[Vision2020] Terri Schiavo's Brain

[Nick Gier]

Greetings:

Below I've appended a NYTimes story about Terri Schiavo's autopsy.  I 
suppose that our anti-science right wingers will somehow cry foul, but the 
evidence is overwhelmingly clear that her brain was in worse shape that 
even the most pessimistic doctors' reports.

According to Roland Puccetti's typology of persons--possible persons (eggs 
and sperm), potential persons (conception to 3rd trimester), beginning 
persons (children with rights from 3rd trimester to age of majority), 
actual persons (adults with rights and duties), and former persons--Schiavo 
was, from 15 years ago, a former person, not an actual person with full 
rights and duties.  For more see www.class.uidaho.edu/ngier/abortion.htm 
and www.class.uidaho.edu/ngier/embryo.htm.

Constantly working on actual personhood,

Nick Gier

June 16, 2005, New York Times

Schiavo Autopsy Says Brain, Withered, Was Untreatable
By ABBY GOODNOUGH

MIAMI, June 15 - An exhaustive autopsy found that Terri Schiavo's brain had 
withered to half the normal size since her collapse in 1990 and that no 
treatment could have remotely improved her condition, medical examiners 
said on Wednesday.

The autopsy results, released almost three months after Ms. Schiavo died 
after the court-ordered removal of her feeding tube, effectively quashed 
allegations by her parents that she had been abused by her husband. Yet the 
findings also questioned the prevailing theory that an eating disorder had 
prompted Ms. Schiavo's collapse, stating there was not enough hard evidence.

The report generally supported the contention of Ms. Schiavo's husband, 
Michael, accepted by judges in six courts over the years, that she was 
unaware and incapable of recovering. And it countered arguments by her 
family, who badly wanted to win custody of Ms. Schiavo, that she was 
responsive and could improve with therapy.

In the last months of her life, the fight over Ms. Schiavo produced a 
searing national debate about the rights of incapacitated people and when 
their lives should end if they left no specific instructions. The question 
of whether Mr. Schiavo should bring about his wife's death by removing her 
feeding tube, or whether he should cede custody to her parents, went on for 
seven years, reaching the Vatican, the White House, Congress and finally 
the United States Supreme Court, which declined to hear the case.

But the autopsy left unresolved the mystery, which haunted not just her 
husband and parents but ultimately much of the nation, of why Ms. Schiavo's 
heart stopped beating late one night when she was 26. The ensuing brain 
damage left her able to breathe on her own but not, most doctors said, to 
think or to have emotions.

"The only diagnosis that I know for sure is that her brain went without 
oxygen," said Dr. Jon R. Thogmartin, the medical examiner who led the 
autopsy in Pinellas County, where Ms. Schiavo had spent her final years in 
a hospice. "Why? That is undetermined."

The autopsy also found that the brain deterioration had left her blind. 
That finding, along with the determination that the brain damage was 
irreversible, caused some Republicans in Washington, who had pushed so hard 
for federal intervention in her case, to have second thoughts. And 
Democrats cited the autopsy results as proof that critics of the federal 
intervention had been vindicated. (Related Article)

At a news conference in Largo, near Tampa, Dr. Thogmartin said the 
condition of Ms. Schiavo's body was "consistent" with earlier medical 
findings that she was in a persistent vegetative state. Her parents, who 
believed she might some day eat and drink on her own or even speak, had 
rejected that diagnosis. But the courts accepted testimony from Ms. 
Schiavo's husband, Michael, that she would not want to stay alive in her 
condition.

"This damage was irreversible," Dr. Thogmartin said of Ms. Schiavo's brain. 
"No amount of therapy or treatment would have regenerated the massive loss 
of neurons."

Yet a lawyer for Ms. Schiavo's parents, Robert and Mary Schindler, said 
they still believed their daughter had responded to their voices and touch. 
The lawyer, David Gibbs, said the parents, who were traveling in Minnesota 
on Wednesday, also doubted the finding that Ms. Schiavo was blind. The 
Schindlers had released videos showing their daughter appearing to smile at 
her mother and track a balloon with her eyes.

"She had a life that was worth saving," Mr. Gibbs said.

Dr. Thogmartin said that in addition to studying Ms. Schiavo's remains, he 
had scoured court, medical and other records and interviewed her family 
members, doctors and other relevant parties. A specialist in Michigan 
separately studied Ms. Schiavo's heart tissue, and a laboratory in 
Connecticut determined that she did not have a genetic mutation that might 
have caused her heart to stop.

Ms. Schiavo had lost more than 100 pounds between her teenage years and the 
time of her collapse, and some doctors had theorized that her heart had 
stopped due to bulimia. Her husband even won a malpractice lawsuit on that 
premise, persuading a jury to award $1 million in damages on the grounds 
that Ms. Schiavo's obstetrician had failed to diagnose bulimia.

But Dr. Thogmartin stopped short of that conclusion. He said that while Ms. 
Schiavo had a low potassium level after her collapse, a symptom of an 
eating disorder, there was no evidence of her taking diet pills or 
laxatives or binging and purging.

"You end up with a 26-year-old that used to be heavy, that now lost the 
weight, is reveling in her thinness now, enjoying her life, and doesn't 
want to gain the weight back," Dr. Thogmartin said. "And if that's a 
bulimic, there's a lot of bulimics out there. It's just not enough."

He added that Ms. Schiavo's potassium level could possibly have dropped 
immediately after her heart stopped, perhaps during resuscitation efforts. 
Or, he said, Ms. Schiavo's habit of drinking excessive amounts of 
caffeinated tea might have even caused the deficiency. But unless new 
evidence comes to light, he said, no one will ever know for sure.

Though Ms. Schiavo went almost two weeks without her gastric feeding tube 
before dying on March 31, Dr. Thogmartin said she technically died of 
"marked dehydration," not starvation.

The autopsy also ruled out heart attack or physical abuse causing Ms. 
Schiavo's collapse. Dr. Thogmartin said drug overdose was unlikely, though 
the toxicology tests performed immediately afterward would not have 
detected an overdose of diet pills or caffeine.

"I don't think drugs were sufficiently ruled out," he said.

Ms. Schiavo's parents had accused Mr. Schiavo of abusing their daughter and 
had even produced bone scans that they said showed damage to her spine, 
ribs and knees. But Dr. Thogmartin said he found only one fracture on a 
vertebra, which he said was likely caused by osteoporosis.

Dr. Michael Baden, a forensic pathologist who used to be New York City's 
chief medical examiner, said the autopsy was more thorough than most and 
should lay to rest all rumors of foul play.

"The politicians said that if she were treated differently she might have 
had a different outcome," said Dr. Baden, who was not involved in the 
autopsy but read the report. "This shows that no matter how you treated 
her, there wouldn't have been a different outcome."

He added, "This doesn't close the book on the cause of this in the first 
place. But we know it wasn't trauma or spousal abuse. Whatever the cause, 
it was a natural one rather than a suspicious one."

Shortly before Ms. Schiavo's death, President Bush cut short a Texas 
vacation and returned to the White House late one night to sign a law 
allowing her parents to seek a federal court review of the case. His 
brother, Gov. Jeb Bush of Florida, also intervened on the Schindlers' 
behalf, even getting the State Legislature to pass a law in 2003 empowering 
him to order Ms. Schiavo's feeding tube reinserted after doctors had 
removed it. But the law was ruled unconstitutional, and Governor Bush 
eventually declared himself out of options.

On Wednesday, Governor Bush praised Dr. Thogmartin and his staff for their 
"careful review" and added that he would "continue to strive to protect our 
most vulnerable citizens."

Michael Schiavo's lawyer, George Felos, said his client felt vindicated by 
the results.

"For years he feels that he's been talking in the wind," Mr. Felos said. 
"Mr. Schiavo was pleased to hear the hard science and evidence of those 
findings."

Lynn Waddell contributed reporting from Largo, Fla., for this article.


"The god you worship is the god you deserve."
~~ Joseph Campbell

"Modern physics has taught us that the nature of any system cannot be 
discovered by dividing it into its component parts and studying each part 
by itself. . . .We must keep our attention fixed on the whole and on the 
interconnection between the parts. The same is true of our intellectual 
life. It is impossible to make a clear cut between science, religion, and 
art. The whole is never equal simply to the sum of its various parts." 
--Max Planck

Nicholas F. Gier
Professor Emeritus, Department of Philosophy, University of Idaho
1037 Colt Rd., Moscow, ID 83843
http://users.adelphia.net/~nickgier/home.htm
208-882-9212/FAX 885-8950
President, Idaho Federation of Teachers, AFL-CIO
http://users.adelphia.net/~nickgier/ift.htm

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