Noted author Joan Didion wrote "The Case of Terri Schiavo," published in the
New York Review of Books of June 9, 2005, an article which presents a lot of information about the case and the people involved, discusses public reaction, and looks at the philosophical questions involved.
A major question that every disabled person is aware of is how much pressure will be put on the disabled to "go ahead and die, stop being a burden on others." Anyone who requires regular medical care could be construed as a burden on others, a burden on society.
Didion's article should be read in its entirety for the facts it presents. Many questionable "facts" were alleged both by those who thought Terri should die and those who thought Terri should live.
Quotes from Didion's article:
"Theresa Schiavo was taken to Humana Northside Hospital in St. Petersburg, where she stayed three months, at first in a coma.
We do not know from either the Humana Northside discharge summary or the later coverage how this coma was scored on the Glasgow Coma Scale, which ranks eye, verbal, and motor response on a combined range from three to fifteen, "GCS three" signifying that the patient has no response and "GCS fifteen" that he or she can speak in an oriented way, open the eyes spontaneously, and obey motor commands."(Note: Terri emerged from coma after three months into the generally unresponsive state in which she remained as long as she lived. What was that state?)
"A few neurologists, in what would be the last months of Theresa Schiavo's life, began to say that her condition could be a "minimally conscious state," a diagnosis in use only since 2002 to differentiate those patients previously diagnosed as vegetative who can track objects or people with their eyes and seem intermittently able to respond to commands. Early in March, at the request of the Florid Department of Children and Families, which was seeking custody of Theresa Schiavo,
she was seen by neurologist from the Mayo Clinic's Florida hospital William P. Cheshire, the director of Mayo's Autonomic Reflex Laboratory. Some doctors and bioethicists with interests in the matter suggested that, as a conservative Christian, Dr. Cheshire brought a bias to the case, but his affidavit seemed to raise questions not before widely addressed.
He noted that the patient had not had complete neurological examination in nearly three years had never had such advanced testing as positron emission tomography (PET) or functional magnetic resonance imaging (fMRI), and that in the absence of such examination and imaging there remained "huge uncertainties" about her neurological status.""Functional magnetic resonance imaging in particular has enabled neuroscientists to detect brain activity in patients previously diagnosed as being in persistent vegetative states. According to Dr. Joseph Fins, chief of the medical ethics division at New York Presbyterian Hospital–Weill Cornell Medical Center, one study suggested that
as many as 30 percent of vegetative patients studied were in fact minimally conscious. On the basis of the ninety minutes Dr. Cheshire spent with Theresa Schiavo, he suggested that she could well be found to fit the more recent "minimally conscious" diagnosis.
He observed that she held his gaze for about thirty seconds, smiled when she heard familiar voices or piano music, and seemed in the changing pitch of her vocalization to be communicating "emotional thought within her brain." Neurologists who had previously examined her described such responses as reflexive.
"Theresa Schiavo was repeatedly described as "brain dead." This was inaccurate: those whose brains are dead are unable even to breathe, and can be kept alive only on ventilators. She was repeatedly described as "terminal." This too was inaccurate. She was "terminal" only in the sense that her husband had obtained a court order authorizing the removal of her feeding tube;
her actual physical health was such that she managed to stay alive in a hospice, in which only palliative treatment is given and patients without antibiotics often die of the pneumonia that accompanies immobility or the bacteremia that accompanies urinary catheterization, for five years."(Note: Michael Schiavo refused to allow Terri to have a PET scan or an fMRI to determine if she was in fact in a "minimally conscious state," a diagnosis not yet in use in 1990 when she suffered cardiac arrest for unknown reasons and was revived by paramedics. He refused to use the latest technology to evaluate her condition.
A neurologist from Cleveland appointed by the Florida court testified in an evidentiary hearing in 2002 that she was
not diagnosed as having had a myocardial infarction aka "heart attack," as was often alleged.)
It was never proven that Terri would have wanted to die in her situation. The judge chose to take the word of Michael Schiavo and his family over the word of Terri's family.
I oppose euthanasia, and am particularly concerned about "mercy killings" of the disabled carried out without the patient's consent, but support people making choices about what care they personally should receive in certain situations. I gave my husband a medical power of attorney the last time I had major surgery so he could make decisions in accordance with my wishes if anything went wrong during the surgery. Earlier that year, his mother had died of ALS. After talking it over with the neurologist, she had refused a feeding tube and we all thought she had made the best choice in her circumstances. We and the neurologist are Catholic.
Read the entire article at:
http://www.nybooks.com/articles/18050
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