On Mon, 28 Mar 2005 11:04:28 -0800 Marta Russell <ap888 at lafn.org> writes:
> Chicago Tribune
>
> > An end to it all
> > --------------------
> >
> > The issues raised by the Terri Schiavo case linger and are as
> complicated
> > as life itself
> >
> > Medical facts are cast aside
> >
> > By Lennard J. Davis, professor at the University of Illinois at
> Chicago in
> > English, disability and human development and medical education
> >
> > March 27, 2005
> >
> > While she may be unable to help herself, Terri Schiavo has been
> immensely
> > useful to just about everyone else.
> >
> > Progressives see any attempt to keep Schiavo alive as a plot by
> > conservative Christians and their Republican allies to push a
> "right to
> > life" agenda. Conservatives, for their part, think that Democrats
> are
> > shoring up their misguided position supporting physician-assisted
> suicide,
> > euthanasia, stem-cell research and abortion.
> >
> > But how can legislators and citizens make decisions about this
> case when
> > they know little about the medical facts?
> >
> > The most common misconception is that Schiavo is brain dead or
> > comatose--that is, completely unconscious without any chance of
> recovery.
> > In fact, she is not comatose but diagnosed as being in a
> "persistent
> > vegetative state."
> >
> > This is a state defined as "wakefulness without awareness," and
> the
> > expectation is that there will be no recovery. Such patients may
> display
> > eye movements, laughter, crying, grunting or thrashing.
> >
> > Yet this diagnosis is not just a simple, cut-and-dried category.
> > Persistent vegetative state is a diagnosis made by external
> observation
> > that infers a lack of consciousness.
> >
> > No brain scan or MRI is used to confirm this neurological
> diagnosis.
> > Family and friends, who spend much more time with the patient,
> often make
> > a very different assessment, asserting that the patient has some
> minimal
> > consciousness.
> >
> > Similar symptoms
> >
> > A similar state, called "locked-in" syndrome, has very similar
> symptoms.
> > These patients have full consciousness, yet they cannot move or
> give a
> > sign that they are aware. Often, the only way they communicate is
> by
> > blinking their eyes. The only outward behavior that may separate
> > persistent vegetative state from locked-in syndrome is the
> patient's
> > ability.
> >
> > The most famous of these cases was French author Jean-Dominique
> Bauby, who
> > wrote his memoir "The Diving Bell and the Butterfly" entirely by
> blinking
> > to indicate individual letters of the alphabet.
> >
> > So it is possible that some people like Terri Schiavo actually
> may be
> > conscious but unable to signal that they are.
I think that Professor Davis is mistaken here. Terri's more recent brain scans indicate that most of her cerebral cortex has severely deterioated, having been replaced by fluid. I would submit that this is quite a different situation from the one that Bauby faced. Presumably, Mr. Bauby did not experience a complete deterioation of his cerebral cortex, or he never would have been able to write his memoir. One needs an intact cerebral cortex for any of the higher cognitive functions.
Professor Davis' points concerning the difficulty in making a correct diagnosis of persistent vegetative state (PVS) are well taken but seem irrelevant to her circumstances now. Apparently, fifteen years ago, her doctors at the time apparently recognized the difficulties of making a correct diagnosis because they signed on to putting her through aggressive treatments to improve her condition. But in the end, those treatments did not work and her condition deterioated.
http://abstractappeal.com/schiavo/infopage.html