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Re-visiting the Terri Schiavo issue

This might just do it:

Using a newly developed brain scan technique, researchers in the U.K. and Belgium revealed that some patients in vegetative states or states of minimal consciousness show signs of awareness, and in one exceptional case, could even answer yes/no questions posed by doctors during a visualization exercise. The findings, published online this week in the New England Journal of Medicine, suggest that previous tests to assess patients' cognition may not fully tap into all potential aspects of awareness. The 29-year-old patient who, on brain scans exhibited responses to yes/no questions, had been in a vegetative state for five years. As one of the study's authors, Martin Monti of the Medical Research Council Cognitive and Brain Sciences Unit in Cambridge, England, summed it up to the Associated Press, "We were stunned when this happened... I find it literally amazing."

The study that yielded this neurological breakthrough included 54 patients at medical centers in Cambridge, England and Liege, Belgium, who were either in a vegetative state, or a state of minimal consciousness, as well as 16 control subjects in healthy mental condition. While undergoing functional magnetic resonance imaging (fMRI) brain scans, patients were asked to perform what the researchers refer to as "imagery tasks": in the first one, they were asked to imagine themselves standing on a tennis court swinging a racket; in the second, they were to imagine themselves wandering along the streets of a familiar city, or through the rooms of their homes. Of the 54 patients, the brain scans revealed that five showed clear signs of awareness during the motor activity exercise (tennis), and four of those five showed signs of awareness during the spatial task (wandering through a city). Four out of five of these patients were in a vegetative state, and all five patients had suffered traumatic brain injury--as opposed to suffering oxygen starvation, (as had been the case with controversial vegetative patient Terri Schiavo).

Interesting how Terri Schiavo is mentioned but in a dismissive way... as if the study isn't countering what has largely been dismissed by the elite in the first place.

It's an eye-opening piece... that ought to give us all pause.

Ought to.

Crossposted(*).


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Comments (19)

The key element of the Schi... (Below threshold)
RB:

The key element of the Schiavo case, in my view, was that Schiavo's wishes were not known; and in the absence of that knowledge, certain people made assumptions and went to court on that basis.

What happened to poor Terri... (Below threshold)
jim2:

What happened to poor Terri Schiavo was a tragedy in many respects. However, as the autopsy proved, there was no possible way that sentient life inhabited that body in those last too many years. The brain was greatly diminished in mass and what brain tissue other than the medulla (that controls automatic functions) that was left was essentially neuron-free scar tissue. There was no connection between the eyes and the brain, despite activists claiming patterned eye motions.

It is the above distinction that the article appears to be trying to make with the Schiavo reference. Bulk higher function brain tissue death from oxygen starvation is simply a different scenario than single act localized trauma.

As sad as this is, the only thing deader than poor Terry Schiavo was then is this horse upon which you are beating now.

RB, Terri Shiavo made her w... (Below threshold)
Dodo David:

RB, Terri Shiavo made her wishes known to her husband while they were in the company of others.

Anyway, the story quoted above says that some - not all - patients in vegetative show awareness.

I cannot imagine a more hor... (Below threshold)
GarandFan:

I cannot imagine a more horrible way to 'live'. Trapped in your own body, but unable to communicate your 'awareness' to others.

As sad as this is,... (Below threshold)
iwogisdead:
As sad as this is, the only thing deader than poor Terry Schiavo was then is this horse upon which you are beating now.

With some remedial composition classes, you might be able to construct a better sentence than that one which I have just now read. [note to liberals--the foregoing was an example of intentional irony].

"As sad as this is, the onl... (Below threshold)
bryanD:

"As sad as this is, the only thing deader than poor Terry Schiavo was then is this horse upon which you are beating now."
2. Posted by jim2

Agreed. Pity posts must die!

(T.S. is with the Lord.)

InteInteresting ho... (Below threshold)
Tina S:
InteInteresting how Terri Schiavo is mentioned but in a dismissive way... as if the study isn't countering what has largely been dismissed by the elite in the first place.

Rick,

You are being far too hypersensitive in interpreting the Time magazine authors intention. Terri Shiavo was a huge news story that captured the attention of the entire country. It would be poor journalism to not say how the new research relates to Terri Schiavo.

Don't leave out the commun... (Below threshold)
Will:

Don't leave out the communication test

For example, when asked, "Is your father's name Alexander?" the patient responded with the visualization task consistent with "yes," the correct answer. When asked, "Is your father's name Thomas?" he responded, "no."

http://wellness.blogs.time.com/2010/02/04/patients-in-vegetative-state-show-awareness/?xid=rss-topstories

If true, this certainly rei... (Below threshold)
Arizona CJ:

If true, this certainly reinforces the need for living wills. Mine clearly states that I choose death in that or similar circumstance.

I can imagine no worse possible fate than being in the condition described. This is absolutely horrific, the stuff of nightmares.

The next question they ask should be if the patient wants to die. If they get a yes, they should of course honor the wish.

There was no reason to keep Terry Schivo alive, and this finding, if true, merely proves that it was better for her to die, just in case there was some awareness still there.

The only qualm I have in her case is that horrific manner of her death; dehydration. It is reprehensible that they did not, once the decision was made, kill her humanely, just in case. You would be prosecuted for killing a murderer or a dog in such a way, but for a human, it's okay? That was repulsive.

Yeah, it all looks hunky do... (Below threshold)
astonerii:

Yeah, it all looks hunky dory until you actually see how they determine if they are aware. It is like that guy they said was talking, it was person interpreting his non activeness into words of activity. Anything to get published, screw scientific method, just make the stuff up as you go.

Actually, the dismisiveness... (Below threshold)

Actually, the dismisiveness was because the person writing the article probably realized that it was murder and could not admit it to himself. It is the difference between "Quality of Life" and "Sanctity of Life".

From why I read, and I read... (Below threshold)
Oyster:

From why I read, and I read a lot at the time, there was nothing that could save Terri. I felt sorry for her parents, but they relinquished all rights to any part of her life when she became an adult and got married. I was far more interested in the aspects of the Schiavo case that had to do with why she ended up as she did. There were way too many unanswered questions.

I'm also concerned with the manner in which Terri was left to die. I had nightmares about it. A horrible situation where her husband decided her life should end, but no one was allowed to end her life either.

The Terri Shiavo case was a... (Below threshold)
Tina S:

The Terri Shiavo case was about separation of powers and states right.

First the Florida legislature passed a law that gave Governor Jeb Bush the ability to over turn the ruling of the states court. The Florida supreme court ruled that unconsitutional because the legislature and Jeb Bush overstated there authority, a violation of separation of powers.

After that failed it became about states rights as national politicians all the way up to President Bush decided they too should be able to overturn the decision reached by the state courts. They tried to nullify the state courts decision by re-trying the case in a national court. The national judge assigned the case warned that it is likely the constitionality of there actions would be challenged. The national judge ruled in favor Terris husband so that becamse a moot point.

First of all, Schiavo's hus... (Below threshold)
kevino:

First of all, Schiavo's husband's behavior is very suspect: he did not remember her wishes until it came time to pull the plug. The reports by the court-appointed masters about his change in plans and his selective memory makes his motives extremely suspect. That having been said, in the absence of a living will, the law in most states basically places the decision in the hands of the nearest relative because that's in the best interest of everyone in the longterm.

But here is the critical legal issue that needs to be addressed: if a person has been critically injured and requires longterm care, it is not in the best interest of the victim to award a huge settlement to pay for that care. That chunk of money can become a temptation for the individual who is responsible for their care while the victim cannot communicate their wishes.

The facts of the case are these:
1. Schiavo suffered an injury due to malpractice.
2. Her husband sued.
3. He won some money for the loss of his wife.
4. He also provided testimony that he intended to provide first class care for his wife for decades to come. He even indicated that he intended to get a nursing degree to be able to personally supervise her care.
5. He won a much larger settlement to provide for his wife's longterm care.
6. Immediately after getting the really big check, he proceeds to change his wife's orders.
7. He suddenly remembered that his wife would not want to live this way.
8. Ultimately, he prevailed in court, and she died.

So how could this have been done better?

The law could be changed to allow courts to set up a trust fund for the benefit of the victim. If a large award of money is needed to provide longterm care, then that money can be held in trust for the benefit of the patient. The family can use the money to provide for the patient, but a court-appointed auditor can insure that the funds are not being used for other purposes and anti-fraud laws will take care of malfeasance. If the patient dies earlier than expected, the remaining funds are returned to the plaintiff - not the family.

It may not be in the best interest of the patient if the person making decisions about the patient's care is also the person who profits from the patient's death.

It seems to me that a singl... (Below threshold)

It seems to me that a single, off-the-cuff, casual remark provoked by a news story about an entirely dissimilar situation has now apparently become a binding legal contract -- even though the deponent in question was not known ever to reiterate such alleged wishes in the several years between the comment in question, and her subsequent grievous brain injury.

The absence of a written living will was supposed to lead to the default assumption that a person wished to live, but thanks to the Schiavo case we now know that people can legally overwrite their own hypothetical feelings onto someone else's situation with nothing more than years-old hearsay.

And people wonder why Palin's use of the phrase "death panels" resonated so.

Meanwhile nearby, the Dutch... (Below threshold)
Don L:

Meanwhile nearby, the Dutch doctors are involuntarily euthanizing patients equal to one of every eleven deaths in the nation -soon to be here if Obama, the first pro-infanticide president ever, has his way. Planned Unparenthood is now campaigning for children world wide to be allowed to abort!

Written living wills are a ... (Below threshold)
Mrs. Right:

Written living wills are a necessity: I hope everyone reading this has one, or calls today to arrange for one. In the event one is unable to communicate, that piece of paper will prove priceless.

How sad that poor Terri was trapped inside her body for so long. While her mind was not intact, her soul (eternal and whole) remained until she was able to move on. I'm glad that now she's free and home.

I'm not sure why this is an... (Below threshold)
Wayne:

I'm not sure why this is an "eye-opening piece". First it is just one experiment and it really didn't state anything that wasn't known before. The fact that some in vegetative are not brain dead has been known for some time. Also that some are conscience of their surrounding is not new. The only thing new is they "may" have a new test to help determine who is or isn't brain dead.

"Written living wills are a... (Below threshold)
Oyster:

"Written living wills are a necessity:"

Written living wills are only good if your wish is to not be resuscitated or have the plug pulled. Ever hear the term non-personhood? It's used to justify abortion too.




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