The Case Against Terri Schiavo (part 2).

 (Picture of  Terri just after she suffered from her brain injury
Taken from her site at
  Terri Schindler-Schiavo Foundation.

Many people over the years have asked the difficult question  "Is Terri in a Persistent Vegetative State (PVS)? " It is a good and fair question and needs to be looked at very carefully so that the general public, that's you and I, can make an informed opinion. Perhaps if we take action regarding our opinion, we may have some influence towards either hastening Terri's death by starvation, or seeing her released into her parents care.

In my first article on Terri I shared my observations regarding Terri's gastronomy tube, (the tube that provides Terri with hydration and nutrition). I came to the conclusion that Terri shouldn't be starved to death by the courts removing her gastronomy tube, because the gastronomy tube is in fact a very simple device used for hydration and nutrition. It is not some high technology device, requiring high medical maintenance, as is sometimes inferred in media articles. If you haven't read the article, you can read it here The Case Against Terri Schiavo (part 1)

In my first article I gave a reasonably full explanation of Terri's condition. Here I will summarize it very briefly.

Terri collapsed  in 1990 from a severe brain injury. Her husband Michael,  on her behalf, brought a medical malpractice case seeking damages so that he could care for her. During the malpractice suit, Michael stated "I believe in the vows I took with my wife, through sickness, in health, for richer or poor. I married my wife because I love her and I want to spend the rest of my life with her. I'm going to do that."  The jury awarded approximately $1.3 million in damages. Approximately $750,000  was set aside to pay for her rehabilitation and care. Seven months after receiving this money, Michael instructed nurses caring for Terri not to give her antibiotics for a urinary infection. This untreated infection could have brought about Terri's death, and this fact was apparently known by Michael. To put it bluntly, seven months after receiving the money, Michael wanted his wife dead!

To pursue his wish to see Terri dead, some years later Michael stated that Terri once said that she did not want to be kept alive artificially. He asked the court if he could wind down the money that had been originally earmarked for her rehabilitation, so that the funds could instead be spent on the legal costs of ending her life. Michael's wish to use the money this way, was of course completely opposite of his original intentions, which were to use the money to help rehabilitate Terry. However, Judge George Greer of the 6th circuit court of Florida, a committed Christian,  gave Michael permission to do this. Since 1992, Terri has not received any rehabilitation. If Terri died, Michael would receive all the money earmarked for her rehabilitation.

Michael has now for some time been petitioning the courts to have Terri starved to death by removing her gastronomy tube. Terri's parents quite understandably want to care for her and do the best that they can for her. Michael and Terri's parents have been backwards and forwards to the courts many times in this battle to have either have Terri killed (Michael's wishes) or to save her (Terri's parents wishes)..

Michael now lives in an adulterous relationship with a women, and has had two children from this relationship. If he divorced Terri, he would not receive any money remaining from Terri's malpractice funds.

One legal argument that Michael's legal team have put forward favoring the idea that Terri should be starved to death is that she is in a PSV (Persistent Vegetative State).

Lets now look at the question of whether or not Terri is in a PVS.

From what I have read, and I am not 100% sure of the numbers here, early on in Terri's legal battle, five expert witnesses were presented to the judge. Two witnesses on behalf of Terri's parents stated that Terri was not in a PVS, while two expert witnesses on behalf of Michael stated that she was in a PVS. Because it was a stalemate, another witness was called by the judge. This witness offered an opinion to the effect that Terri was in a PVS. The court then ruled that this was so. It seems to me, and please correct me if I am wrong, that from that ruling, any further appeals to the court regarding Terri's conditions suggesting that she is not in a PVS, will be rejected because the court has already said that she is in a PVS. This PVS ruling by the court has enabled the newspapers and reporters worldwide to say in their editorials that Terri is in a PVS.

It certainly does seem that Terri's condition of being in a PVS (based on a court's ruling), is set in concrete and cannot easily be changed, as evidenced by the following extract from a court order regarding Michael Schiavo, petitioner, and Robert and Mary Schindler (Terri's parents), respondents. 

I only quote one paragraph from the court order. You can examine the full court order by downloading it from Terri's website at www.terrisfight.org

Sept 17 2003 3:25PM Sixth Judicial Circuit
IN THE CIRCUIT COURT FOR PINELLAS COUNTY, FLORIDA
PROBATE DIVISION
File No. 90-2908GD-003

ORDER

The affidavits of the 3 speech professionals clearly demonstrate that they disagree with the previous rulings of this court as amplified by the four opinions of the Second District Court of Appeal. All viewed the videos which were part of the October 2002 evidentiary hearing and one reviewed early medical records too. Dr. Gimon says that she is "not in a persistent vegetative state", and is "clearly able to respond cognitively to environmental stimuli". Ms. Mele says Terri is "clearly vocalizing". Ms. Stinson says  she is "attempting to communicate with her father" and "is able to learn and has sufficient cognitive and motor ability to respond". They all reference an audiotape prepared by Mr. Schindler, Sr. and how the tape shows interaction between Terri and her parents. (Interestingly enough, the affidavit of Mr. Schindler, Sr. is silent as to this tape.) It is very clear therefrom that they do not believe that Terri is in a persistent vegetative state. Therefore, any conclusion that they have reached would be totally flawed. (my emphasis in red). 

Judge Greer, the presiding judge, concluded.

ORDER AND ADJUDGED that the Petition for Immediate Therapy filed herein by Robert and Mary Schindler be and the same is hereby denied.

It would seem that if any evidence is presented to Judge Greer showing that Terri is not in a PVS, this evidence will immediately and automatically be dismissed, because previously the court/s have/has ruled that Terri is in a PVS. I find this absolutely amazing. Actually I am stunned. Of course, I have no legal expertise, and judge Greer is most probably simply following the rules and protocol of the secular court system.

Although the courts have ruled that Terri is in a PVS. I personally don't believe for one moment that she is.

I have done some research on PVS and found some extremely disturbing statistics, regarding the condition. I will quote from only two papers. You can research the information for yourself regarding misdiagnosis of PVS. There is a large amount of statistical data showing that PVS is extremely difficult to diagnose.

In a paper entitled 

* Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit prepared by Keith Andrews, director of medical services,  Lesley Murphy, senior clinical psychologist, Ros Munday, senior occupational therapist, Clare Littlewood, senior occupational therapist, all from the Royal Hospital for Neurodisability, London SW15 3SW, they found that 

Of the 40 patients referred as being in the vegetative state, 17 (43%) were considered as having been misdiagnosed;

In a document entitled 

**Misdiagnosis of Vegetative State prepared by Helen GILL, MD, Fellow of Low Awareness States, Institute of Complex Disabilities, Royal Hospital for Neuro - disability, London, UK she states

It is evident from the discussion of the issues outlined above that there is considerable potential for misdiagnosis. This is a concept that is of great importance to the patient, the family and the Court. There have been several studies which have shown that misdiagnosis of the vegetative state is very common (my emphasis). For instance Tresch et al (8) found that 18% of long term patients in nursing homes in the USA, diagnosed, as being in the Vegetative State were able to communicate. Nancy Childs et al (9) in found that 37% of patients admitted to her rehabilitation unit with a diagnosis of the vegetative state were aware. Research at the Royal Hospital for Neuro- disability by Andrews et al (10) found that 43% of patients admitted with a diagnosis of VS for longer than 6 months were misdiagnosed, including several patients who had been thought to be vegetative for several years.

If we look at the early ruling that Terri was in a PVS, given by five experts, the three to two vote in favor of her being so is only a tiny margin. Add to that the evidence in the two papers above, and it becomes very, very clear that it is quite likely, dare I say even probable, that Terri is not in a PVS.

Of course all I have done here is quoted from the literature, so if I may, I would like to share why I, at the personal level, do not believe that Terri is in a PVS. Let me explain.

My wife and I have a severely brain injured child, who in many ways neurologically is similar to Terri.

Tim, our son, suffers from intractable seizures and has a gastronomy tube, just like Terri. Tim was just after birth diagnosed with Infantile Myoclonic Epilepsy, which is an extremely rare form of severe brain injury. The senior neurologist at the children's hospital, based on medical texts, said that Tim would only live from one to two years. He also said that Tim was "The worst case" (level of brain injury) that he had ever seen! Tim is now 16. Because he is no longer an infant, the medical profession have had to come up with another diagnosis, which is Lennox Gestalt Syndrome. This is another extremely rare and serious form of brain injury. Doctors can make mistakes in diagnosis, and do regularly. They are not God.

Looking at Terri and comparing her neurological function (abilities and skills) with Tim, there are things that Terri can do that Tim can't, and Tim doesn't have PVS. For example Terri can track a balloon; Tim can't (and he isn't blind). Terri can respond to stimulus by making sounds. Tim can't, although he can make sounds. 

I have looked at Terri's videos at her site many times. I have struggled with the images that I have seen and asked myself, "Is Terri really smiling and responding to Terri's mum?" I ask myself "Is she really tracking the balloon?" And to answer those questions, I feel that the answer is "Yes".

There are times when looking at Tim that you could be fooled into thinking that he might be comatose or in a PVS. For example, Tim has zero concept of time. He has no circadian rhythm; that is to say he can't differentiate between day and night. He will have moments of sleep and he will have wakeful, moments, which will be totally random in duration. He may sleep during the day for 12 hours and then stay awake during the night for four hours. Or he may stay awake for over 20 hours and then sleep for five hours. There is no pattern whatsoever. Incidentally this can be an indication of PVS. When Tim sleeps, he is so deeply asleep that we cannot arouse him. We can lift his arms and legs, tickle him under the arms, rough him up, and there is absolutely no response whatsoever.

Tim has zero ability to use his arms and legs purposefully, although there are times that he can stretch his arms. These limitations of movement could be an indication of PVS..

What I have said about Tim and his sleep pattern and saying that you might think he has is in a coma or has PVS, of course is a simplification of the matter. My observations of his zero ability to use his arms and legs purposefully is also a simplification of his condition. However, I hope that you will recognize the point that I am trying to make, and that is that PVS and many other illnesses are extremely difficult to diagnose.

Before you jump to conclusions and say that Terri is in a PVS, I would like to invite you to visit her site and look at the videos and judge for yourself. You may, just like me, come to the conclusion that Terri is not in a PVS. And if you come back from seeing the videos feeling that there is no hope for Terri, that would not be correct. There is considerable evidence that Terri can be helped and receive meaningful rehabilitation. In fact, just after her injury, she did receive a little rehabilitation for a short period of time and showed some progress. The only problem with her receiving any more rehabilitation is that Michael, through the courts has refused her to have any since approximately 1992. 

Conclusion.

If Terri is not in a PVS, then that would be one reason among many for her not to be starved to death, a death that would be terribly painful; no different from the death you or I would experience if we were starved to death.

Links mentioned in this article

*Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit prepared by Keith Andrews
**Misdiagnosis of Vegetative State prepared by Helen GILL, MD

As of this writing Terri's situation is critical. The courts, may as early as 22nd of February allow Michael to remove the feeding tube, and so kill her. Please consider visiting Terri's site at www.terrisfight.org and see how you can help save Terri. 

If you are a Christian, you might like to answer the question "Who is Terri to me?" The answer is simple isn't it; She is your sister in Christ as well as my sister in Christ. We as Christians have a God given responsibility towards her. She is also from a biblical point of view a widow, and needs to be visited and cared for.

The injustices mentioned in this article are only the tip of the iceberg regarding Terri's plight and the totally unfair treatment that she has endured because she is disabled. My next article will look at the "death wish" that Terri is supposed to have made. I will also look at the significant evidence that indicates that her condition can improve with rehabilitation. 

About the author:

Paul Copeland is 58 years young. He is happily married to Alison. Their children are Tim, aged 16, who is profoundly disabled and Alicia who is 22 and engaged to be married. Paul's family are Christians. He, is very concerned about Terri's welfare and has set up a site at www.saveterri.com, to alert folk about Terri's plight. Paul can be contacted at:

paulcopeland@saveterri.com

Tell a friend about this site!

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