Excellent review of the Terri Schiavo case

Joan Didion of the New York Review of Books has done a very lengthy, and thorough analysis of the Terri Schiavo case. Some quotes of interest are:

On the major diagnostic points alone, Theresa Schiavo was not tetraplegic and could breathe unaided, but seemed not to have retained the ability to think. Most neurologists have called her condition a "persistent vegetative state," in which the patient has normal sleep-wake cycles but does not respond. Since the diagnosis of a persistent vegetative state is based on the absence of response, any response from a patient who has received the diagnosis is presumed to be reflexive.

This is what many had been saying -- that the PVS diagnosis was self-fulfilling in as much as it is based on the lack of response, yet the diagnosis is used to dismiss responses as just reflex. Family members (who weren't trying to murder here) and friends reported responses that denoted awareness, but also reported that for some reason she would not respond to strangers. Some people who Terri got to know, eventually saw the responses. But doctors who would stay one or two brief visits, would be unable to see the responses and dismiss the family's observations.

However comforting it may have been to believe this, the suggestion (no diagnosis exists) of an "eating disorder" appears to have been entirely assumptive, based on no evidence beyond the unexceptional facts that she had some years before gained weight, gone on a diet, and lost the weight. We do know that on Theresa Schiavo's initial testing the level of serum potassium was 2.0, not only well below the "normal" range, which is 3.5 to 5.0, but also below the level, 3.0, at which cardiac effects may be expected. Bulimia, or any vomiting at all, can cause potassium deficiency. Since other common causes include kidney disorders, colon polyps, and the ingestion of diuretics, laxatives, asthma medications, certain penicillins, or even large amounts of licorice, the lowered serum potassium level on its own does not tell us what led to the deficiency that is believed to have triggered the cardiac arrest.

Another point that was continually brought out by Terri's supporters, but dismissed by the courts as well as the media as well as most doctors. There was never any real attempt at diagnosing her, even in why she had the original collapse. They made a guess, and left it at that. What a sorry state our medical profession is when that is how they treat someone's life. What a sorry state the media is when they don't even care enough to notice. As for the courts, their handling of Terri's welfare was nothing less than criminal.

Hat Tip: Patterico

Posted by Danny Carlton at May 23, 2005 07:12 AM