Tuesday, April 05, 2005

Oh no, he's going to resort to facts!

Lost in the Schiavo debate was medical science and that's too bad.
April 5, 2005
One hates to spoil a good argument with facts, but the sad affair of Terri Schiavo and the wingnuts who politicized it requires most sentient humans to sit back, take a deep breath and think about what actually happened. Benedict Carey has an excellent piece in the New York Times describing the various states of brain injury, the differences between coma, sleep and vegetative states, persistent and otherwise. The law, of course, was not the issue, part of the rage from the right. In every state, the spouse’s views trump the parents. The husband said she would not want to be kept alive, and absent a written declaration to the contrary, that view pertains in law. But you know that. Huge amounts of misinformation were disseminated, however, largely on cable news (whose influence, incidentally, is great exaggerated in the mainstream media), so that the moral and legal issues involved--and there were profound moral issues--were obscured by deliberate obfuscation and slander. Since those issues are important and interesting, that’s too bad. Carey’s story points out that comas are like sleep, and are measured a continuum of unresponsiveness. People in comas can move around or make sounds though they many not remember any of it. After about two or three weeks, the eyes pop open and the brain begins to slowly restore activities, one by one. It’s like it shuts down for repairs and slowly turns on the lights one by one. Eventually, lucky patients wake up as the cortex resumes operation. In this case, “neurologists were all but unanimous in diagnosing the condition of Ms. Schiavo, whose heart stopped temporarily in 1990, depriving her brain of oxygen. Brain cells and neural connections wither and die without oxygen, like marine life in a drained lake, leaving virtually nothing unharmed.” She had no cortex left, as brain scans showed clearly. She was not in a coma; she was in a persistent vegetative state and she wasn't going to wake up. Despite the mumblings of the chattering set on Fox News, there is not a single case of anyone recovering from this condition after two years, Carey reports, quoting a 1994 study. Mrs. Schiavo was in a persistent vegetative state for 15 years! My research in the National Medical Library failed to show an exception after anything near that length of time in the 10 years since that study. So, if the Schiavo case has any value, and her death any purpose, the debate ought to be over whether removing the feeding tube is moral or not. Under Orthodox Jewish law, the beliefs of many conservative Christian and Catholics , it is not moral, it is murder. (They make a distinction between respirators and feeding tubes). Lots of other people, including many Jews and Protestants, think it is the right thing to do. That’s what the discussion ought to be about. Terri Schiavo is long since gone.

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