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What's The Real Evidence In The Terri Schiavo Case?
You want some evidence?
Turns out that in October, 2003, Florida Governor Jeb Bush appointed a legal guardian for Terri Schiavo. His name is Jay Wolfson, and he’s a doctor and a lawyer. He issued a comprehensive report on Terri’s condition two months later.
Here is a quote from that report: Wolfson “was not able to independently determine that there were consistent, repetitive, intentional, reproducible interactive and aware activities."
Think about those words, which were chosen carefully by Wolfson. Yes, they are in line with the official definition of Persistent Vegetative State (PVS). But more importantly, Wolson was approaching the patient as an object, in the way that a physicist might approach some phenomenon that needed to be confirmed by REPEATED TESTING TO OBTAIN THE EXACT SAME RESULT EVERY TIME.
Consistent. Repetitive. Reproducible.
In other words, if Terri followed, with her eyes, the movement of a pen and smiled at the little exercise---if she did this ONCE, but then later, when the same test was run SHE DIDN’T DO IT, the doctor could conclude that she wasn’t really aware, because the test did not turn out to be CONSISTENT, REPETITIVE, AND REPRODUCIBLE.
Are you getting this???
Think.
The doctor says, “Hello, Terri.” Terri nods and smiles. Two days later, the doctor says hello again, and this time there is no response. He concludes the patient is not aware, but is in a persistent vegetative state, because the hello test was not CONSISTENT, REPETITIVE, AND REPRODUCIBLE.
The patient as object.
One day she smiles when the doctor says hello, but can't track the pen as he moves it across her field of vision. The next day she can track the pen but can't smile (or doesn't want to) when the doctor says hello. Therefore, the pen test and the hello test are both judged to be failures, because they aren't CONSISTENT, REPETITIVE, AND REPRODUCIBLE.
Any non-medical human would say Terri is aware, but the doctor knows better. He's doing science.
All right. Now let’s go to a definition of persistent vegetative state.
From encyclopedia.laborlawtalk.com: "A persistent vegetative state (or PVS) is a condition of patients with severe brain damage in whom coma has progressed to a state of 'wakefulness without awareness'. The term was introduced by two doctors in 1972 to describe a syndrome that seemed to have been made possible by medicine's increased capacities to keep patients' bodies alive. A persistent vegetative state is not the same as coma, the major distinction being that coma sufferers cannot breathe on their own.
"Patients in a persistent vegetative state are usually considered to be unconscious and unaware, but exhibit sleep-wake cycles and some behaviors that can be construed as arising from partial consciousness, such as grinding their teeth, swallowing, smiling, shedding tears, grunting, moaning, or screaming without any apparent external stimulus. Their heads and eyes can track moving objects or turn towards a sound.
"Few people ever recover from PVS, but in occasional cases, family members who visit the patient will detect evidence of awareness when doctors with limited patient contact will deny it. Eye tracking is often the earliest symptom of recovery."
This definition is obviously bizarre because of its contradictions and vague pronouncements. It admits that patients in PVS are usually considered to be unaware---and yet they exhibit some behaviors that can be construed as arising from partial awareness. Which is it? Partial awareness? Are you going to kill someone with partial awareness? Are you going to kill someone if the standard by which you're judging the key factor of their awareness is too vague to be of any use?
The definition goes on to imply that the ability to track moving objects or turn toward a sound is considered usual in PVS but unimportant. But in the next paragraph, “eye tracking is often [OFTEN] the earliest symptom of recovery.”
"Let's see. We know Terri tracks objects with her eyes, but we're not sure what that means. So let's kill her."
The definition also makes it clear that doctors may not see the signs of awareness that family members see. I would put some nurses into that family-member category, too. By close, friendly, and continued contact, they notice that patient is actually aware.
What signs has Terri exhibited?
Here are a few excerpts from an explosive sworn statement (2003!) given by a nurse, Carla Sauer Iyer. You can read the whole statement at rense.com. This nurse has made some major accusations against Terri’s husband Michael. I've left those out of this discussion.
AFFIDAVIT
STATE OF FLORIDA )
COUNTY OF PINELLAS )
BEFORE ME the undersigned authority personally appeared CARLA SAUER IYER,
R.N., who being first duly sworn, deposes and says:
1. My name is Carla Sauer Iyer. I am over the age of eighteen and make this statement of my own personal knowledge.
2. I am a registered nurse in the State of Florida, having been licensed continuously in Florida from 1997 to the present. Prior to that I was a Licensed Practical Nurse for about four years.
3. I was employed at Palm Garden of Largo Convalescent Center in Largo, Florida from April of 1995 to July 1996, while Terri Schiavo was a patient there.
…6. To the best of my recollection, rehabilitation had been ordered for Terri, but I never saw any being done or had any reason at all to believe that there was ever any rehab of Terri done at Palm Gardens while I was there. I became concerned because nothing was being done for Terri at all, no antibiotics, no tests, no range of motion therapy, no stimulation, no nothing…
7. Terri's medical condition was systematically distorted and misrepresented. When I worked with her, she was alert and oriented. Terri spoke on a regular basis while in my presence, saying such things as "mommy," and "help me." "Help me" was, in fact, one of her most frequent utterances. I heard her say it hundreds of times. Terri would try to say the word "pain" when she was in discomfort, but it came out more like "pay." She didn't say the "n" sound very well. During her menses she would indicate her discomfort by saying "pay" and moving her arms toward her lower abdominal area. Other ways that she would indicate that she was in pain included pursing her lips, grimacing, thrashing in bed, curling her toes or moving her legs around. She would let you know when she had a bowel movement by flipping up the covers and pulling on her diaper.
8. When I came into her room and said "Hi, Terri", she would always recognize my voice and her name, and would turn her head all the way toward me, saying "Haaaiiiii" sort of, as she did. I recognized this as a "hi", which is very close to what it sounded like, the whole sound being only a second or two long. When I told her humorous stories about my life or something I read in the paper, Terri would chuckle, sometimes more a giggle or laugh. She would move her whole body, upper and lower. Her legs would sometimes be off the bed, and need to be repositioned. I made numerous entries into the nursing notes in her chart, stating verbatim what she said and her various behaviors, but by my next on-duty shift, the notes would be deleted from her chart.
end of excerpt
If this nurse----was she ever allowed to testify in any of the court proceedings?---not as far as I can tell---is speaking the truth, Terri was definitely NOT in PVS. Nor was any attempt made to rehabilitate her.
Now let’s turn to an excellent and thoughtful critique of the medical definition of PVS. The article is “PVS; Ethical Crux, Medical Fiction?” by Chris Borthwick. You can find it online.
Borthwick, in this brief excerpt I extract, is zeroing in on a 1994 Multi-Society Task Force convened to clarify the PVS state. The results of the Task Force study (part 2) were published in The New England Journal of Medicine (30, 22, 1572-1579).
Borthwick:
The Multi-Society Task Force begins with this definition.
· "A patient in a persistent vegetative state becomes permanently
vegetative when the diagnosis of irreversibility can be established with
a high degree of clinical certainty - that is, when the chance that the
patient will regain consciousness is exceedingly small." (54)
By the end of the page, however, the definitional criteria have been expanded
immensely.
· "These data... can be used by a physician to determine when
a persistent vegetative state becomes permanent - that is, when a physician
can tell the patient's family or surrogate with a high degree of medical
certainty that there is no further hope for recovery of consciousness or
that, if consciousness were recovered, the patient would be left severely
disabled. (55)
Borthwick then correctly points out that the expanded definition of PVS allows for patients who are neither in a persistent nor vegetative state. They are simply "severely disabled."
This is what you could call the ultimate medical backup. No need to argue the fine points about consciousness versus unconsciousness, permanence versus temporary-ness. Forget it. IF THEY RECOVER CONSCIOUSNESS AND ARE SEVERELY DISABLED, THEY’RE STILL PVS…AND RELATIVES CAN DECIDE TO LET THEM DIE.
Of course, we aren’t hearing about this particular shell game in the Schiavo case. But it’s there, in the background, if any law suits are filed.
From all of the above, you can get a clearer picture of the murder in progress.
Consciousness is not something you can define according to the medical criteria that have been engraved in stone. The medical standards are not a way to judge consciousness. But the doctors rule the roost. The judges---despite their garble about the fine points of the law---are basically siding with the doctors. It's a closed loop. And no one who has influence in this crime is interested in hearing testimony from a lowly nurse who does not have a medical degree. What could she possibly know? What she may have observed (that she claims was scrubbed out of her reports) is not CONSISTENT, REPETITIVE, AND REPRODUCIBLE.
Therefore, kill the patient. Kill Terri Schiavo.
