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A sensible view of the Terri Schiavo case

On The Voice of Reason (slogan: “A penny saved is a government oversight”), there is a pretty clear headed little essay of what I think is most the reasonable position on this absurdly emotive case.

71 comments to A sensible view of the Terri Schiavo case

  • Lune

    “Absurdly emotive” thought:

    “Besides being disabled, Schiavo and I have something important in common, that is, someone attempted to terminate my life by removing my endotracheal tube during resuscitation in my first hour of life. This was a quality-of-life decision: I was simply taking too long to breathe on my own, and the person who pulled the tube believed I would be severely disabled if I lived, since lack of oxygen causes cerebral palsy. (I was saved by my family doctor inserting another tube as quickly as possible.) The point of this is not that I ended up at Harvard and Schiavo did not, as some people would undoubtedly conclude. The point is that society already believes to some degree that it is acceptable to murder disabled people.”

    Read it all here.

  • Lune

    And I suppose you think it is positively progressive of them to not allow anyone to try to feed Terri, they say no feeding tube and they say no real food. What kind of court order is that?

    “Just die!”

    BTW, it is illegal to starve someone that can swallow (at least in Florida), but they have not tested to see if she can!

  • Johnathan Pearce

    For me, the shifting sands of this whole issue make it hard to draw any hard and fast conclusions other than the following: the State should keep out of it as far as possible. Never has it been more important for people to observe the limitations of government and its agents.

    There is also another point to consider. As a result of this dreadful story, thousands, possibly tens and hundreds of thousands of people are likely to sign agreements stating that if they reach a vegetative state, they will choose the option of a painless death rather than be kept in such a state for years on end. A case of the Law of Unintended Consequences.

    Lune, I very much doubt that this poor woman can swallow food, and I would have thought it would have been attempted if it were possible. Your language is unwarranted.

  • The ‘absurdly emotive’ bit for me is the lack of an attempt to come to reasoned positions by so many of the media and political commentators on both sides. Yes, the issue of what to do with the vegetative body of a loved one is perforce ‘emotive’, at least for the people directly involved, but most of the wailing and gnashing of teeth I have heard watching the TV (the ‘absurd’ part) serves mostly to cloud the issue rather than deal with the issues.

  • Winzeler

    the State should keep out of it as far as possible.

    Like I said last time this came up, this situation really flushes the chumps of the libertarian mindset.

  • Lune

    “Lune, I very much doubt that this poor woman can swallow food, and I would have thought it would have been attempted if it were possible. Your language is unwarranted.”

    You would have thought? They are not trying to feed her naturally, it is a fact. The judge has ordered that no one feed her, that is also fact. They have not done testing and attempted to asses her true state for many years now even though we now know that brain tissue can – and does – regenerate.

    One of the doctors believes, after looking at scans of her brain, that regeneration took place between ’96 and ’02. I realize that everyone has the best facts that money can buy but I think exhausting all the possibilities (such as trying to feed her naturally) is warranted.

    You very much doubt that she can swallow? Shouldn’t we find out!?

    Listen to yourself.

    Does anyone not see the absurdity of the court’s ruling? Do you think the disabled citizens groups and the disabled individuals are paranoid?

  • Winzeler

    I better explain my comment before everyone goes nuts with it.

    Anyone who looks at this issue with concern and says, “This is a travesty. We should do something about it.” or “This is a travesty. We need to do something about.” is a statist. A libertarian who is concerned about this issue looks at it and says, “This is a travesty. I want to do something about it.” In which case he/she might do all kinds of things to affect the circumstances to his/her desired outcome short of initiating force.

    See, it’s a very subtle, but monumentously important difference

  • Kevin McGehee:

    I see a lot of people saying all of this could have been avoided if only Terri had made out a living will. Trouble is, until the last few weeks, nobody knew you needed a living will if you wanted to, you know, live.

    Check out his living will, too.

  • Johnathan

    Lune, what evidence can you cite (give some links if possible) that the medical folk have refused to try to see if she could consume food naturally at any point? Give us some sources rather than imply that those entrusted with her care decided not to bother to try. I actually would like to know.

    What I want to see in this cases is facts, rather than ad hominem attacks and impugning of people’s motives.

  • GCooper

    Johnathan says:

    “Lune, what evidence can you cite (give some links if possible) that the medical folk have refused to try to see if she could consume food naturally at any point?”

    Damn seeing if she can feed herself. They haven’t even performed an MRI scan. That’s tantamount to malpratice – quite astonishing.

  • Johnathan

    GCooper, again, you may be right but I wish you could give some evidence for the MRI scan thing. I am getting increasingly bemused by all the claims I read about how this lady has been badly treated but a lot of the evidence seems, well, thin. I am willing to stand corrected.

    BTW, the article that Perry links to is probably the sanest thing I have read so far about this issue.

  • Verity

    Michael Gove presents a very well articulate and reasoned piece in The Times. timesonline.co.uk (I don’t know how to do links on Firefox.)

    I thought the news that she was no longer urinating, indicating kidney failure was horrifying. They deliberately caused kidney failure in perfectly well functioning kidneys. Other than the feeding tube, she need no assistance from any life support equipment. She is breathing herself, and I read a tragic bulletin that her heart is beating strongly.

    This case is so horribly disturbing. I have no sympathy with the religious right and I take a realistic view of people on life support having it removed. But this is too close to murder for me. I just hate it. Those poor parents!

  • The Voice of Reason has it about right, I think.

    All the theories about what a horrible person Mr. Schiavo is founder on the facts, which is probably why they grow more and more outlandish all the time. Simply put, he has had nothing to gain for years now by continuing as her guardian, not money, not anything. Why does he do it? The simplest explanation is what V of R puts forth – he is trying to do the right thing by his wife.

    In his position, up against the dreadful Schindler clan and their odious allies (Randall Terry? please!), I would be acting just as he has.

    The Schindlers and the right-wingers they have recruited into their cause are pushing for more government supervision of your last days. Make no mistake about it – they want to restrict your ability, through your proxies, to reject medical care.

    That is profoundly un-libertarian. Forcing medical care on people against their wishes, as best we can determine them, “for their own good” should cause everyone who thinks of themselves as a libertarian to break out in hives.

  • Verity

    R C Dean – I’m not sure the Schindlers recruited the religious right – although in desperation, you will make anyone your ally. But one of the family went outside the hospice yesterday and told the people on vigils and with signs to please go away. He said, “You don’t speak for our family.”

  • GCooper

    Johnathan writes:

    “GCooper, again, you may be right but I wish you could give some evidence for the MRI scan thing.”

    I’m sorry, my primary source was the Sunday Telegraph and I’m enough of a sweet old fashioned thing to still read a paper version.

    A quick search, however, suggests this might satisfy your needs: Link

  • GCooper

    Verity writes:

    “I thought the news that she was no longer urinating, indicating kidney failure was horrifying. They deliberately caused kidney failure in perfectly well functioning kidneys. Other than the feeding tube, she need no assistance from any life support equipment. She is breathing herself, and I read a tragic bulletin that her heart is beating strongly.”

    Quite! Death by dehydration is not a pretty spectacle and were the people concerned doing this to a duck in this country, they would (quite rightly) be hauled before the courts by the RSPCA.

    As for those complaining about smears against Terri Schiavo’s husband, while they, themselves, smear others by association – that simply beggars belief.

    I have nothing but contempt for the religious Right and I refuse to have my dislike of what looks (admittedly from a distance) like extremely unethical behaviour condemned by an association I utterly refute.

    You don’t have to be a Baptist Bible-thumper to be alarmed by what is being done to this poor woman.

  • Verity

    I haven’t seen this addressed anywhere else, although it may have been, but it strikes me as strange that a young, pretty, happily married woman would be a bulimic. On a diet to lose a couple of pounds, yes. Constantly. But to be so severely, outlandishly bulimic that she had no potassium in her body?

    The only other one I can think of was Diana, about whom I have never had a good word to say, but no one could deny that she was very unhappy and knew her husband had rejected her.

    Normal young married men are constantly being asked by their wives, “Do you think I’m fat?” and most of them know what the correct answer is. If Terri was so severely bulimic, it tells me that she was trying to please a husband who demanded perfection, or who was constantly criticising and undermining her.

    Bulimia is normally found among young single women and girls who have a poor self-image and worry that no one will be attracted to them – when it is found at all – not happily married young women.

    If any other women are reading this thread, I’d be interested in your comments.

    Something about this case just doesn’t add up.

  • Denise W

    Verity,

    I admit I don’t know for sure but I saw an interview on the news with one of Terri’s friends. She said that Michael’s demanding of the removal of the feeding tube was one of his ways of still trying to control her. Or something to that effect. So according to this friend, he was the controlling type, which I would imagine could cause a woman to be bulimic. So whether or not she was really happily married, we don’t know for sure. But is the friend telling the truth? Who knows.

    GCooper,

    I heard that Michael refused to allow any MRI scans to be done.

  • Verity

    Thanks, Denise W.

    I think Michael hates her. And she knew it. He probably told her she was fat, so she thought if only she got thin enough, he’d love her. I know it’s speculation, but it’s where the facts would appear to lead us.

    Any man who has his comatose wife’s wedding and engagement rings melted down and fashioned into a ring for himself …

  • GCooper

    Denise W writes:

    “I heard that Michael refused to allow any MRI scans to be done.”

    Allegedly, this is the case. One can only wonder why.

    As for Verity’s point, I’d feel uncomfortable speculating.

    However, I have read and re-read the article Perry de Havilland refers us to and have been unable to find any convincing ethical argument in it. Anyone who has endured a divorce will shudder at the thought of the power of life or death being conferred on a spouse.

    Guardian, Schmardian!

  • Alice Bachini

    It seems that anyone who wishes to be kept *alive*, should they be unfortunate enough to suffer severe brain-damage, had better make a living will to that effect while they still can.

    Not all next-of-kins are paragons of virtue, even if Michael Shiavo is. And over the years, next-of-kins can disappear, leaving one in the hands of other, less preferred next-of-kins.

    People who want to stay alive certainly can’t trust the law to err on the side of safety after a case like this.

  • Steve

    Verity, are you quite insane? You have absolutely no evidence to say “He probably told her she was fat”. And what facts would lead us to this conclusion? Absolutely none.

    And the reason no MRI has been performed recently is that it would tear the experimental brain implants that Terri recieved clean out of her head, but what good are facts when you can spout nasty, malicious unfounded gossip about some poor sod who is being portrayed as the devil incarnate by people with absolutely no idea what they are talking about?

  • GCooper

    Steve writes:

    “And the reason no MRI has been performed recently is that it would tear the experimental brain implants that Terri recieved clean out of her head, but what good are facts when you can spout nasty, malicious unfounded gossip about some poor sod who is being portrayed as the devil incarnate by people with absolutely no idea what they are talking about?”

    We’ve heard quite a bit about emotive claptrap in this case. The above post epitomises it.

    The “experimental brain implants” don’t need to be “torn out” prior to an MRI scan. They can be removed, surgically, much as they were introduced.

    The vehemence of your post, incidentally, shows that the rabidity isn’t quite as one-sided as is pretended.

  • Verity

    Steve, I don’t believe I’m “quite insane” or even mildly insane, but then, who’s to say?

    I explained what led me to conclude that Michael told her she was fat. She was an obsessive bulimic. Women who are accepted and loved by their husbands for who they are, do not force themselves to vomit their meals up. This is a sign of abnormal discontent with their physical self-image. It is well within the means of any husband to tell his wife he doesn’t think she’s fat, or he likes her curves, or thinks she’d just right, or whatever.

    That a woman forces herself to vomit to such a bizarre extent she has no potassium in her system is a sign that she is desperately trying to live up to some man’s idea, perhaps very frequently articulated, of perfection. Women don’t become bulimic because they lost the schoolboard election or didn’t get the job they wanted. It’s an emotional thing.

    Alice’s post had some very sane advice.

  • Steve

    Terri Schiavo was bulimic = Micheal Schiavo is an evil man who was forever telling her she was a disgusting fatass. Right. Why do you hate this man so much with absolutely no evidence, Verity?

  • GCooper

    Steve writes:

    “Why do you hate this man so much with absolutely no evidence, Verity?”

    I hope Verity will forgive me for intervening, but one has to ask, why are you so frenetic in your defence of him?

  • Verity

    Steve, slow down.

    I have no idea about the Schiavo’s marriage and I came to the thought that causing a person who had lung, heart, liver and kidney function to die of starvation and dehydration was very gruesome quite recently. This evening, in fact.

    Bulimia is extreme behaviour in a young married woman.

    I don’t know Michael. I introduced a new thought on this thread that I hadn’t seen addressed before and specifically wondered what other women thought.

    You have called me “quite insane” and have accused me of “hating this man so much”. Go and put a cold wet towel across your fevered brow and lie down in a dark room for a while.

  • Dale Amon

    The issues from my view point are rather simple:

    1) She did not leave a living will on the subject so
    the presumption cannot be that she prefers
    death.

    2) The actions of Congress and the President clearly
    show a lack of respect for Federalism and State’s
    RIghts. Of course what is new there? Federalism
    is only useful if you are out of power.

    3) Who pays? It is not the responsibility of Floridians to
    cover the costs of keeping her alive. If others wish
    to cough up the money rather than pontificate,
    then let them take responsibility for her
    continued daily care. If one of you fears being
    in her position, then it is your responsibility to
    take out and pay for an appropriate insurance
    policy now.

    So my answer is, George should butt out and all those
    who are appalled by it should be given custody and have the bills sent to them for the rest of her natural life.

  • A few people in this thread have mentioned the lack of an MRI. An MRI has never been performed because nobody thought it was necessary. The extent of Terri’s brain damage has been very clear for a long time. To quote from the excellent Wikipedia article on the Schiavo case:

    The lack of oxygen to the brain suffered after Schiavo’s heart attack in 1990 caused catastrophic brain damage. Schiavo’s cerebral cortex has been completely destroyed and replaced by cerebrospinal fluid. The upper brain is about 80 percent destroyed, and there is also damage to the lower brain. The only part of the brain that remains intact is the brain stem, which controls functions such as breathing and heartbeat—allowing Schiavo to survive (with a feeding tube) even though she no longer has any cognitive function…… Schiavo could be evaluated with a PET scan in her current condition. However, an MRI cannot be done without first surgically removing experimental electrodes which were implanted within her brain in 1992, something that Michael Schiavo has chosen not to do. [13] (http://www.nationalreview.com/script/printpage.asp?ref=/comment/johansen200503160848.asp) At any rate, neither a PET nor an MRI could change the fundamental finding of both X-rays and CAT, which is that over 50 percent of Terri’s brain is destroyed.

    Read the rest of the section “Medical Opinions” in that article. There are other good summaries of the Schiavo case here and here.

    Two physicians were selected by Terri’s parents in 2002 to put their case in court. Those physicians examined Terri then and could have ordered an MRI if they thought it would help their case. They didn’t, because all an MRI would do is confirm that Terri’s brain is largely destroyed. The only reason the issue has been dragged up now is as a stalling tactic by the parents.

    Incidentally, about those two physicians the parents selected. One of them is not even a neurologist – he’s a radiologist. Both of them proposed their own special therapy method, which was rejected due to, in the words of the court, “the total absence of supporting case studies or medical literature”. Why is it that the parents could not find credible neurologists to represent them?

    This disturbing passage from Wikipedia should give you some insight into the mindset of the parents:

    Schiavo’s parents have stated that several days after the removal of the feeding tube, Schiavo made an attempt to say “I want to live” in response to their attempts to coach her. An emergency motion to restore the feeding tube claims that “she managed to articulate the first two vowel sounds, first articulating AH and then virtually screaming WAH.”

    I have a huge credibility problem with anyone who hears “ah wah” from Terri and explains to me that she was actually saying “I want to live”. God save me from such “interpreters” if I ever wind up in a similar state.

  • David Mercer

    Verity, from everything I’ve seen of Michael Schiavo, I don’t think I’d like the man at all if I met him, and he may have had something to do with her bulimia (I’d actually put odds on that he did), BUT, as someone who has had a fiancee go secretly bulemic on him in the past, take exception to your characterizing all men who are in a truly involved relationship with a woman who gets bulemia as some kind of monster.

    My ex had all kinds of latent shit going on under the surface that only came up when she was in a good relationship. Wonderful that, someone finally feeling good enough to open the icky boxes in their head, and that’s what happened, isn’t it. It obviously had to do with my girlfriends self image, but that had to do with her mother, not me.

    Terry Schiavo’s mom probably gave her a complex about her appearance, and then michael being an ass did her in.

  • Randall Terry’s presence in the Schiavo circus has been annoying enough, but does anyone have any notion why Jesse Jackson has chosen to put his oar into these murky waters? I myself can come up with only two theories:

    1. He wants to go on record against any precedent that could endanger members of his potential constituency. Google “baby sun texas” to get an idea what I’m on about here.

    2. Some Machiavellian wag convinced him to foist himself onto the theocons.

    Of course, there’s also the mandate to get publicity at any cost, but in Jackson’s case that goes without saying.

  • Johnathan

    “I think Michael hates her (Terri)”, writes Verity. This is the sort of statement from well-intentioned people that makes me see red. How does Verity know that for sure? It is a pretty nasty accusation to make without being certain of the facts.

    GCooper, thanks for the MRI scan angle.

  • Steve

    The reason I am so vehement about defending Michael Schiavo is because of the lynch mob mentality of certain commenters here who are ready to make absolutely horrific accusations about the man with no evidence whatsoever.

  • GCooper

    ChrisV writes:

    “An MRI has never been performed because nobody thought it was necessary.”

    Nobody? That’s stretching the truth beyond its natural elasticity by quite a margin. You might find the link I posted earlier in response to Johnathan’s request of interest in this respect, where it relates to medical opinion.

    Clearly, an MRI scan was required and should have been performed. That it was not is and that her husband did not want one, is very odd indeed.

  • GCooper, you’re kidding right? I covered this disturbing “I want to live” rubbish in my last comment. The only other thing of substance in that article is this “almost 50″ doctors who have signed affidavits asking for an MRI. I can’t speak for the Telegraph’s claims, which are unsubstantiated. The Wikipedia article includes this information:

    They cite the testimony and affidavits of 33 physicians and therapists (including 15 neurologists) who, after reviewing video segments provided by her parents, believe that Schiavo should receive further tests and/or would likely respond to therapy. Only two of these physicians, however, had access to her full medical history and examined her in person. Some of these physicians have claimed that there is a “strong likelihood that Mrs. Schiavo is in a ‘minimally conscious state.'” There were six video segments provided by Schiavo’s parents totaling four minutes and twenty seconds in length (edited down from four and a half hours of videotape, the rest of the recorded video has not been released publicly).

    I have the choice here between believing experts who examined Terri personally and viewed scans of her brain – or I can believe unnamed “doctors” (often not neurologists) who viewed 4 minutes of selectively edited videotape and decided that was good enough to sign affidavits.

    Again I repeat: If an MRI is so critical, why did the parent-appointed court physicians not demand one? Why is it that the interpretation of the existing scans is not in dispute?

  • Also: It isn’t “odd” that her husband doesn’t want an MRI performed. He doesn’t want one because it is so transparently a stalling tactic from the parents. Unlike you, Michael has not joined this case in the last month or so. He has been bound up in this thing for years and I imagine is heartily sick of it.

  • Bolie Williams IV

    The following are very easy to find online with a simple search:

    1. Affidavit from a neurologist who examined Terri that states that further tests are required to rule out a minimally conscious state.

    2. Comments from a number of doctors that a single CT scan is not sufficient to prove the loss of her cerebral cortex. It certainly shows that she has probably suffered significant loss of her cerebral cortex, but further scans are necessary to verify this.

    3. She has not had an MRI or a PET scan. A PET scan would not require removing the implants.

    4. The Judge did not issue an order allowing her feeding tube to be removed, he issued an order requiring her feeding tube to be removed. In this unusual case, the Judge actually ordered her execution. This is not normally done.

    5. Almost $500,000 of Terri’s medical care money was spent by Michael on lawyers trying to have her feeding tube removed with the Judge’s approval. When the money was awarded for her medical care, I’m not sure that’s what was intended.

    6. Even though people who are PVS don’t feel pain, Terri has been receiving pain medication for menstrual cramps and has shown responses to pain.

    I think it’s likely that she is PVS and her consciousness is gone. But I’ve seen enough questions from enough doctors, including some who’ve examined her, that I don’t believe that enough effort was taken to verify such an extreme diagnosis. If she was being diagnosed with an ear infection, I wouldn’t worry so much if the diagnosis wasn’t right. But with a diagnosis that amounts to death of consciousness, I would have liked to see more effort made to be certain of the diagnosis.

    Either way, allowing an otherwise physically healthy person to die of dehydration is pretty gruesome.

    Bolie IV

  • GCooper

    ChrisV writes:

    “GCooper, you’re kidding right?”

    On the contrary. I’d trust the credibility of an article in the Sunday Telegraph against an article on Wikipedia (!) any day of the week.

    As for the rest, there’s no point in duplicating what Bolie Williams IV has said – notably the cruel means of inducing death that has been chosen.

    It’s hard though not to note, once again, the vehemence (not to say venom) behind some of the pro-husband comentators, both here and elsewhere. You have to wonder what emotions are being invested in this tragic case. And why.

  • If all this stuff is so easy to find with a search, why don’t you provide any links to substantiate any of the things that you say?

    I know several of the things you are saying are false without doing any searching at all:

    (1) The evidence of brain damage is not based on a “single CT scan”. A cursory glance at the summary articles reveals a 2001 CT scan, a 2002 CAT scan, multiple EEGs and X-rays. There were likely more scans performed that aren’t mentioned. Note that the physicians hired by Terri’s parents in 2002 did NOT dispute the physical damage done to Terri. Nor did they request any further scans back then. Why not?

    (2) It is a complete nonsense to suggest that ordering the tube removed is not the way things are normally done. Under Florida law a determination is made about what the wishes of the patient would have been and then they are carried out. If the judge were to rule that the tube is “allowed” to be removed, then on whose shoulders does the decision to remove it or not rest?

    (3) Patients in PVS do commonly respond to pain stimulus. This is not the same as feeling pain in a conscious sense. I am only guessing, but I imagine the reason Terri was receiving pain medication is to quieten her down, rather than out of concern for her welfare.

  • Verity

    Thanks to ChrisV for some very interesting information. It explains much – although, of course, in this strange case, probably nothing will ever be fully explained.

    Thank you, David Mercer for the same reason. “as someone who has had a fiancee go secretly bulemic on him in the past, take exception to your characterizing all men who are in a truly involved relationship with a woman who gets bulemia as some kind of monster.”

    Could you point out where I said that, please?
    Did I say “all men”? Did I say “some kind of monster”?

    I posited a theory about why a young woman in a secure marriage would develop this kind of very extreme behaviour which left her without a trace of potassium in her system. That is an awful lot of violent throwing up – day after day.

    I asked for comments about my observation, particularly from women, because no matter how thin they are, all young women worry about being too fat.

    None of us here, that I know, of is involved in this case. We are outsiders commenting on a blog whose subject was introduced for the purpose, Jonathan. I’m sorry if having opinions or inviting speculation from others on a blog is suddenly regarded as so aberrant that it makes you see red.

    It looks to me – purely, purely speculatively – as though Michael took advantage of insecurity to encourage Terri to be beholden to him for any approval he chose to bestow. It is a thought. That is all.

    Again, this is from my experience of life. It is very easy to reassure a young wife that she is desirable. It is equally easy to destablise her by withholding approval and forcing her to try harder. FACT: David, your own case notwithstanding, I can say that I have honestly never known of, nor heard of, a woman in a secure relationship throwing up her food to reach some impossible goal of thinness. For one thing, everyone knows that FACT: vomiting every day ruins one’s teeth with such frequent exposure to stomach acid.

    SPECULATION: if she was vomiting to the extent that she was losing and never replacing potassium to a critical degree, she would already have been very thin and her husband ought to have been worried about her. In fact, he ought to have insisted on getting her diagnosed for rapid weight loss.

    I came to this discussion late because for the last week or so I have dismissed it as more crazy American religious right trying to force their views on everyone else. It is only since I read that her healthy kidneys had shut down and that her heart was still beating strongly that I felt a terrible pang. Now Bolie mentions the heartrending news that she is receiving morphine for menstrual cramps. If she is unable to communicate anything, how do they know she has cramps and is suffering pain? If she’s not communicating it, why are they giving her morphine if they’re so sure she’s in PVS?

    This is all as fragmented and disjointed and unreal as a nightmare.

    None of the above is presented as fact.

  • GCooper, heh. Personally I’d take Wikipedia any day of the week. But be that as it may, since the additional information that Wikipedia provides (that the vast majority of the doctors had not examined Terri or her medical history) is not contradicted by the Telegraph, we can all assume it is true until you provide me with anything that contradicts it.

    I note also that you have avoided responding to the question of why additional brain scans were not requested back in 2002, and why the parents’ representatives did not then question the interpretation of the original scans.

    I’ve seen this crap about the vehemence of the “pro-husband” (I am pro-Terri’s wishes and pro-rule of law, not pro-husband) commentators on other sites. The emotion is not difficult to understand for anyone with the imagination to picture themselves in a similar situation to Terri’s. I don’t believe Terri is conscious, but those are the terms the other side are arguing on. If I were minimally conscious in a hospital bed, in a similar state to Terri, and you talked to my friends and family, they would tell you that I would rather have medical support withdrawn. Suppose you personally chose to deliberately ignore this evidence and order me to be given medical treatment. I would regard this as torture and an extremely serious breach of my liberties, and if it were within my power I would not hesitate to kill you to prevent you doing this.

    So yes, you’ll forgive me for getting emotional about the case.

  • Duncan

    Words “rule of law” mean anything to anyone here?

    1. Legally a person has the right to refuse medical treatment (in the US, specifically FL in this case)

    2. If a person is unable to express their wishes in regards to this, the decision falls to someone, appointed by law… in Florida, this law says that someone is the spouse.

    3. Over 15 years, and 20 hearings later, Michael has done nothing, despite what we may, infer, assume, deduce or suspect, in the view of the Florida courts to make his status as her spouse invalid.

    Therefore Michael, by law, has the final say as to speaking for his wife.

    That is ALL there is to this case.

  • Verity

    I just want to add that, like G Cooper, I have been dismayed by the level of anger defenders of the huband are manifesting to speculation that he may have been, directly or indirectly, to blame for the bulimia and thus the coma.

  • Verity

    Duncan – You are correct when you say that is all there is to the disposition of this case and there is no point in thrashing around in a forest of legal arguments and medical technicalities because the arguments are done.

    Some of us are nevertheless shaken that this apparently healthy body has been condemned to be put to death because of a brain malfunction. We won’t know the extent of the brain damage until the autopsy because there doesn’t seem to have been a huge effort to determine it before proceeding on this course. Watching someone starve and dehydrate to death when the human reaction is to want to give them water and nutrition and comfort them is horrible. The pain of the parents does not bear thinking about.

  • S. Weasel

    Food and water are not medical treatment. The woman is alive, stable, breathing on her own and her health is (was) not in decline. She’s severely brain damaged and cannot communicate, but we have no idea how much sensory input she experiences.

    I understand Stephen Hawking has a feeding tube, too. And soon, the Pope. Neither one can communicate without help. Anyone care to do the honors…?

    Or is it moral to starve stupid things but not smart things? Could you put a mouse in a box and watch it for a couple of weeks to see if it had starved yet? I know Terri Schiavo won’t be reading the Wall Street Journal, but can you guarantee she hasn’t the information-processing ability of a mouse?

    Count me libertarian, irreligious, and really bothered by this.

  • Winzeler

    inducing death

    put to death

    There is a radical difference between puting to death/inducing death and permitting it.

  • S. Weasel

    There is a radical difference between puting to death/inducing death and permitting it.

    If by “permitting” death you mean denying food and water to a physically healthy organism, then the main difference is that “putting to death” would at least be honest and quick, while “permitting” it is a cowardly, cruel bit of sophistry.

  • Winzeler

    If you call allowing nature to take is course “cruel,” then, yes it is. It may be cowardly, but it is not oppressive. Cowardly is only dishonorable, it is not evil like murder or manslaughter, where a life was “taken” as opposed to “permitted to go.”

  • Winzeler

    If you call allowing nature to take is course “cruel,” then, yes it is. It may be cowardly, but it is not oppressive. Cowardly is only dishonorable, it is not evil like murder or manslaughter, where a life was “taken” as opposed to “permitted to go.”

  • GCooper

    Duncan asserts:

    “That is ALL there is to this case.”

    Not quite. There is also the considerable question of whether he is a fit person to be making that judgement and in whose interests he is making it.

  • S. Weasel

    If you call allowing nature to take is course “cruel,” then, yes it is.

    I do if the object of your attention is otherwise perfectly healthy but unable to feed itself. It would obvously not be okay to leave an infant to starve and describe it as “nature taking its course.” We don’t starve Alzheimer’s victims when they can no longer feed themselves. Ditto, paralytics. What is it so “natural” about this compared to that?

  • GCooper

    Chris V writes:

    “I’ve seen this crap about the vehemence of the “pro-husband” (I am pro-Terri’s wishes and pro-rule of law, not pro-husband) commentators on other sites.”

    But you don’t know Mrs. Schiavo’s wishes. You haven’t the faintest notion what they are or were. All you know is what her husband claims them to have been.

    This seems, under the circumstances, a rather generous presumption on your part.

    Chris V also says:

    “The emotion is not difficult to understand for anyone with the imagination to picture themselves in a similar situation to Terri’s.”

    Well quite. But what if, somewhere within the minimal reaches of her consciousness is the desire to remain alive? Even an earthworm manifests that.

    And:

    “I would regard this as torture and an extremely serious breach of my liberties, and if it were within my power I would not hesitate to kill you to prevent you doing this.”

    Leaving aside the (apparently obligatory in these arguments) blowhard Clint Eastwood routine, you are, again, making an assumption that she wishes to die and you are imagining yourself in her position on that basis.

    Now try it the other way round – being condemned to a slow and possibly painful death without being able to raise a whisper of protest.

    Finally, I have absolutely no idea why a full MRI scan was not ordered in the past. For all I know, Mrs. Schiavo’s doctors could have been incompetent. I do, however, know that one should and could have been carried out and that her husband refused to allow it.

  • Verity

    In response to G Cooper – There are a couple of points. First, yes, I think the character of the husband is of profound importance here. He spent the insurance money supposedly destined for her care in fighting in the courts to have medical intervention removed. SPECULATION ALERT: He may have a cold, controlling nature that motivated his wife to try to please him by embarking on a dangerous programme to make herself perfect in his eyes. ALERT ENDS.

    It’s discomfiting that judges are taking hearsay evidence from this individual alone. It’s not as though her family and friends have rallied round and said, “Oh, yes, whenever we’ve encountered news of brain dead people, Terri always said, ‘Never let that happen to me!”. We only have his word for it and he has much to gain.

    In addition, many of us have expressed repulsion at the notion of being kept on life support, and she may have done so, too. But she isn’t on life support. She had healthy, functioning kidneys, her heart is strong, her lungs are strong, and now we even hear that she is menstruating! So even her ovaries are functioning normally.

    It is very disturbing to find myself in the same general territory as the American religious right. I would have placed a bet that it would never happen.

  • S. Weasel

    Worse than finding yourself on the same side as the American religious right, Verity, is the assumption that you must be one, because there is no other explanation for your position. I hate that the conversation is being framed as “emotional bible-thumping right-wing fundies versus the pure, clear illumination of science and law” (not so much here, thank goodness).

    I’ll put my atheist cred up against anyone’s — what religious types call the soul, I call the brain. But our instruments can’t show us how much of Schiavo’s mind is left, or what it’s up to. Atheists should fight harder than anyone for the preservation of the individual, because we believe no-one gets an encore performance.

  • I'm suffering for my art

    S. Weasel : Stop talking twaddle. I can’t see a single utterance of Verity’s that would even remotely associate her with the religious right. She isn’t appealing to any deity, she’s not ranting on about right to life etc. She is merely stating what many of us feel – Terri Schiavo is not “dead enough” to be pushed over the brink – especially using a method such as starvation of food/fluids.

    Incidentally, your position on the matter is extremely blurry, apart from the fact you seem to be crudely labelling yourself an atheist, and others fundamentalist Christians. I understand English but what you’ve written places you where in the discussion?

  • S. Weasel

    No, I’m suffering from my art, I’m not sure you do understand English.

  • Verity

    Suffering – Thanks for the gallantry, but I think S Weasel was just commenting on the skewed nature of this argument by noting that if you take a position opposed to that of the “rationalists” who can’t see anything wrong with the courts accepting the unsubstantiated word of Michael, you will be nailed as a religious right nut – instead of a rational person who disagrees with them for rational reasons.

  • I'm suffering for my art

    S. Weasel – Fair cop. Apologies. I really shouldn’t comment at 4am…

  • I'm suffering for my art

    Oh, AND after a bottle of cheap Spanish red. I should definitely stick to our cheap Australian plonk. Not that I’d be any more comprehending, but it’s somewhat more drinkable…

  • GCooper (and Verity):

    The husband was not the only one to give evidence about Terri’s wishes. There were two other witnesses to comments she had made (admittedly both Schiavo family members).

    You don’t know what Terri’s wishes were either. We shouldn’t resolve these cases by saying “oh well if we don’t know for absolute certain, we should keep them all alive”. That just guarantees you will get it wrong in the majority of cases (since the majority of people would want to die in such a situation, according to opinion polls). The courts should tend towards the side of life in such situations. The Second District affirmed this on appeal, but also affirmed that the judge had had sufficient evidence to decide that living would not have been Terri’s wishes. The court hears evidence and then they deliver a verdict. This is called the rule of law.

    I’m aware that being condemned to death when you don’t want to be is a pretty bad deal. I was pointing out that the other side of the coin isn’t so hot either, so I don’t think you have the moral authority to demand administering treatment as a default position, with a prohibitively high standard of proof, when that isn’t what the majority of people would want. You appear to be of the view that if one person has treatment withdrawn against their wishes, that is worth 100 patients being treated against their wishes. I reject that completely.

    I’m not sure what you meant about the earthworm, by the way, but I’m pretty sure I disagree. An earthworm doesn’t manifest anything.

  • S. Weasel

    ChrisV: I’d like to see an opinion poll of the number of people who would rather die than live like Christopher Reeve. I’m guessing the numbers would be even higher. I gather that changes after a few months when it’s actually you. A written will — or at least unanimous opinion among your caretakers — is not a “prohibitively high standard of proof” in a question of life or death.

    Scratch that — I would accept the Schiavo standard for unplugging a breathing tube (you do realize this will be enshrined as the Schiavo standard, yes?). If you can’t breath on your own, it speaks to a higher level of brain damage — and, at least, a quick death. Any method of death that takes ten days (and counting) shouldn’t be permitted a creature that apparently needs morphine to endure it.

    I’m suffering for my art: if you’re on the outside of a bottle of red, I’m suffering more than you are. I’m for a jigger of cold medicine, and bed.

  • I'm suffering for my art

    S. Weasel – my suffering is postponed until I’m at work and the morning coffee’s worn off. Stupidly I stayed up ridiculously late last night. 4 hours later, I wake up to the garbage truck. No doubt it’ll catch up with me in a few hours. The lack of sleep, not the garbage truck. Once again, sorry about being a tosser last night.

  • Verity

    Well, ChrisV, I didn’t write it, but an earthworm manifests a will to live. It will attempt to flee a threat. Every sentient being manifests a will to continue in this state.

    So the only other people on record, among all Terri’s relations and all her friends and all her acquaintances and colleagues, who are sure Terri would want to die in this situation are two more members of the Schiavo clan.

    No, of course I don’t know what Terri’s wishes would have been. Neither, I submit, does anyone else who is not a very interested party. It seems to be a very tiny enclave of people who know for sure that Terri would have wished for death, and they all happen to be Schiavos. No best friends, no family, no close colleagues, no casual acquaintances who remember a casual remark. The only people in the entire world who can vouch for Terri’s wishes are three Schiavos.

    Anyway, the case is over.

  • We as a society don’t face a choice here between withdrawing Terri’s treatment and doing nothing. The choice is between withholding treatment and forcibly giving treatment and either could be a catastrophic mistake. Wrongful death is obviously more serious, but not massively more so – the alternative is potentially years of torture.

    There’s a well known effect in psychology which is often referred to as “decision avoidance”. I can take an example from the world of gambling. If you are dealt 16 versus dealer’s 10 in blackjack, the percentages favour hitting – taking another card, even though you are very likely to bust. What you find in the real world, though, is that players new to the game are reluctant to do this. They would rather stand because inaction gives them the illusion of having avoided the decision. The general lesson is that when placed in a dilemma, with two bad options, people tend to favour the one that they perceive as inaction.

    If we lobby for Terri to be forcibly treated, we do not absolve ourselves of moral responsibility in the case. If Terri suffers as a result of treatment which is against her wishes, we are responsible for that just as we would have been responsible for her death in the event treatment is wrongly withheld.

    I think demanding a standard of proof such as a written will before withholding treatment flows from the perception of giving treatment as being inaction, or the default position. Turning it around, I could say that given opinion polls, the odds are that Terri would not have wanted treatment, so you must prove with a written document that she does want it. That would be a pretty extreme position and I don’t endorse it, but hopefully you can see what I’m getting at. We don’t start from a default position of administering treatment and then seek to prove that treatment is not required. We start from a neutral position, weigh the evidence, and decide one way or the other.

    Verity: An earthworm is a very simple organism – not sentient. As far as I know it doesn’t possess a brain. By saying it has a “will to live”, you’re therefore saying that “will to live” is defined in terms of the behaviour of an organism, rather than its internal mental states. This is a philosophy called behaviourism, which is not all that widely defended anymore (although the dominant theory is the similar functionalism. In my opinion “will to live” should be defined in terms of conscious mental states, so an earthworm doesn’t qualify.

  • Verity

    An earthworm has a nervous system and has some cloudy desire to protect it and not feel pain.

  • Verity

    PS – This has nothing to do with Terri’s case and I don’t remember who brought earthworms into this.

  • Jon H

    Verity,

    Maybe her bulimia was triggered by their move from Pennsylvania to Florida. I should think that could be quite stressful for a woman with weight and self-image problems, given the tendency to wear less clothing, all year, due to the warmer weather.

    Up north, if you’re heavy you have half the year or so in which you can wear clothes that make you look good. The other part of the year, you’re in outfits that aren’t flattering. And you’re surrounded by fitter people running around in revealing clothes.

    When I lived in San Diego in 1997, I was struck by the amount of plastic surgery advertising. There was far more of it than I’d seen in Ohio, Pennsylvania, or Connecticut, where I’d lived previously.

    I think that’s due to the climate, and the fashions worn, and the competition to look good.

    I’d think Florida would be a similar environment.

    Perhaps Terri Schiavo felt she was in competition with other women in Florida, which triggered bulimia.

  • Jon H

    S. Weasel writes: “We don’t starve Alzheimer’s victims when they can no longer feed themselves.”

    Sure we do, every day. When Alzheimers progresses to the point where the person can no longer swallow, refusal of a feeding and hydration tube is a common option invoked by a living will or a guardian.

  • Jon H

    “The Alzheimer’s Association’s Ethics Advisory Panel suggests that efforts at life extension in the advanced stage of Alzheimer’s create avoidable suffering for people who could live out the remainder of their lives in greater comfort and peace.

    In the panel’s view, antibiotics given to treat bacterial infections are considered life-extension efforts. So are all invasive technologies — cardiopulmonary resuscitation, dialysis and tube feeding, for example.”

    http://www.cnn.com/HEALTH/library/HQ/00618.html

  • S. Weasel

    When Alzheimers progresses to the point where the person can no longer swallow, refusal of a feeding and hydration tube is a common option invoked by a living will or a guardian.

    We discover they cannot swallow when they choke — if not fatally, then it will probably not be decided to feed by intubation. At the point we find their existence tiresome, we don’t call in a doctor to say, “I’m pretty sure she can’t swallow any more, so let’s refuse the opportunity…”

  • Lune

    Granddaughter yanks grandma’s feeding tube
    81-year-old neither terminally ill, comatose, nor in vegetative state