Why did Florida put Terri Schiavo to death? Because that was the demand of a husband who refused to divorce her and denied her medical care, while he lived with another woman. Michael Schiavo is the ACLU poster boy for family values.
—PATRICK J. BUCHANAN1
At the outset I mentioned the Schindlers’ case hinged upon two simple legal questions:
AWhat was Terri’s medical condition?
What were Terri’s wishes about ending her life in the case of a medical tragedy?
As to the first question, the court ruled Terri was in a persistent vegetative state (PVS); regarding the second question, Florida law allowed the court to rely upon hearsay evidence to conclude Terri would want to suffer a horrific death rather than live as a disabled person who was loved and cared for by her family. As we saw earlier, Terri left no written instructions expressing her own wishes.
Understandably, when the independent medical examiner, Dr. Thogmartin, filed his autopsy findings, the $64,000 question on everybody’s mind was this: Had Terri been in a persistent vegetative state as the court had ruled? Could she feel pain? Could she think? Did Terri really recognize her mother and cry when Mary left the room? Or was Judge Greer right when he insisted that ‘‘all of the credible medical evidence this court has received over the last five years’’2 pointed to her being cognitively unresponsive?
Dr. Thogmartin began by making it clear that ‘‘PVS is a clinical diagnosis arrived at through physical examination of living patients’’ (emphasis added). Terri was dead. How, then, could Dr. Thogmartin make a definitive postmortem determination as to whether or not Terri was in PVS? He couldn’t . . . and didn’t.
You might want to read that again.
The IME did not declare Terri to be PVS.
About as close as he got was to rely upon the findings of consulting neuropathologist, Dr. Stephen J. Nelson. Let’s not forget that Dr. Nelson never saw Terri when she was alive either. Like Dr. Thogmartin, he didn’t have the benefit of looking at a ‘‘living patient.’’ He only had a severely dehydrated body and brain to work with.
In Dr. Nelson’s view, ‘‘There’s nothing in her autopsy report . . . that is inconsistent with persistent vegetative state.’’3 Which is, frankly, like saying, ‘‘Maybe she was, but it’s impossible to determine that by an autopsy.’’ He also didn’t rule out the possibility that Terri might have been in a minimally conscious state (MCS) instead of in PVS. You see, there are no reliable studies on what the PVS brain of a corpse looks like when compared with that of a deceased MCS brain.
I was told by one neurologist that the neuropathological features of MCS are not even known as yet. It is, therefore, impossible to differentiate between a brain that supports minimal consciousness from one that does not through an autopsy. In fact, I am told, the same neurological indications might support different levels of consiousness. Dr. Nelson never claimed to compare Terri’s brain with the brain of a deceased MCS patient. The news media, however, eager to justify Terri’s death, did not consult knowledgeable neurologists about these subtleties.
Here’s my point.
Although it was widely reported that the pathological findings were consistent with PVS, the news media did not report the equally plausible conclusion that the findings could have been equally consistent with MCS—a condition from which patients have improved.
Nevertheless, George Felos was quick to put the best spin on the IME’s findings. With the IME report in hand, Mr. Felos trumpeted the news that ‘‘in the words of the medical examiners, the results are very consistent with a persistent vegetative state.’’4 Mr. Felos got as much mileage as possible out of this nonconclusion in order to lead the public down the road toward a belief that Terri was indeed PVS. I’m not surprised that Mr. Felos placed his spin on the IME’s findings. According to his view, Terri had as much life as a ‘‘houseplant’’—a term he had previously used to characterize Terri.
Here’s what’s troubling.
The medical examiner was not in any position to confirm or deny whether Terri was in PVS because he never examined her as a living patient. PVS is a clinical diagnosis that must be made on a living patient, not a diagnosis that can be based on autopsy findings.
Nevertheless, the media dutifully reported the PVS verdict with little regard for these facts.