Ampersand has a great post about the 17 affidavits filed on behalf of Terri Schiavo by "medical experts."
As Amp notes, none of the experts addresses the implications of Terri's cerebral cortex having been destroyed and replaced by fluid. Nor does anyone attempt to defuse the observation that Terri's movements can be explained by non-conscious processes but not by higher brain activity because she doesn't actually have those higher brain centers anymore.
Moreover, most of the "experts" are quite upfront about having viewed only heavily-edited videos, whereas the trial judge and the doctors who saw the uncut footage saw no evidence of consciousness. Several of the affidavit filers state explicitly that their opinions are based on video clips from Terri's parents' website! (See Amp's post for a more extensive discussion of the scans and the video.)
Not a single one of the so-called experts has even examined Terri. Generally speaking it is considered unethical for a physician to diagnose a patient without examining her. Only a handful of the "experts" even claimed to have reviewed her medical records. Most filed from outside the state of Florida.
Two of the experts identified by the Schiavo Foundation website as "Dr." hold no doctoral degree of any kind (speech and language pathologists Hyikn and and Lakas), and a third claims to have a doctorate in "neuroscience" but admits under oath that his PhD is in clinical psychology (Dr. Hooper).
Dr. Ralph Ankenman is a psychiatrist who wants to treat Terri with Namenda (memantine) a drug indicated only for Alzheimer's disease. Ankenman hypothesizes that Schiavo's speech is "blocked" because she is in a dissociative state akin to that of some patients with severe postraumatic stress disorder. He admits that neither his blocking theory nor his as yet untested proposal to treat massive cortical brain damage with Namenda is what you'd call a "standard concept." As he puts it, "Unfortunately there is as yet no published literature validating these assertions." His recommendations are especially unorthodox, given that Terri Schiavo is neither catatonic nor comatose.
Dr. Beatrice Engstrand believes Terri is conscious based on "a television show that [she] watched" and her experience caring for the Central Park Jogger in 1989. It is difficult to see how Dr. Engstrand's experiences with the Central Park Jogger afford any insight in to Schiavo's case. The CPJ was never in a persistent vegetative state, in fact the patient was only comatose for 12 days.
Dr. Richard Neubaeur wants to treat Terri with hyperbaric therapy, herbs, and acupuncture. It should also be noted that Dr. Neubaeur is also the owner of the largest neurological hyperbaric clinic in Florida and that his affidavit reads like an infomercial.
Dr. Carolyn Heron's affidavit contains at least two elementary errors about the neuropathology of PVS. She argues that the fact that Terri's swallowing reflex is partially preserved indicates that she is not in a PVS. In fact, the reflexive component of swallowing is often preserved to various degrees in patients with PVS (cf. Cole G, Cowie VA. Clin Neuropathol. 1987;6:104-9.) Dr. Heron also claims that the fact that Terri doesn't choke on her own saliva is evidence that she is not in a PVS, again, saliva-handling is a brainstem reflex that is preserved in PVS.*
Dr. Lawrence Huntoon's assessment is based on video clips from "Terri Schiavo's web site." (sic)
Perhaps the most bizarre contribution comes from Dr. Richard Weidman, the head physician at the US Department of Engraving and Printing.
He has not examined Terri Schiavo, instead he bases his opinions on his experiences with his mother, who had Alzheimer's disease. He states:
"I am willing to compare test results done on my mother's brain to those done on Ms. Schiavo's brain and then testify as to the behavior displayed by my mother and how that would be important to Ms. Schiavo."
The Terri Schiavo Foundation promises more affidavits soon.
* Some of the "experts" claim that Terri could be taught to swallow again. If this were feasible, it might be a relevant consideration because the issue is that Terri didn't want to be kept alive artificially. In fact, it is completely unrealistic to think that Terri could survive without a feeding tube.
To put it bluntly, Terri has to be fed by tube is because she is unconscious--it's just not safe to feed unconscious people by mouth, no matter how robust their swallowing reflexes may be. Think drunks and vomit--people who have passed out can easily choke to death even though they retain a much higher level of consciousness than Terri. Ronald Reagan's doctors believe that, like many Alzheimer's patients, the former President died of pneumonia caused by aspirating food while conscious but demented.
No one who cares about Terri's welfare or dignity would ever endorse this doomed swallowing experiment. Death by aspiration pneumonia would be much uglier and more protracted than death by dehydration.
Recent Comments