Medical Fact Should Decide Terri's Fate, Not Partisan
Having personally experienced the agonies that propel both sides
in the Terri Schiavo case, I come to this conclusion: The best
solution would be to keep her alive long enough to determine,
for once and for all, if she is indeed in a persistent vegetative
state with no hope of improvement.
If the diagnosis of PVS is correct, then she should be allowed
to die, as her husband argues. If it isn't, then she should receive
rehabilitative therapy, which her parents are willing to oversee.
The amazing fact is that, through the 15 years of her illness
and 11 years of bitter legal wrangling - now highly politicized
-Schiavo has never had an MRI (magnetic resonance imaging) or
a PET (positron emission tomography) scan, which would quickly
determine whether she is really beyond hope of recovery.
She once received a CT scan (computed tomography) that supported
one of several past diagnoses of PVS, but MRIs and PETs are more
modern technology that would give definitive information.
Chances are, she is beyond recovery, based on information collected
in 2003 by Jay Wolfson, a lawyer and public health expert appointed
to advise the Florida courts and Gov. Jeb Bush (R) on the case.
After reading 30,000 pages of court records, interviewing health
professionals who had treated Schiavo and dozens of other experts,
and after visiting her and interviewing her husband and parents,
Wolfson concluded that Schiavo's "neurological tests and
CT scans indicate objective measures of the persistent vegetative
state. These data indicate that Theresa's cerebral cortex is principally
liquid, having shrunken due to the severe anoxic [oxygen deprivation]
trauma 13 years ago.
"It is noteworthy to recall that from the time of her collapse,
and for more than three years, Theresa did receive active physical,
occupational, speech and even recreational therapy. ... In the
observed circumstances, the behavior that Theresa manifests is
attributable to brain stem and forebrain functions that are reflexive,
rather than cognitive."
Last week, this medical consensus was challenged, principally
by Senate Majority Leader (and heart surgeon) Bill Frist (R-Tenn.)
and a neurologist from the esteemed Mayo Clinic.
The thalamic implant makes an MRI impossible, but a PET scan
would tell whether there is any activity in Schiavo's cerebral
If there's anything encouraging to be taken from the Schiavo
controversy, it's this: The public is overwhelmingly on the side
of allowing someone to die who is beyond hope of recovery.
That's important for the future of medicine and the economy in
this country. A significant proportion of overall U.S. medical
costs are paid to care for people in the last weeks of life.
Where lives can be saved, obviously the cost is "worth it."
And, in unclear circumstances, it is right to "err on the
side of life."
At the same time, the hospice movement and the growth of "palliative
medicine" offer humane alternatives to heroic medical intervention
when a person's case is hopeless. Polling on the Schiavo case
indicates strong public support for these developments.
It's also encouraging that, amid the mad rush by most Republicans
to the "right to life" side of the Schiavo argument
and most liberal Democrats to the opposite side, some politicians
managed to think independently.
Democrats such as Sen. Tom Harkin (Iowa), a longstanding defender
of the disabled, sided with Republicans on the Schiavo case, only
to be pilloried by liberal columnists for lacking the guts to
stand up to the forces of right-wing "theocracy."
I can sympathize with the passions felt by the participants in
the Schiavo dispute, husband Michael Schiavo and Terri's family,
the Schindlers. What's harder to stomach is the certitude of the
My wife, Milly, descended in late 2003 into something like PVS
because of a "Parkinson's-plus" syndrome known as Multi-Aystem
Atrophy. A PET scan confirmed this was happening.
Yet like Schiavo's parents, I hoped beyond hope that Milly was
"there." I was sure I saw signs of responsiveness that
others - including my daughter, a doctor - said were not there.
Last summer, like Schiavo's husband, I finally concluded that
Milly was "gone." In conformity with her "living
will," I resolved to stop her feeding tube in August. She
died naturally on July 22, sparing me the final agony.
But I understand why Michael Schiavo would resist an outside
intervention in what was inherently - and legally - his business,
and declared to be so in past cases by the U.S. Supreme Court.
The Wolfson report shows that, contrary to allegations of neglect,
he provided consistent, loving care to Terri.
"It is notable that through more than 13 years after Theresa's
collapse, she has never had a bedsore," Wolfson wrote. On
the other hand, I can understand the Schindlers' desperate desire
to keep their daughter alive and their rage at Michael Schiavo's
decision to "kill" her.
What's dismaying is the knee-jerk tendency among liberals and
conservatives to rush so passionately to one side or the other
in this case. It has more to do with winning the culture war than
helping Terri Schiavo, whose fate should rest on medical fact,
not political posturing.
Kondracke is the Executive Editor of Roll Call.
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