same people who are screaming about how cruel starvation is also go apeshit over allowing active euthenasia.

    From what I have read, if she were to feel any pain from the dehydration (the feeding tube IIRC, means her stomach ain’t exactly been full for the last 15 years) doctors can administer morphine or other painkillers to ease that. I certainly remember my own mother’s death from cancer 8 years ago, she did not eat for 4 – 5 days at the end, while still conscious, and felt no hunger pains or even thirst, likely because of the morphine she was on.

    If she can feel pain, more importantly, what kind of sensation has she been feeling having a hole in her abdomen all these years?

  12. #12 Ed Brayton
    March 24, 2005

    Jim-

    None of Wolfson’s recommendations were carried out because the Florida law under which he was appointed was deemed unconstitutional (and rightly so). He had already delivered his final report, however, and it was made public. What he was hoping for was for the two sides to agree upon a series of tests and upon what would be done depending on the outcomes of them, but that was apparently impossible to do.

  13. #13 sparkles
    March 25, 2005

    From the National Institute of Neurological Disorders and Stroke:

    A persistent vegetative state refers to a condition in which individuals have lost cognitive neurological function and awareness of the environment but retain noncognitive function and a perserved sleep-wake cycle.
    It is sometimes described as when a person is technically alive, but his/her brain is dead. In persistent vegetative state the individual loses the higher cerebral powers of the brain, but the functions of the brainstem, such as respiration and circulation, remain relatively intact. Spontaneous movements may occur and the eyes may open in response to external stimuli. Patients in a vegetative state may appear somewhat normal. They may occasionally grimace, cry, or laugh.

    Paul Schotsmans, a medical ethicist, says if PVS patients felt pain, it would fundamentally change the discussion of withdrawing the feeding tube. He cites you must be conscious to experience pain. He concludes that the pain of being in PVS would be “more burdensome and more prolonged” than any pain experienced while dying after the withdrawal of food and fluids.

    From Court records, here is a timeline of Terri Schiavo’s treatment. By the way, Michael and Terri Schiavo lived with her parents. Michael continued to live with them after Terri became PVS for a few years. He attempted for eight years to get her treatment. This man did all he could to help her. Here is the timeline:

    November 1984… Terri & Michael marry
    February 1990… Terri suffers cardiac arrest and a severe loss of oxygen to her brain
    May 1990… Terri leaves hospital and is brought to a rehabiliation center for aggressive therapy
    July 1990… Terri is brought to the home where her husband and parents live; after a few weeks, she is brought back to the rehabilitation center
    November 1990… Terri is taken to California for experimental therapies
    January 1991… Terri is returned to Florida and placed at a rehabilitation center in Brandon
    July 1991… Terri is transfered to a skilled nursing facility where she receives aggressive physical therapy and speech therapy
    May 1992… Michael and the Schindlers stop living together
    January 1993… Michael recovers $1 million settlement for medical malpractice claim involving Terri’s care; jury had ruled in Michael’s favor on allegations Terri’s doctors failed to diagnose her bulimia, which led to her heart failure; case settled while on appeal
    March 1994… Terri is transferred to a Largo nursing home
    May 1998… Michael files petition for court to determine whether Terri’s feeding tube should be removed; Michael takes position that Terri would choose to remove the tube; Terri’s parents take position that Terri would choose not to remove the tube
    February 2000… Following trial, Judge Greer rules that clear and convincing evidence shows Terri would choose not to receive life-prolonging medical care under her current circumstances (i.e., that she would choose to have the tube removed)
    March 2000… Judge Greer denies petition for more swallowing tests, finds it uncontested Terri cannot swallow sufficiently to live
    April 2000… Terri is transferred to a Hospice facility
    January 2001… Second District Court of Appeal affirms the trial court’s decision regarding Terri’s wishes
    April 23, 2001… Florida Supreme Court denies review of the Second District’s decision
    April 23 or 24, 2001… Trial court orders feeding tube removed
    April 24, 2001… Terri’s feeding tube is removed for the first time
    April 26, 2001… Terri’s parents file motion asserting they have new evidence regarding Terri’s wishes
    April 26, 2001… Trial court denies Terri’s parents’ motion as untimely
    April 26, 2001… Terri’s parents file new legal action against Michael Schiavo and request that the removal of Terri’s feeding tube be enjoined; the case is randomly assigned to Judge Quesada
    April 26, 2001… Judge Quesada grants the temporary injunction, orders Terri’s feeding tube restored
    July 2001… Second District rules that Judge Greer erred in denying the motion alleging new evidence and, in essence, orders the trial court to consider whether new circumstances make enforcement of the original order inequitable; Second District also reverses the temporary injunction and orders dismissal of much of the new action filed before Judge Quesada [READ]
    (uncertain)… Terri’s parents detail their reasons why enforcement is inequitable: (1) new witnesses have new information regarding Terri’s wishes, and (2) new medical treatment could sufficiently restore Terri’s cognitive functioning such that Terri would decide that, under those circumstances, she would continue life-prolonging measures; Terri’s parents also move to disqualify Judge Greer
    (uncertain)… Trial court denies both motions as insufficient
    October 2001… Second District affirms the denial of the motion to disqualify and the motion regarding the new witnesses; the appellate court reverses the order with regard to potential new medical treatments and orders a trial on that question with doctors testifying for both sides and a court-appointed independent doctor
    March 2002… Florida Supreme Court denies review of the Second District’s decision
    October 2002… Judge Greer holds a trial on the new medical treatment issue, hearing from doctors for both sides and a court-appointed independent doctor; Terri’s parents also assert that Terri is not in a persistent vegetative state
    Schindlers file emergency motion for relief from judgment based on a 1991 bone scan report indicating Terri’s body had previously been subjected to trauma
    November 22, 2002… Following trial, Judge Greer denies Schindlers’ motion for relief (new medical evidence motion), rules that no new treatment offers sufficient promise of improving Terri’s cognitive functioning and that Terri is, in fact, in a persistent vegetative state
    November 22, 2002… On this same day, Judge Greer denies Schindlers’ emergency motion related to the 1991 bone scan
    June 2003… Second District affirms the trial court’s decision denying Schindlers’ motion for relief from judgment
    August 22, 2003… Florida Supreme Court denies review of the Second District’s decision
    August 30, 2003… Terri’s parents file federal action challenging Florida’s laws on life-prolonging procedures as unconstitutional
    September 17, 2003… Judge Greer denies Schindlers’ motion to provide additional therapy, finding it an effort to retry the issues that were previously tried
    October 10, 2003… Federal court dismisses Schindlers’ case
    October 15, 2003… Terri’s feeding tube is removed for the second time
    October 20, 2003… Florida House passes a bill to permit the Governor to issue a stay in cases like Terri’s and restore her feeding tube
    October 21, 2003… Federal court rejects injunction request
    October 21, 2003… Florida House and Senate pass a bill known informally as “Terri’s Law” to permit the Governor to issue a stay in cases like Terri’s and restore her feeding tube; Governor signs the bill into law and immediately orders a stay; Terri is briefly hospitalized while her feeding tube is restored
    October 21, 2003… Michael brings suit against the Governor, asking to enjoin the Governor’s stay on grounds “Terri’s Law” is unconstitutional; Judge Baird rejects Michael’s request for an immediate injunction, allowing the tube to be restored, and requests briefs on the constitutional arguments involving the new law
    November 7, 2003… Judge Baird rejects Governor’s motion to dismiss Michael’s suit and have case litigated in Tallahassee
    November 20, 2003… Judge Baird rejects Governor’s request for the judge to recuse himself
    December 1, 2003… Guardian ad litem appointed under “Terri’s Law” to advise Governor submits report to Governor
    December 10, 2003… Second District rejects Governor’s effort to have Judge Baird disqualified
    April 2004… Second District affirms Judge Baird’s decision denying Governor’s motion to dismiss and have case litigated in Tallahassee
    May 2004… Judge Baird declares “Terri’s Law” unconstitutional on numerous grounds
    June 2004… Second District certifies “Terri’s Law” case directly to the Florida Supreme Court
    July 2004… Schindlers file new motion for relief from judgment based on Pope John Paul II speech
    September 2004… Florida Supreme Court affirms Judge Baird’s ruling that “Terri’s Law” is unconstitutional
    October 2004… Judge Greer denies Schindlers’ most recent motion for relief from judgment (motion based on Pope John Paul II speech)
    December 1, 2004… Governor asks U.S. Supreme Court to review Florida Supreme Court’s decision declaring “Terri’s Law” unconstitutional
    December 29, 2004… Second District affirms (without written opinion) Judge Greer’s ruling denying Schindlers’ most recent motion for relief from judgment
    January 6, 2005… Schindlers file new motion for relief from judgment, alleging Terri never had her own attorney, that the trial court impermissibly applied the law retroactively, and that the original trial on Terri’s wishes violated separation of powers principles
    January 24, 2005… U.S. Supreme Court declines review in “Terri’s Law” case

    February 11, 2005… Judge Greer denies Schindlers’ latest motion for relief from judgment (motion raising various due process challenges)
    February 23, 2005… Florida’s Department of Children and Families asks to intervene and for 60-day stay to permit investigation of alleged abuse
    February 23, 2005… Schindlers file motion requesting new tests to determine Terri’s status
    February 25, 2005… Judge Greer rules motions appear endless, he will grant no further stays; sets March 18 date for removal of feeding tube
    February 28, 2005… Schindlers file motion requesting that Terri be fed orally
    March 2, 2005… Schindlers file new motion for relief from judgment, arguing factual error in original judgment
    March 8, 2005… Judge Greer denies Schindlers’ motion to feed Terri orally
    March 9, 2005… Judge Greer denies Schindlers’ motion requesting new tests
    March 9, 2005… Judge Greer denies Schindlers’ most recent motion for relief from judgment (motion based on factual error)
    March 10, 2005… Judge Greer denies Department of Children and Families request to intervene and for stay, finds agency is free to investigate
    March 16, 2005… Second District affirms Judge Greer’s denial of Schindlers’ motion raising various due process challenges, emphasizes law has been followed in this case
    March 18, 2005… Schindlers file new federal action arguing due process violations in original trial; case assigned to Judge Moody
    March 18, 2005… Judge Moody denies new federal claim, citing lack of jurisdiction
    March 18, 2005… Congressional committee issues subpoenas for Michael, Terri, and Terri’s caregivers to appear at hearing to be held at the hospice where Terri has stayed
    March 18, 2005… Congressional committee files motion to intervene and modify order requiring the removal of Terri’s feeding tube
    March 18, 2005… Judge Greer denies congressional committee motion, ruling no grounds exist for intervention
    March 18, 2005… Congressional committee requests Florida Supreme Court and Second District stay the feeding tube’s removal
    March 18, 2005… Terri’s feeding tube removed for the third time
    March 18, 2005… Florida Supreme Court denies congressional committee request, citing lack of jurisdiction
    March 18, 2005… Second District denies congressional committee request as without merit
    March 21, 2005… Congress enacts Terri’s Law II, authorizing Terri’s parents to seek federal court review of whether Terri’s federal rights have been protected
    March 21, 2005… Schindlers file new action in federal court based on new law, claiming Terri’s federal rights have been violated
    March 22, 2005… Judge Whittemore denies Schindlers’ request to have Terri’s feeding tube reinserted, finding no substantial likelihood the Schindlers will succeed with their claims [READ]
    March 23, 2005… In a 2-1 decision, Eleventh Circuit affirms Judge Whittemore’s decision not to restore Terri’s feeding tube

    Terri Schiavo has had due process of the law.

  14. #14 Vic Vanity
    March 25, 2005

    here is an Excellent florida law blog

    http://abstractappeal.com/schiavo/schiavoposts2004.html

  15. #15 ~DS~
    March 25, 2005

    Courts have heard evidence from the principles, reviewed medical diagnosis, and weighed the matter as carefully as they possibly can. Appeals courts have examined the case from a State and Federal Constitutional basis. State and federal legislative bodies have examined it. The consensus court decisions have been that Terry Schiavo is not going to improve, that the case was properly pursued, that she is in a persistent vegetative state, and that she would not have wished to be kept alive under these circumstances. (I can provide you a Florida radiologist who works with a neurologist, both of whom actually examined Schiavo in person at great length, and both of whom are not any kind of raving liberal whatsoever, flatly stating that Schiavo’s EEG has been flat for fifteen years and her cerebrum is full of fluid, which means even the tiny portions of cerebral cortex which aren’t cerebro-spinal fluid and do have a few intact neurons aren’t firing at all). This has been shown to exist beyond a reasonable doubt. You may not like it, but those are the facts on record. It’s tragic, it’s understandably unbearable to those who love her, especially given that she can smile and grimace and moan which we humans respond to emotionally. I sincerely wish this was not the case and there was hope for her. No one is ‘happy’ this poor lady is in this kind of shape; good Lord what the hell is wrong with someone that they would stoop to implying otherwise?
    That is what the courts and doctors have found. IOW, the courts, the docs, the radiologists, and the majority of the public, have found that you and your fundie pals are dead wrong and don’t have a shred of a leg to stand on medically or legally (And the fundie neurologist who is claiming otherwise without even having examined the woman is an embaressment to docs nationwide) , and that you should quite bluntly fucking butt out, you’re not wanted or welcome. They’ve decided you, or Jeb, or Bush, or Delay, have no more right to go charging into this matter, and taking the law in your own hands, than Osama bin Laden does. End of story.

    As sad as this case is for everyone involved, it raises a host of interesting and dicey issues regarding quaility of life, euthinasia, assisted suicide, and family rights. And I feel those matters should be discussed. Should we keep people alive to the last possible second regardless of their own wishes or those nearest them? Should we force the insurance companies or medicare to pay, or should we foreclose on their relatives assets to cover the bill, or lay it on the taxpayers, locally, state wide, or federally? Would it be Consitutional to do any or all of that? Is it Consitutional to make states or local municpalities pay for Federal mandates, or vice versa? When the patient is at least partially to blame for their own predictament, do the same rules apply; if for example their condition was the result of a crack overdose, driving drunk, or comitting a crime? Who decides these matters, courts, congress, the spouse, the parents, the legal guardian, the children, the governor, the President? Would it afect the process, or should it, if Schiavo was 90 years old, or age six?
    These are all legitimate issues that everyone has pretty much shied away from over the years and by default left to the doctors and the families of the victims. And they need to be discussed, because unlike extraordinary rendition, or evolution vs creationism, this issue will likely affect you or someone you know during your life, and probably more than once.

    But the freaky thing here is that a fringe group of fanatics is claiming that their subjective faith in a supernatural deity, and their unquestionable, narrow, intepretation of what that Deity wishes in this case, which cannot be confirmed in anyway of course we’re all just supposed to take their word for it, trumps science, medicine, marriage, the decrees of any other other religious group who doesn’t buy their claims, The Law, and the vast majority of public opinion. And that the Congress, or the Governor, or political groups, can simply ignore those laws they don’t like and unilaterally act as they please, with no accountability to the courts, police, voters, or public. That they are Divinely authorized by God-eh, as intepreteted by one and only one religious persuasion (Although I’m sure the Iranian Clerics and the Sunni Wahhibists would agree comepletely here), to go storming into a hospital room and kidnap a body at gunpoint in flagrant violation of legally decided courses of action. And in this case concerning the aforementioned law, the public is squarely behind the court and medical decisions in massive majorities, with only a small fringe element insisting the law be broken by elected officials, who are sworn to act in the interests of the plurality which elected them. The implications for our culture if this behavior were widely accepted as the norm are, in a word, staggering. The precedent it could set is ghastly.

  16. #16 ~DS~
    March 25, 2005

    Oh sorry I hit the wrong Blog (Windows you suck!), but some if it is still relevant imo.