Jolie Rouge

Doctors debate Schiavo's condition
Friday, March 25, 2005


(AP) -- An affidavit filed this week that questions whether Terri Schiavo is in a persistent vegetative state is not the first time that diagnosis has been challenged in court. But the last time doctors fought it out in front of a judge, the diagnosis was upheld.

The issue arose again this week when a neurologist, Dr. William Cheshire of the Mayo Clinic in Jacksonville, Florida, said in a court document that he believed it's more likely that Schiavo is in a "minimally conscious state."

In a persistent vegetative state, a person is awake but not aware of himself or his environment, and making only reflex movements. In a minimally conscious state, a person's behavior shows inconsistent but reproducible signs of consciousness. For example, a patient can occasionally follow simple commands -- scratch his nose if it itches -- or try to use an object such as a comb correctly.

The Mayo Clinic in Jacksonville said in a statement that Cheshire, at the request of the state of Florida, observed Schiavo at her bedside and reviewed her medical history but did not conduct an extensive examination of her.

In his affidavit, Cheshire said Schiavo showed several behaviors "that I believe cast a reasonable doubt on the prior diagnosis" of persistent vegetative state. For example, he said, her face brightens and she smiles in response to familiar voices such as those of her parents. Her eyes don't track moving objects consistently, but "she does fixate her gaze on colorful objects or human faces for some 15 seconds at a time," he said.

"Although Terri did not demonstrate during our 90-minute visit compelling evidence of verbalization, conscious awareness or volitional behavior, yet the visitor has the distinct sense of the presence of a living human being who seems at some level to be aware of some things around her," Cheshire said in the affidavit.

But the first part of that sentence, in fact, "starts to meet the criteria for vegetative state," said Dr. Gene Sung, director of the neurocritical care and stroke section of the University of Southern California.

Sung, who has not been involved with the case, said of Cheshire that "unfortunately his feelings, and possibly his religious beliefs, are affecting his medical decision." Cheshire is listed as director of biotech ethics for the Center for Bioethics and Human Dignity, which notes on its Web site that it was founded by Christian bioethicists.

Sung said the original diagnosis was based on repeated examinations by "very distinguished neurologists" and he said he is as comfortable with that diagnosis as he can be without examining Schiavo himself.

Dr. Roger Albin, a professor of neurology at the University of Michigan who also was not involved in the Schiavo case, agreed. "I don't think there's any reason to doubt the diagnosis. ...I don't think her evaluation could have been done better."

He also said he's not aware of any evidence that a person could emerge from years in a persistent vegetative state and enter a minimally conscious state, especially in a case such as Schiavo's, where blood flow to the brain had been temporarily cut off in 1990.

The diagnosis has been a court matter, both in 2000 and in 2002. In the latter year, a Florida judge agreed with four neurologists that Schiavo was in a persistent vegetative state. Brain scans and examinations were conducted in 2002, but no new neurological evaluation has been ordered since, and the medical record has been closed.

Testimony in those cases included statements from Schiavo's treating physician, Dr. Victor Gambone, who said in 2000 that he agreed with the diagnosis. He said Schiavo's daily caregivers told him they could not get any response indicating an appreciation of her surroundings.

In 2002, Dr. Ronald Cranford, an expert on persistent vegetative states who was brought into the case by Schiavo's husband, testified that key centers of Schiavo's brain probably had no viable neurons left. She was not actually fixing her gaze on her mother, as had been suggested, but rather showing a reflex action seen in patients in the a vegetative state.

Cranford said Thursday he still has no doubt the diagnosis is correct and that Cheshire is "flat-out wrong."

Two other neurologists also agreed with the diagnosis, including one appointed by the court to examine and evaluate Schiavo.

But doctors representing Schiavo's parents at the 2002 hearing had a different conclusion. Dr. William Hammesfahr, a Florida neurologist, said his examination of Schiavo found she is "definitely aware of her mother" and communicating by following instructions and in looking at people. And a radiologist said a brain scan in 2002 showed more normal appearance than one in 1996 and said there was a "significant probability that she would improve" with certain treatments.

But the court was not given any objective data to support that latter assertion, said Dr. Timothy Quill, director of the Center for Palliative Care and Clinical Ethics of the University of Rochester Medical Center, writing in a commentary published online this week by the New England Journal of Medicine.

Hammesfahr has been a figure of controversy. In 2001, the Florida Department of Health accused him of falsely advertising a neurological treatment and exploiting a patient for financial gain. The treatment is "contrary to current neurological knowledge," the department said. Hammesfahr denied the accusations, and in an interview Thursday he said the probation and fine against him were overturned on appeal.

On Thursday, Dr. Lawrence J. Schneiderman of the University of California, San Diego, a specialist in bioethics of medical futility and end-of-life care, said in an interview, "He's a quack, to put it the politest way I can."

Hammesfahr said he believes Schiavo can be helped by treatment and that numerous other neurologists, some of whom actually examined Schiavo, agreed. "I'm not the only person who has said she can be rehabilitated," he said. "Are we all quacks?

http://www.cnn.com/2005/HEALTH/03/2...s.ap/index.html

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okay - we can agree that Hammesfahr may be a "quack" - that does not mean eveyone who shares the same opinion in this case is also a quack.

and we already discussed the fact that a doctor can "consult" via records to make a diagnosese

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Laissez les bon temps rouler! Going to church doesn't make you a Christian any more than standing in a garage makes you a car.** a 4 day work week & sex slaves ~ I say Tyt for PRESIDENT! Not to be taken internally, literally or seriously ....Suki ebaynni IS THAT BETTER ?

Jolie Rouge

That doesn't cover the medical expenses - just the cost of 24 hour security ... for comatose inmates. Not like they are going to jump out of bed and escape - ya know ? Restraints applied and even *I* could "guard" them... hire a few retired grannies - they can work on their knitting while they "guard" and will cost a whole lot less for the taxpayers.

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Laissez les bon temps rouler! Going to church doesn't make you a Christian any more than standing in a garage makes you a car.** a 4 day work week & sex slaves ~ I say Tyt for PRESIDENT! Not to be taken internally, literally or seriously ....Suki ebaynni IS THAT BETTER ?

Jaidness

lmao are you mocking me? I am far from the voice of reason ahahahahaha...I don't mean to sound so harsh about the whole thing but there are so many other issues out there that need our attention and support and passion and research and understanding

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Crazy,but thats how it goes Millions of people,living as foes,maybe,it's not too late,to learn how to love and forget how to hate.~Ozzy~Crazy Train
In your house,I long to be,Room by room,patiently,I'll wait for you there,Like a stone,I'll wait for you there Alone~ LIke A Stone ~Audioslave(for my hubby)

janelle

Remember, as temporal beings we are all terminal. It has taken the Netherlands less than one generation to "progress" from "right to die" to active euthanasia of "...life unworthy of life," to quote the Nazi Medical Society, c.1933!

I took that from another web site but it is so true.

Linus1223

Thanks, Jaidness, for the articles that you've been posting.

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God loves everyone..including homosexuals.

YNKYH8R

Not at all. But I wonder if anyone has noticed....when Terri dies the supporters will have a taste of what the Democrats went through when Kerry wasn't elected.

That's Karma Baby!

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ARMPIT

janelle

3/30/2005 3:51:34 PM
''My prayers have been with Terri & her family daily.I cannot even imagine denying this young lady food & water. To be denied the essentials of life,its criminal. I don't know what Michaels problem is, but Michael MOVE ON and let Terri be with her family and friends who love her and don't have an agenda. When the time comes God will take Terri home but as long as she is still here she must have a mission and none of us know what that is. Only God knows and I can only imagine his disappointed that we have denied one of his children the food & water she needs to exist.Think through your life,most of us have been touched by a handicapped person in one way or another, how can we deny this young lady life, because she is now handicapped? What a sad world if we only keep the perfect around & not value the imperfections that make this world whole. (sounds like something Hitler would have done) God Bless all of Terri's friends and family. I will continue to pray for all of you."


Another quote on the other web site. Beliefnet

Jaidness

thanks linus and ynkyhtr...
Ive often thought of saying just like so many said when the Dems lost, it's over...get overrrrrr ittttt
and now back to our regularly scheduled rantings lol

__________________
Crazy,but thats how it goes Millions of people,living as foes,maybe,it's not too late,to learn how to love and forget how to hate.~Ozzy~Crazy Train
In your house,I long to be,Room by room,patiently,I'll wait for you there,Like a stone,I'll wait for you there Alone~ LIke A Stone ~Audioslave(for my hubby)

Jaidness

Morris joined effort to downplay President Bush's role in Schiavo case, claimed he "has stepped lightly on the issue"

Following the lead of Fox News host Brit Hume, Fox News contributor Dick Morris attempted to downplay President Bush's involvement in the Terri Schiavo case. In his March 30 column in The Hill, Morris claimed that Bush "has stepped lightly on the issue, and his popularity and effectiveness will not be affected." In fact, Bush and his staff have played a leading role in the case.

Morris's and Hume's statements ignored Bush's unusual and highly publicized actions on the night of March 20. Beyond signing the unprecedented legislation that granted a federal court jurisdiction in the Schiavo case, news reports noted the extraordinary steps Bush took to sign the measure as soon as possible after Congress passed the bill, including his abrupt return to the White House from a vacation in Texas. A March 21 New York Times article noted that Bush "made the rare decision to interrupt his Texas vacation and rush back to Washington to be in place to sign a bill that could restore Ms. Schiavo's feeding tube" and that "the White House said that the issue had become one of 'defending life,' and that time was of the essence." The article further noted that Bush's "dramatic return was seen as a powerful embrace of the 'culture of life' issues of religious conservatives who helped him win the White House in 2004."

Furthermore, the Bush administration helped lawmakers with "technical advice" in drafting the legislation that Bush later signed, and Bush's own Justice Department filed legal arguments in federal court supporting the efforts of Terri Schiavo's parents to have their daughter's feeding tube restored, according to a March 22 New York Times article.

Others have noted similar efforts by conservatives to minimize the role that Bush and members of Congress played in passing the legislation. In his March 28 "White House Briefing," Washington Post online columnist Dan Froomkin noted Bush's apparent "retreat into silence" on the Schiavo case following the release of opinion polls showing an overwhelming bipartisan consensus that Bush and Congress should not have intervened, as well as Bush's own recent drop in public approval ratings.

— N.C.

http://mediamatters.org/items/printable/200503300006

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Crazy,but thats how it goes Millions of people,living as foes,maybe,it's not too late,to learn how to love and forget how to hate.~Ozzy~Crazy Train
In your house,I long to be,Room by room,patiently,I'll wait for you there,Like a stone,I'll wait for you there Alone~ LIke A Stone ~Audioslave(for my hubby)

Jaidness

John Gibson's and Fox News' description of Schiavo case: "Terri's Fight"

On the March 28 edition of Fox News' The Big Story, host John Gibson again injected his opinion into news coverage of the Terri Schiavo case by characterizing Schiavo's ordeal as her "fight for life." For most of Gibson's segment on Schiavo, the on-screen text read: "Terri's Fight." Gibson has already suggested that Democrats "sided for [a] questionable husband and dying" in the Schiavo case.

Media Matters for America documented a number of "hard news" reporters and anchors from Fox News and other cable news outlets making statements in support of those who want Schiavo's feeding tube reinserted, referring to them as "Terri's advocates" and "Terri's supporters." As with the other phrases, Gibson's use of the phrase "Terri's Fight" amounts to taking sides in the dispute, since the court case centers precisely on whether Terri Schiavo would want to continue living in a persistent vegetative state and, by extension, who her true "advocates" are.

Gibson opened his March 28 show this way:

Hi, everybody, this is The Big Story. I'm John Gibson. Terri Schiavo is not giving up the fight for life, and neither are her parents.

The on-screen text during Gibson's segment -- "Terri's Fight" -- is an echo of www.terrisfight.org, the website of the Terri Schindler-Schiavo Foundation, an organization that works to "aid Terri and her immediate family by providing the resources they need to protect Terri from a court-ordered dehydration and starvation death."

Gibson made his personal views on the Schiavo case clear in a March 25 "My Word" commentary: "Just to burnish my reputation as a bomb thrower, I think [Florida Gov.] Jeb Bush should give serious thought to storming the Bastille. By that I mean he should think about telling his cops to go over to Terri Schiavo's hospice, go inside, put her on a gurney and load her into an ambulance. They could take her to a hospital, revive her, and reattach her feeding tube."

— S.S.M.
http://mediamatters.org/items/printable/200503290002

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Crazy,but thats how it goes Millions of people,living as foes,maybe,it's not too late,to learn how to love and forget how to hate.~Ozzy~Crazy Train
In your house,I long to be,Room by room,patiently,I'll wait for you there,Like a stone,I'll wait for you there Alone~ LIke A Stone ~Audioslave(for my hubby)

YankeeMary

Why do you post if you want no one to reply, several times you have complained when no one responds to your post then when they do respond and you do not like it they are picking on you. If you start at the beginning of this thread you will see that I have not only quoted others but also commented on their posts, so it wasn't a "personal thing" here, actually Jolie probably could claim that before you could and its not personal with Jolie either. Yes our opinions differ and yes one day I WILL face my GOD and I am proud to say today, tomorrow and on that day right in front of him that I have lived my life to the fullest extent doing his work. I AM NOT ASHAMED THAT I HAVE COMPASSION FOR THIS POOR WOMAN. It is not a sin for me to feel this way. But I do believe JUDGING people is WRONG (the BIBLE says so). So how about this, you worry about your God and I will worry about mine. And may I suggest if you do not want others to comment on your posts then do NOT post, its that simple. I am sorry you felt as though I was hurting your feelings or whatever it is you are trying to say, for it was not my intentions. I have my own convictions over this as you do yours and guess what? They are allowed to be different. Debating is alot different then arguing.

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The more you complain, the longer God makes you live.