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March 22, 2005

Comments

Oh. My. God.
I knew they were bad, but THIS bad?
THIS is the commentary - on the floor of the US Congress - by "our" elected officials on the Terri Schiavo case?
I am surprised the chaplain didn't replace "God Bless America" with "God Help America"!
Saddest, of all:
What difference will it make?

The thing about all this that most disturbs me is the outrageous cruelty of those who have lied to Terri Schiavo's parents. This is nothing but the worst kind of con-artistry: taking advantage of their natural feelings about wanting to believe their daughter can get better, by telling them outrageous lies - in order, as far as I can see, to make political capital out of it.

I'm disgusted.

I'm not particularly bothered by rhethoric of compassion; frankly, I wish Congress was more compassionate more often. I'm not too surprised by a lack of understanding of her medical status (except on the part of those asserting they are doctors). It's not the area of expertise of most of those in congress.

What bothers me is the hypocrisy of acting like a single person being taken off life support is the apocalypse when many of these people have actively supported measures which reduce people's access to medical help necessary to sustain life.

Furthermore, Medicare and Medicaid are headed for utter financial crises; they ought to take some of that energy and see about using it to ensure these programs that help the health of millions of Americans don't come apart at the seams.

This, in case you had any doubt, is what's really going on here:

Christian evangelicals, a key component in President Bush's Republican Party, believe the case of brain-damaged Florida woman Terri Schiavo may help inject new life into their long campaign against abortion.

"The right-to-life issue has been with us for over 30 years but never has it dominated the news headlines day after day as it is doing now," said Louis Sheldon, chairman of the Traditional Values Coalition.

"This case has generated a kind of inspirational activism. It is giving revival and renewal to millions of people who feel strongly about the culture of life and the protection of life," he said.

Republican leaders and President Bush had little choice other than to respond to Christian evangelical demands on the Schiavo case or risk alienating a crucial part of their political base, political analysts said.

"Bush and the Republicans can't do all that much on many of the things the religious right cares about. They can't end abortion rights and they can only ban gay marriage so many times," said American University political scientist David Lublin, who has studied the evangelical community.

"Here's a way they can tell their supporters, 'Look, we're acting on your agenda,"' Lublin said.

Personally, I think the line about how they can only ban gay marriage so many times should win this guy an award of some sort.

Thank you Katherine

Question:

Is it a violation of ethics for doctors to opine about patients not under their care?

Here is what the dispute is all about (from today's New York Times).:

On Friday, as the leaders of both chambers scrambled to try to stop the removal of Ms. Schiavo's feeding tube, Mr. DeLay, a Texas Republican, turned his attention to social conservatives gathered at a Washington hotel and described what he viewed as the intertwined struggle to save Ms. Schiavo, expand the conservative movement and defend himself against accusations of ethical lapses.

"One thing that God has brought to us is Terri Schiavo, to help elevate the visibility of what is going on in America," Mr. DeLay told a conference organized by the Family Research Council, a conservative Christian group. A recording of the event was provided by the advocacy organization Americans United for Separation of Church and State.

"This is exactly the issue that is going on in America, of attacks against the conservative movement, against me and against many others," Mr. DeLay said.

Here is what the dispute is all about (from today's New York Times).:

On Friday, as the leaders of both chambers scrambled to try to stop the removal of Ms. Schiavo's feeding tube, Mr. DeLay, a Texas Republican, turned his attention to social conservatives gathered at a Washington hotel and described what he viewed as the intertwined struggle to save Ms. Schiavo, expand the conservative movement and defend himself against accusations of ethical lapses.

"One thing that God has brought to us is Terri Schiavo, to help elevate the visibility of what is going on in America," Mr. DeLay told a conference organized by the Family Research Council, a conservative Christian group. A recording of the event was provided by the advocacy organization Americans United for Separation of Church and State.

"This is exactly the issue that is going on in America, of attacks against the conservative movement, against me and against many others," Mr. DeLay said.

"This is exactly the issue that is going on in America, of attacks against the conservative movement, against me and against many others," Mr. DeLay said.

Only a charlatan like DeLay could take a tragedy this poignant and make it all about him.

All of the statements above are either false or deeply misleading. I must assume that the Congressman and Congresswoman did not knowingly lie, since I cannot imagine what possible motivation [emphasis added] they would have for doing so, but they have certainly showed a reckless indifference for the truth.

Their motivation -- naked political expediency -- which makes it easy to understand why they find lying expedient.

I would suggest you cross the line and call it what it is -- lying. Part of the reason this type of dishonest discourse works is the reluctance to call it what it truly is. It does not poison discourse by accurately calling out the liars. It is the remedy to counteract the poison caused by such dishonest rhetoric.

Also, there is almost no moral difference between advocating passionately for something by making statements that are recklesly indifferent to the truth, and deliberately lying. Both a deliberate devices to mislead -- one is just craftier than the other.

The accusation of lying should not be made lightly and I believe it should be used sparingly. But it also should not be needlessly withheld when you are slapped in the face with it.

Schiavo: Some Legal Questions for You

Can congress pass a law that extends the statute of limitations on claims after the exisiting statute has expired?
QUESTION 1:

Accept for the moment that the statue of limitations for bringing any Federal Claims on behalf of Terri Schiavo would have commenced on the day that Judge Greer first handed down his ruling that Terri Schiavo would have chosen to have the PEG tube removed, on February 11, 2000, and that was more than 5 years ago, and further
accept that the statute of limitations for any Federal Claim that could have been brought is four years, can Congress constitutionally extend, alter or modify the statute of limitations so as to permit the Federal claims that were brought in the Federal Court yesterday to go forward?

QUESTION 2:

If today, Arty Duckworth's wife, Gillian (all taking place in New York), was in a PVS, and she, like Terri, had declared her desires, and Gillian's parents said to keep her feeding tube in, while Arty wants to do what Gillian wanted, i.e., remove the tube, and the NY courts ordered its removal, could Gillian's parents take their case to Federal Court?

QUESTION 3:

On the flip side, ask yourselves this question #2: If today, Arty Duckworth's wife, Gillian (all taking place in New York), was in a PVS, and she, UNlike Terri, had declared her desires TO KEEP A FEEDING TUBE IN, and Gillian's parents said to WITHDRAW her feeding tube, while Arty wants to do what Gillian wanted, i.e., KEEP the tube IN, and the NY courts ordered it KEPT IN, could Gillian's parents take their case to Federal Court TO ENFORCE HER RIGHT TO DIE?

I would suggest you cross the line and call it what it is -- lying.

I agree with dmbeaster. It's time to call it what it is.

Out of curiosity I checked to see what the Weekly Standard had to say about Schiavo and found this by Fred Barnes, which repeats some of the lies quoted by Katherine.

So the rot spreads, and being polite does not help stop it. We are dealing with repeat offenders here.

Hey, how about the Schindler's lawyers "case," which basically amounts to "she's a Catholic, ergo Catholic doctrine trumps all."

Also, there is almost no moral difference between advocating passionately for something by making statements that are recklesly indifferent to the truth, and deliberately lying.

Mea culpa for the posting rule I'm about to break, but the former is referred to as bullshit.

Apologies for reposting this (especially under a post with the title hubris, as I am asserting that it is so important that it deserves a repost) but on CNN, a nurse named Carla Sauer-Iyer claims that she was Terri Schiavo's nurse from April 1995 to July 1996 with claims of not only swallowing but speech on the part of Terri Schiavo during that time, along with alleged insulin injections by Michael Schiavo. She also claims that the judge's gag order has prevented these facts from coming out. A google yields a huge number of hits on this and google news brings up a few news articles.

I think it is worthy of bringing up again because it shows that these comments by senators are only the tip of the iceberg. This nurse, after bobbing around in the basement of floating memes, rises to the top, and makes her accusations, and, unless there is an X-files like conspiracy, is lying, lying, lying and if the claims that she makes are not dissected by the media that lets her appear, it is just enabling.

CNN also had Pat Mahoney from the Christian Defense Coalition decrying the judge. Interestingly, googling Christian Defense Coalition gets this link that says this:

We Are Equipped to Provide You With Earned Media

When a topic is hot, reporters are told by their editors to cover it (whether they want to or not); talk-show producers must find a guest to speak on this "hot topic." And there are "hot topics" developing throughout the day, every day. If fate ties you to a hot topic, a breaking news item, you will have to beat the press away with a stick.

More often, the case is that you need help making the press recognize a connection between you and a breaking story. That's where we come in--we do it everyday for somebody. Why not for you?

We find a way to make you, your position, your expertise, tied to the hot topic. Then we take you, and your "hot topic" to reporters and news producers who need of what you have. We find a way for you to be the "go-to" guest. We find a way for you to be quoted in newspapers worldwide.

In other words, we get you earned media.

Everyday the beast (the mass media) must be fed. All we do is make you an easy meal for the beast. They use us, we use them.

How come he gets picked as the 'protestor on the street'?

Anarch:

No offense taken, but I would be interested in some reason behind your passion.

Here's my thinking.

1. Factual assertions of the type we are discussing are made with the intention of inducing someone else to believe them and act on their presumed truth.

2. Making such factual assertions carries the moral implication that you have some factual basis for asserting that fact as true. This is a basic moral rule -- the corollary is that if one does not have facts on a subject, morally one should either say nothing or indicate that one is expressing opinion and is not attempting to induce belief and action based on facts.

3. Asserting alleged facts with reckless indifference to whether they are true or not -- you are trying to induce beliefs and actions based on the alleged truth of a facts whether or not they are true. You are deliberately misrepresenting that you have a basis for suggesting that others should also believe and act in reliance on these "facts." Maybe you will get lucky, and the fact accidently is true; or maybe not.

Your motive is very similar to a deliberate lie -- to induce belief and action in reliance on facts when you do not have any reason to believe the facts to be true. We are not talking about a good faith mistake in asserting a factual statement, but reckless indifference to truth. This is simply another form of deception. Lying is worse, but the primary moral evil is deception, and both types of conduct (deliberate lying and reckless indifference) achieve that goal. That is why I stated that morally, they are very similar.

I certainly understand why one of my friends who know Rep. Sensenbrenner calls him "big, dumb Jim".

I doubt that any of the people, other than Delay, who made these comments have any idea that they were lying. They were given talking points and spit them out. Most of them displayed profound ignorance of the case and made statements contrary to fact. Sure, doctors have a duty to keep their mouth shut, but being in the House seems to bring out the worst in many.

This is about distracting everyone from the news about Tom Delay's criminal behavior. It seems to be working -- for Tom.

I don't hesitate to call lying lying. But I think people generally persuade themselves they're doing the right thing--e.g. lying about rendition protects intelligence sources. I don't see how you could persuade yourself that lying about her medical condition and falsely accusing her husband and thousands of other Americans of murder from the House floor is doing the right thing. Therefore I think they've actually convinced themselves--based on no serious research at all--that it's true.

I mean, look at this article:

Terri was sitting up in her lounge chair, dressed and looking alert and well. Her feeding tube had been plugged in around 11 a.m. and we all felt good that she was still being fed. Suzanne and I were talking, joking, and laughing with Terri, telling her she was going to go to Washington D.C. to testify before Congress, which meant that finally Terri’s husband Michael would be required to fix her wheelchair. After that Suzanne could take Terri to the mall shopping and could wheel her outdoors every day to feel the wind and sunshine on her face, something she has not been able to do for more than five years....

The most dramatic event of this visit happened at one point when I was sitting on Terri’s bed next to Suzanne. Terri was sitting in her lounge chair and her aunt was standing at the foot of the chair. I stood up and learned over Terri. I took her arms in both of my hands. I said to her, “Terri if you could only say ‘I want to live’ this whole thing could be over today.” I begged her to try very hard to say, “I want to live.” To my enormous shock and surprise, Terri’s eyes opened wide, she looked me square in the face, and with a look of great concentration, she said, “Ahhhhhhh.” Then, seeming to summon up all the strength she had, she virtually screamed, “Waaaaaaaa.” She yelled so loudly that Michael Vitadamo, Suzanne’s husband, and the female police officer who were then standing together outside Terri’s door, clearly heard her. At that point, Terri had a look of anguish on her face that I had never seen before and she seemed to be struggling hard, but was unable to complete the sentence. She became very frustrated and began to cry. I was horrified that I was obviously causing Terri so much anguish. Suzanne and I began to stroke Terri’s face and hair to comfort her. I told Terri I was very sorry. It had not been my intention to upset her so much. Suzanne and I assured Terri that her efforts were much appreciated and that she did not need to try to say anything more. I promised Terri I would tell the world that she had tried to say “I want to live.”...

Just as Terri’s husband Michael has told the world he must keep an alleged promise to kill Terri, a promise remembered a million dollars and nearly a decade after the fact; I must keep my promise to Terri immediately. Time is running out for her. I went out to the banks of cameras outside the hospice facility and told the story immediately. Now I must also tell the story in writing for the world to hear. It may be the last effective thing I can do to try to keep Terri alive so she can get the testing, therapy, and rehabilitative help she so desperately needs before it is too late.

....Just before I left the room, I leaned over Terri and spoke right into her ear. I told her I was very sorry I had not been able to stop the feeding tube from being taken out and I was very sorry I had to leave her alone. But I reminded her that Jesus would stay right by her side even when no one else was there with her. When I mentioned Jesus’ name, Terri again laughed out loud. She became very agitated and began loudly trying to speak to me again. As Terri continued to laugh and try to speak, I quietly prayed in her ear, kissed her, placed her in Jesus’ care, and left the room.

This was written by one of the Schindler family's attorneys

It's less lying, than a complete forsaking of reason.

"[I] placed her in Jesus' care" - this sounds very odd to me. I assume that in a Christian world everybody's in Jesus's care all the time - or at the very least all believers are. And that in such a world attorneys wouldn't get to do the placing regardless.

No offense taken, but I would be interested in some reason behind your passion.

I wasn't being passionate; I'm simply saying that reckless disregard for the truth is what Harry Frankfurt calls "bullshit" (in his seminal paper-turned-book, On Bullshit), hence the link.

This is simply another form of deception.

I'm going to actually have to read the book at some point, but my understanding is that Frankfurt places it in a different category than mere lying for precisely that reason: it isn't deception, which carries with it the connotation that the speaker is deliberately leading the audience away from the truth, but rather a willingness to lead the audience to a position independent of its relation to the truth. It's that independence -- that orthogonality, for those who dig the geekspeak -- that distinguishes bullshit from lying and potentially puts it into a separate moral sphere.

All of which is far more exciting and exhausting than the intent behind my original comment, which was simply to note that, thanks to Professor Frankfurt, we now have a particular word to describe this particular trope: bullshit. :)

[That's four more rules violations, by my count. I feel like there ought to be a Southpark-like counter in the lower left corner that dings every time I say "bullshit".

*ding* Make that five rules violations.]

Solomon might have suggested that since it is not clear whether Terri's parents or her husband has her best interests in mind, then she should be split in half and one half would then be given to each party. I wonder who then would concede.

then she should be split in half and one half would then be given to each party. I wonder who then would concede.

The real question is: would it make any difference?

I don't know much about the legal side of this, but why this outrage in a nation with the death penalty?
How many execution orders did Bush sign as governor of texas? And now he comes back to save a life that has been almost gone for 15 years, because of " moral values" - how can anyone not see through this?
Where I live - Holland - no one would buy this.
It seems to me that washington - white house, congress and press - are acting out a fairy tale story because so many people prefer a story over reality.

Rilkefan hit the nail on the head. The attorney doesn't get to place anyone is Jesus's hands. But he thinks he can. That kind of assumption, which is correctly labeled "hubris" in my opinion, is not uncommon in the EXTREME religous right. They really do attribute to themselves devine powers and special access to God and Jesus.
By the way, not all religous fundamentalists are supportive of this debacle. My mother-in-law is every inch a religious conservative and she is appalled. She wouldn't let medics revive her husband when he finally died after a year of bedridden pain. She has empathy ( which is a more Christian quality than hubris) for Terri and the people want to, as she puts it, release her body to follow her soul to Heaven.

This is an aptly named thread.

Anarch:

Thanks for the follow up and humor. I re-read your link in greater detail, and Frankfurt's point is interesting.

Mac, could you flesh out your point?

Another scintillating "I'm-rubber-you're-glue" contribution from Mac. How do you stay at the top of your game like that?

Phil for a guy who claimed to hate content free snark, you sure seem enjoy its usage.

The attorney doesn't get to place anyone is Jesus's hands. But he thinks he can. That kind of assumption, which is correctly labeled "hubris" in my opinion, is not uncommon in the EXTREME religous right. They really do attribute to themselves devine powers and special access to God and Jesus.

Or more likely he misspoke and meant to say something more like "I left her in Jesus' care". I really doubt that he believes that he has some sort of direct control over what Jesus does.

From James Q Wilson article in WSJ via NRO:

This policy endorses the right of a person to end his or her life with medical help. It is justified by the alleged success of this policy in the Netherlands.

But it has not been a success in the Netherlands. In that country there have been well over 1,000 doctor-induced deaths among patients who had not requested death, and in a large fraction of those cases the patients were sufficiently competent to have made the request had they wished.

If this is true, rob, then in Holland there is a terrible injustice occuring. That is what we are trying to avoid here. I for one, believe that that when Terri and Michael married, then her primary guardian became Michael, but I can also understand her parents wishes.

This is a very unfortunate tragedy.

My mother and a grandmother, both deeply religious women, died of cancer after more than 2 years of being very ill. They both welcomed death in the end, as they saw it as being released.
This is to me a very Christian way to see death; much more so than clinging to this life no matter what.

Here is a link to a long excerpt of Harry Frankfurt's On -ahem- B******t.

It's very scholarly but also quite readable.

I understand, rob. My mother died last year shortly after being diagnosed with a terrible form of cancer (multiple myeloma). My dad, who might be characterized by some here as an extreme right-wing Christian, and the rest of my family considered it to be a blessing, especially to her. She really was fearful of the chemo and then becoming a parapalegic, which often happens with that disease.

Dave C,
I don’t know the sources of this WSJ-article, but the term “doctor-induced deaths” can mean anything from administering aspirin to outright murder.
In the Netherlands, there is not a procedure for people who want to commit suicide (that is still very controversial here too) but it deals with people who are already dying. There is always a balance between limiting suffering and prolonging life, for drugs like painkillers in a very ill body are just poison. In the case of my mother, she started with using painkillers herself; when she could not speak anymore the doctor and my father agreed to keep giving painkillers as long as she gave indications of pain. This meant increasing doses towards the end, and no doubt shortened her life. But this is what we knew she wanted; a few days or weeks longer “life” with more pain was not an option.

Confused.

Before before, thought:

Torture bad.


Then say:

No.

Torture Good.

Torture Good?

Yes.

Torture Good.

War Good.

Killing Good.

All Good.

Torture Good.

OK.

Torture Good.


Now say:

Torture Bad.

Torture Bad?


OK

But...

Confused.

It very possible that Michael gave Terri better care, than she would have him, if their roles had been reversed. And possibly his parents would not have struggled with the situation so long.

I suppose I could say that he should have stopped the feeding before he started another family, or gotten a divorce and moved on with his life, but I think Michael didn't want to be the "bad guy" back then. And so now it has come to this.

Each of us suffers from human frailty. It is part of our nature as much as the many admirable qualities of people. If I were a praying kind of guy, I would pray just as much for Michael as for Terri and her parents.

Let's not forget the trusty doctors in the Senate:

Among them was Senator Tom Coburn, Republican of Oklahoma and a family practice doctor, who said in an interview, "I don't think you have to examine her. All you have to do is look at her on TV. Any doctor with any conscience can look at her and know that she does not have a terminal disease and know that she has some function."
"Dr. Frist, who has certified that patients were brain dead so that their organs could be transplanted, said he was comfortable concluding that Ms. Schiavo was "clearly responsive." But he said he was not making a diagnosis, just insisting that the courts develop a new set of facts.

"Nobody went back and read all 33 medical affidavits, I can tell you that," he added. "And if they read them, they wouldn't know how to judge them."

!!!!!!

link

As bad as the practice of medicine has been in Congress of late -- by those with and without licenses -- the practice of law has been downright pathetic. They gave standing and lifted res judicata, but no substantive relief, and thought the parents could just sort of invent a constitutional right of some kind? Who'd they think they were dealing with here? Earl Warren?

One last thing: there's been a lot of talk about the uses of living wills, but family members I've spoken to say that more important is a "durable power of attorney" which designates one person to make decisions for you. A living will is also useful but it's very difficult to predict the exact cirumstances of your condition & it may be that you'd want your relative to be able to override it. I don't think you need a lawyer for a basic version, just witnesses.

has anyone else considered that by making most of the country focus on this issue and determining when human life ends they could then turn around and say "well this should also be the criteria for determining when life begins" ?

has anyone else considered that by making most of the country focus on this issue and determining when human life ends they could then turn around and say "well this should also be the criteria for determining when life begins" ?

"They" could, but given the recent polls I suspect they wouldn't like the results.

Never claimed to hate it in general, Mac. I just wonder why, since everyone knows you're capable of stringing together more than ten words in a row, why your entire range of contribution here seems to be limited to one-liners. Once again, we're given a situation in which a poster has brought to light an issue, or new information on an issue, and your response is, essentially, "Is not!" Do you have anything to, you know, say about the statements in the post? Or did you actually just expect Katherine and others to scroll down and say, "Ohmigod, Mac is right -- we are being hubristic! We must stop it, now?"

Considering that you threw a snit and didn't comment here during the time that Tacitus was banned, and instantly reappeared the moment he was unbanned, I'd think you'd put a little more effort into things. Snark is fine. Nothing but snark towards people you appear to like and respect -- or have at least said you have, and I assume you're telling the truth -- and whose opinions you appear to want to influence seems worse than useless.

I don't expect you to care much about what I say, but if I had ten bucks to wager, I'd wager that people whose opinion you do care about are as baffled by it as I am.

Good God:

"I don't think you have to examine her. All you have to do is look at her on TV."

It's a good thing he's a Senator now. If he were my doctor, I'd be moving to another practice as fast as I could...

Who'd they think they were dealing with here? Earl Warren?

Who, by the way, was also a Republican.

Katherine:

It's less lying, than a complete forsaking of reason.

Good point, as to some of them. Or perhaps its faith-based reasoning, if there is such a thing.

As to others (DeLay, Frist), I would say that lying still describes them.

It *is* a complete forsaking of reason. That's the underlying issue here, even beyond the family law dynamics and "right to life" dynamics.

What you have is the power and authority of political group asserting its beliefs are more true than the verifiable facts (in this case, facts of medical science and neurology). It's important to the neo-medievalists running the government now that objective, testable, verifiable logic models be delegitimized, in favor of an "I Believe It So It Must Be True" model. Their pet projects don't stand up to factual analysis, so factual analysis has to lose.

The latest philosophical wrinkles involve the Schindlers and their allies saying this particular case should be decided by theology.

One of the Schindler's lawyers argued that the feeding tube must be re-inserted because the Pope says so, it's Catholic doctrine, and Terri was a Catholic. This is really fascinating, because he said obedience to Catholic doctrine should prevail *regardless* of what Terri herself said she wanted (thus apparently acknowledging that Terri did say she wouldn't want to live in her current condition).

And one of the sideshow clowns dressed in priestly garb has said that, since Michael Schiavo committed adultery, Biblical law holds that his marriage to Terri is null and void; therefore, he doesn't qualify as her legal next of kin. Who needs a divorce proceeding? Or a conscious, aware Petitioner? Let the Bible dissolve the marriage, without any input from married couple themselves.

This thinking is as dangerous as it is dingbat. It's like they want to make believe the Enlightenment never happened, that secular society doesn't exist.

neo-medievalists

Great descriptor! That's exactly what they are, in so many ways!

For so many of us, who recently made agonizing feeding tube decision for a beloved parent, this debate is reviving the trauma of the decision all over again. The real dilemma most of us will face involves feeding tubes and dementia, not persistent vegative states. I wish the media coverage would make that clearer.

My incredible mother suffered from dementia probably resulting from a fall down the stairs, Progressive Supranuclear Palsly, a worse than Parkinson's disease, and early Alzheimer's disease. In the last two years of her life, she needed help with all the activities of daily life. Fortunately the family was able to care for her at home because she had long-term health insurance and adequate economic resources. In the last year of her life, she developed worsening swallowing difficulties and died on Good Friday a year ago from aspiration pneumonia.

Several times a feeding tube was recommended. She had made it absolutely clear she didn't want a feeding tube; she stated that in her advance directive. She had decided against a feeding tube for my father in 1987, when he succumbed to end stage Alzheimer's Disease. She spent 14 years as an Alzheimer leader and legislative advocate and educated thousands of people about end-of-life decsions, including memebers of Congress.

Her situation was not comparable to my dad's. She still could communicate, relate to people, enjoyied music, loved watching videos of Broadway musicals, operas, ballet, watch the news She was a reduced version of herself, but she still had some quality of life. She seemed to be responding well to a new medication. Her decline was slow, but her actual death was unexpected. She died peacefully at home, surrounded by her family. Newsday eulogized her as a "teacher, activist, trailblazer."

If we had told ourselves her wishes were not applicable to the state she found herself in, she could well have lived long enough to rejoice over five of her grandchildren's marriages. So of course I have misgivings and doubts about our decision.

Fortunately, thanks to her guidance, her six children were able to agree to follow her wishes. Some of us wishes her directive might have given us more leeway.

We all miss her terribly. In many ways her granddaughter Katherine carries her torch.

Well, look. We knew all along that the "sanctity of marriage" meant "non-sanctity of the marriages we don't like", and "activist judges" meant "judges who make decisions we don't like".

You read this, right?

In the longer term, the effort to undermine the judiciary is of a piece with the effort to undermine traditional sources of news. The goal is a political field cleared of any facts that might offer resistance to the claims of the party in power. People are unwilling to believe that there are no facts, but the trivially true claim that all facts are subject to bias in interpretation can be exaggerated to achieve the same effect.

These excerpts from Dr. Cranford's reports are also helpful:

An MRI was never recommended because, in this case and other patients in a permanent vegetative state, the CT scans were more than adequate to demonstrate the extremely severe atrophy of the cerebral hemispheres, and an MRI would add nothing of significance to what we see on the CT scans. Plus the MRI is contraindicated because of the intrathalamic stimulators implanted in Terri's brain. A PET scan was never done in this case because it was never needed. The classic clinical signs on examination, the CT scans, and the flat EEG's were more than adequate to diagnose PVS to the highest degree of medical certainty.
The following is a sample of the completely fallacious opinions rendered about Terri’s medical condition by Drs. Maxfield and Hammesfahr. Twelve years after an hypoxic-ischemic insult, and serial CT scans showing extremely severe atrophy of the cerebral hemispheres, both doctors said there was a “chance for recovery,” with the potential for response to treatment. Dr. Maxfield testified that “abnormal brain dissolves, so what’s left [as seen in the CT scans] is “normal, functioning brain.” He further stated that the most recent CT scan shows “improvement.” They gave no published data to support their opinions on their proposed treatments of HBO and vasodilator therapy but instead presented an infomercial style approach of anecdotal cases of dramatic responses to their therapies. There are no credible articles in the peer-reviewed medical literature on HBO or vasodilator therapies as effective treatment for patients with chronic brain damage. The articles on the internet on vasodilator therapy, including those by Dr. Hammesfahr, are extremely poorly written, and only a cursory examination of these articles would tell any medical professional that they could not have possibly been peer-reviewed.

emphasis added.

there's also this, from the document Rivka links to:

The initial CT scan on the day of admission, February 25, 1990, was normal but further CT scans documented a progression of widespread cerebral hemisphere atrophy, eventually resulting in CT scans of 1996 and 2002 showing extreme atrophy (CT scans-1996, 2002: “diffuse encephalomalacia and infarction consistent with anoxia, hydrocephalus ex vacuo, neural stimulator present); prior to these most recent two CT scans, CT scans had been performed on February 25, 1990, February 27, 1990, and March 30, 1990, with an MRI scan on July 24, 1990.The two most recent EEG’s have demonstrated no electrical activity-on July 8, 2002: “no evidence of cerebral activity;” and October 4, 2002-“does not have any definite brain activity. However, most of the tracing is obscured by artifact from muscle and eye movement.” The clinical exams over the years were entirely consistent with diagnosis of permanent vegetative state secondary to hypoxic-ischemic encephalopathy. From the initial hospitalization in February, 1990, until the present time, there have been no significant changes in Terri’s neurological findings, and nothing in the medical records to suggest any disagreement whatsoever among Terri’s attending and consulting physicians about the underlying diagnosis and prognosis for recovery.

One of the latest talking points is that the testimony about Terri Schiavo's wishes is "hearsay evidence" that it was improper for a judge to admit and/or improper for Florida legislature to allow. Of course, Terri Schiavo is obviously not available for cross-examination, so this rule would prevent any testimony about any oral statements from an incapacitated person about the wishes for their medical treatment. This would be an awful, awful, idea. If someone had a living will calling for no heroic measures, but told their spouse in an ambulance that they weren't ready to die yet & did want the doctors to do everything possible if something happened, you would obviously want that evidence to be admissible.

In addition, as far as I can tell, Theresa Schiavo's statements to her husband and husband's family fall within one of the hearsay exceptions in Rule 803 of the Federal Rules of Evidence:

3) Then Existing Mental, Emotional, or Physical Condition. A statement of the declarant's then existing state of mind, emotion, sensation, or physical condition (such as intent, plan, motive, design, mental feeling, pain, and bodily health) offered to prove his present condition or future action, but not including a statement of memory or belief to prove the fact remembered or believed unless it relates to the execution, revocation, identification, or terms of declarant's will.

I looked up Florida's rules of evidence, and they have a similar exception:

a) A statement of the declarant's then-existing state of mind, emotion, or physical sensation, including a statement of intent, plan, motive, design, mental feeling, pain, or bodily health, when such evidence is offered to:

1. Prove the declarant's state of mind, emotion, or physical sensation at that time or at any other time when such state is an issue in the action.

2. Prove or explain acts of subsequent conduct of the declarant.

(b) However, this subsection does not make admissible:

1. An after-the-fact statement of memory or belief to prove the fact remembered or believed, unless such statement relates to the execution, revocation, identification, or terms of the declarant's will.

2. A statement made under circumstances that indicate its lack of trustworthiness.

Under both federal and Florida law, such evidence is admissible even if the person who made the statement is available to testify. So I can't see anything unusual about Florida allowing it in a proceeding like this.

Living wills were also not common and were not necessarily binding on state courts in 1990. Needless to say they still aren't common among people in their twenties. They're a good way to guide your family in sorting through some of the difficult issues, but they are not a foolproof way to stop what's happening in this case.

(hi mom.)
(now I'm horribly embarrassed. well, I should be doing legal research anyway.)

Aw! I loved Mary's post, and to Mary: I for one, think Katherine does great work and only wish she had more time to post articles here.

gotta ditto votermom here.

Mary, we're sure the legal research Katherine's skipping to write here is important, but the work she does here makes tremendous difference in many of our lives, so you'll understand if we're torn about where she should focus her energies.

Mary: In many ways her granddaughter Katherine carries her torch.

You have a daughter to be proud of. (And it sounds like you had a mother to be proud of, too.)

My great-aunt (I never knew either of my grandmothers) died of heart failure at the age of 93 in her own home, as she wanted, though she was very frail and beginning to suffer from multi-infarct dementia. She was a terrific person: I still miss her. I hope to carry on her legacy, not least her splendid stubbornness. No one ever pushed her around. But I am very, very glad that I never had to make the decision to try and prolong her life by artificial means. She wanted to die at home, not in a hospital or a care home: she got her way. She was good at that.

DaveCBut it has not been a success in the Netherlands. In that country there have been well over 1,000 doctor-induced deaths among patients who had not requested death, and in a large fraction of those cases the patients were sufficiently competent to have made the request had they wished.

I have not read about their competenty to make the request; be aware that 2/3 of the requests for euthanasia are not fulfilled in the Netherlands. About 1/3 because people die beforehand and about 1/3 because people do not meet the requirements. If you are in a coma, or have a brain tumor, you cannot confirm your will to die at the moment of euthanasia, even if you have clearly indicated that you wanted it during the illness. That counts as a death without permission.

I know there have been studies, which have been extrapolated and say that there are probabely about 900 cases per year. Majority of patients were cancerpatients, younger than 65 years, more than half would die within max. a weak and almost 90% would die within max. a month. Trouble is that those studies are less common in other countries, so it is hard to compare figures like that. It might happen a lot more in the States (because people cannot afford treatment or palliative care for instance) but you would not know about it.

The last Dutch study was published in the Lancet (pdf) if you want to see all the figures. Take account of the fact that our new euthanasia law was not in effect though (april 2002, the report deals with figures 1990-1995-2000).

I don't have a dog in the fight over Ms Schiavo's termination - hell, being starved to death is probably a month in the country compared to what she's been through in the last fifteen years - but I do have to say that no, it's not that simple.
I’m a left liberal Australian; I’m an atheist; I’m in favour of voluntary euthanasia; I’m not bigoted about involuntary euthanasia; but -
No, PVS isn’t that simple or that final. The misdiagnosis rate is huge, the definition is shifty, and the consequences horrendous. Have a look at http://home.vicnet.net.au/~borth/PVS.htm and see whether you disagree with any of it. I’m not jumping on any bandwagon; the first paper on the site was published in 1995.
As I say, I don't mind whether you kill Schiavo, but the price of killing her seems to be agreement to the proposition that people in PVS can't feel pain, which leads inevitably to even more frequent hideous cruelties to the thousands of people diagnosed as PVS who are still hanging around.
And the CAT scans aren't determinative, unfortunately. As Lorber pointed out some time ago in 'Is your Brain Really Necessary?' (http://web.archive.org/web/20030404031139/http://www.enidreed.com/serv01.htm, people can be conscious - indeed, get to university -- with vanishingly small amounts of cortex and a headful of water. Different circumstances, certainly, no clear comparison, but underlining that at our present state of knowledge it's not possible to make a priori statements on what any particular brain geography has to mean.
The relevant comparison isn't between Schiavo's scan and mine or yours; it's between Schiavo's scan and those of other people diagnosed with PVS who have later recovered consciousness, and that's a study that hasn't been done. Some of the europeans - Laureys, for example - are looking at this, but America doesn't seem to see there's an issue.
The only valid test is how the person behaves - measured not at a random visit but after they've had the necessary pre-prep. I'd have to say that Andrews' team at the Royal Hospital of Neurology is about the only group whose techniques I'd trust.

My understanding is that the misdiagnosis rate is very high, but the medical scans here, and above all the sheer length of time of unresponsiveness, rule it out as conclusively as it is possible to do.

Looking at the 11th Court of Appeals decision, it looks like Pryor wasn't one of the two dissenters. If I was Bush, I'd be pissed: what's the point of making a recess appointment of a hack if he's going to then wander off the reservation?

Damn, that mother/daughter thing up-thread was so cool.

I wonder how many of the people supporting intervention in the Schiavo case are smokers?

Would they understand that they are busy giving congress precedent to intervene for their own health and take away their cigarettes? I suppose they're safe in the knowledge that congress wouldn't do that to big tobacco though...

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