Congress better get thousands of more "nonprecedential" bills ready.
Reuters
Schiavo Recovery Impossible, Experts Say
Mon Mar 21, 2005 01:05 PM ET
WASHINGTON (Reuters) - Terri Schiavo, at the center of an emotional and political storm over whether she should be allowed to die, will almost certainly never recover from her unconscious condition, neurologists agree.
She is in a permanent vegetative state, and no one has ever come back from such a condition, according to the American Academy of Neurology.
"Approximately 10,000 to 25,000 adults and 6,000 to 10,000 children in the United States are diagnosed as being in the persistent vegetative state," the Multi-Society Task Force on Persistent Vegetative State says in its 1995 guidelines on the condition, the latest available.
"Survival beyond 10 years is unusual. The chance for survival of greater than 15 years is approximately 1 in 15,000 to 1 in 75,000," it adds.
While most neurologists agree that recovery is almost impossible, the decision on whether and how long to keep such a patient alive is usually left to the individual doctor and the patient's guardian.
Schiavo has been in the condition, which is far more severe than a coma, since she had a heart attack in 1990 that deprived her brain of oxygen. Under the medical definition, that became a permanent state after a month.
Her husband and legal guardian, Michael Schiavo, has fought to allow her to die and courts have supported him.
The tube was removed on Friday after Florida courts rejected numerous last-ditch legal attempts by the parents, Bob and Mary Schindler, to keep their daughter alive. But early in the hours of Monday morning President Bush signed a bill allowing federal courts to again intervene in the matter.
The Schindlers believe their daughter responds to them and her condition could improve with treatment. Tennessee Sen. Bill Frist, a surgeon and Senate majority leader, has viewed videotapes and agrees.
But Dr. Ronald Cranford, a neurologist and bioethicist at the University of Minnesota Medical School, said reflexes can fool non-specialists.
"To the families and loved ones, and to inexperienced health care professionals, PVS patients often look fairly 'normal,"' Cranford said in a statement.
"Their eyes are open and moving about during the periods of wakefulness that alternate with periods of sleep; there may be spontaneous movements of the arms and legs, and at times these patients appear to smile, grimace, laugh, utter guttural sounds, groan and moan, and manifest other facial expressions and sounds that appear to reflect cognitive functions and emotions, especially in the eyes of the family."
Such patients can even squeeze a hand in response to a caress, Swedish Covenant Hospital in Chicago says in guidance posted on its Internet Web site.
"Sadly, these actions often appear meaningful to hopeful families but are all automatic reflexes -- not movements with a purpose," it reads.
"There are no confirmed reports of anyone fully recovering from a permanent vegetative state lasting more than three months."
This is because in such patients, the cerebral cortex has been destroyed, said Dr. Lawrence Schneiderman, a physician and bioethicist at the University of California, San Diego.
"Four to six minutes of anoxia, lack of oxygen, destroys that completely," Schneiderman wrote in comments posted on the Internet at seeingthedifference.berkeley.edu.
"The rest of your brain, particularly the brain stem, can survive for fifteen or twenty minutes without oxygen," added Schneiderman, who signed a friend of the court brief in July of last year supporting Michael Schiavo.
"What happens is that that part of the brain, the cerebral cortex, which is us, our personality, who we are, how we think -- our capacity to experience, see, hear, think, emote -- that may be permanently destroyed."
Experts say Terri Schiavo would experience no discomfort if allowed to die, as the part of her brain that experiences pain is unlikely to be functioning.
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