Friday, September 08, 2006

Terri Schiavo and the "Unconscious" Interactive Patient

I can't let it go: I just can't.

A lot of people thought about poor Terri when it was revealed that a British patient diagnosed as PVS was clearly interactive, based on MRI testing. That brought to many people's minds, mine included, the request of Terri's folks that she receive a test that would measure brain function rather than mere structure. This was refused adamantly by Judge Greer.

I have been checking to see if the test used on the British woman would have been usable with Terri. The answer is no. The test in the British case was a form of MRI. Terri couldn't have an MRI because the strong magnetic field generated by the test would not have been safe due to the fact she had electrodes implanted in her brain from an experimental procedure she received early in her disability.

However, she could have had a PET scan, which uses radiation to measure function. This was the test the Schindlers requested. Which raises the question of whether a PET scan could have provided the same kind of details about Terri that were revealed about the British patient from the MRI. So, I have been asking doctors I know to find out.

One doctor, a neurologist, told me the PET would indeed have been able to measure the extent of Terri's brain function. But a different doctor, a brilliant man with 5 board certified specialties, but not in neurology, told me that while the PET could have measured function, it couldn't have delivered the kind of sophisticated results that were described in the UK case. Based on what both these physicians have told me, it seems that some measure of function could have been measured, but not the kind of quick snapshots of specific brain centers firing when the UK patient was asked, for example, to imagine herself playing a game of tennis.

Still, the bottom line is that while Terri was lying in the bed waiting for the appeals courts to deliver her death warrant, it would have done no harm to give her a PET scan to see what could be seen. Nor would it have harmed anyone for Judge Greer to have permitted very respected rehabilitation therapists, who believed they could have helped Terri relearn how to swallow on her own, to give it a try. Judge Greer's adamant refusal to permit a PET scan and therapy is inexplicable--if,that is, he wanted the fullest record possible before the helpless woman he was duty-bound to protect was dehydrated to death.

6 Comments:

At September 09, 2006 , Blogger OTE admin said...

I completely agree. What a travesty that was and a horrible precedent was set for profoundly disabled people.

 
At September 10, 2006 , Blogger CS said...

Of course all the Cranfordists would claim it all was nothing but 'blind reflexes.' She could stand up and talk and the fools wouldn't be able to figure it out.

It is a good question- why did Mike and Greer absolutely not want any such tests done? Were they just too fixated on getting it all over with? Was Mike's wedding day getting too close?

 
At September 11, 2006 , Blogger Lydia McGrew said...

Of course, we should never let it go.

Question about MRI: I believe there was said to be no reason why the pieces of hardware in Terri's brain could not have been removed. Indeed, I even read that Michael was _supposed_ to have them removed after the experimental therapy they were part of had not worked. Is this right? If so, then the obvious road to getting the best info. wd. have been to remove them and have the MRI.

It's worth pointing out (sadly), that the courts always fell back on the idea that they had already determined Terri's wishes. The idea seemed to be that even if she wasn't in a PVS, she still wouldn't have wanted to live as she was--dependent, unable to communicate, blah, blah--so they really didn't have to _worry_ too much about whether she was really in a PVS, much less get it fully tested.

The swallowing test and therapy issue is more pointed from a legal point of view: I have tried in my own state to induce the Right to Life organization to press for legislation requiring that a patient about to be dehydrated receive a swallow test and, if able to swallow, receive food and water by mouth. I was told that such legislation would never pass. I've always wondered whether it is _really_ true that spoon feeding can be legally required if a person is able to receive it. I have a sinking feeling that, even if Terri could have swallowed and that was known, they could have dehydrated her anyway.

 
At October 28, 2006 , Blogger Julia said...

Dear Mr. Smith:

I am so happy to have discovered your blog, since I have known of your work, and in fact, I cited "The Culture of Death" in one of my published articles.

Ironically, that article, "Could Alternative Medicine Have Saved Terri Schiavo?," published by "Alternative and Complementary Therapies" Magazine, also discusses, at great length, the use of the PET Scan to diagnose true "brain death," or lack thereof.

As you will see from reading my article, I strongly believe that a "real number" was done on the Schiavos by both the medical AND legal systems. What I learned from doing my research for this article –- and even more, from advocating for my husband during his 15 years of life following his 1990 brain tumor diagnosis -- have convinced me that it is an extremely sane response to be terrified of the American Medical System!

You may find my article on the left side of my site, http://www.honestmedicine.typepad.com, under "Julia Schopick's published articles."

I hope you will read my article, and that you will write to me to tell me what you think of it.

Thank you very much -- and keep up the good work!
Julia Schopick
http://www.honestmedicine.typepad.com
JuliaS1573@aol.com

 
At October 28, 2006 , Blogger Julia said...

Dear Mr. Smith:

Please note that when I posted my comments on your blog, I couldn't figure out how to sign in under my typepad account. My blogger account is not active now.

Sorry for the confusion.
Julia Schopick
http://www.honestmedicine.typepad.com

 
At March 09, 2007 , Blogger Unknown said...

Mr. Smith,
I challenge you to consider what a family member in a vegitative state does to those it touches. Having lived this for almost 4 years, I am fed up with people who have not experienced what my family has trying to judge how things should be handled. What about the patient's wishes? My mother would not want to be alive in the sense that she is now. Who are you to say that she should be?

 

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