Tuesday, February 22

What Are We?

The recent national interest in the Sarah Scantlin/Terri Schiavo cases speak a lot to the morality of our age as well as to innovations in medical science.

Sarah Scantlin is the young Kansas woman who was hit by a car when she was 18 and has been in a coma for 20 years. Suddenly, a few weeks ago, she began to speak.
Terri Schiavo is the young Florida woman who has been in a coma for 15 years -- only she is awake and responsive. She can sit in a chair and even managed to stand last week for a few moments. Her husband wants the court to pull her feeding tube so that she will die.

The Kansas case has been a delight and a joy. The national media as represented by ABC went bonkers with delight as did we bloggers -- and half the nation, I dare say. We celebrated Sarah's miracle. . .and, logically,. . .wondered if it might happen for Terri.

Meanwhile, back in Florida, Terri's case is being tried as a "right to die" case. Although he has no directive saying so, her husband, Michael Schiavo, has spent the entire past 15 years trying to convince the court she doesn't want to live. Her parents have fought with all their resources to keep her alive. Terri, herself, seeems to be struggling for life. Everything she has tried to do has emphasized her will to live.

It is amazing that, in a country dedicated to "life, liberty and the pursuit of happiness" would have even one judge who would rule in favor of death over life. To be fair to the judge, we will assume that he didn't avail himself of the opportunity to see Terri for himself, but took the word of Michael's attorney, a known "right to die" advocate. But isn't it the responsibility of someone who takes anothers life in his hands to avail himself of first-hand information? Possibly not.

Fortunately Americans from all over the country have turned to Terri's case and done all they could to save her. We are a nation of light and life.

Comes now news of what's going on in the medical profession.

The Omaha Herald reports "Even in a coma, brains often work."

Thousands of brain-damaged people who are treated as if they are unaware may in fact hear and register what is going on around them but be unable to respond, a new brain imaging study suggests.

The findings, if confirmed in follow-up experiments, could have sweeping implications for determining the best care for these patients.

Some researchers said the report, which appeared this week in the journal Neurology, also could affect legal cases in which parties dispute the mental state of an unresponsive patient.

They said the research showed that brain-imaging technology could be a powerful tool to help doctors and family members determine whether a person had lost all awareness.

"This study gave me goose bumps, because it shows this possibility of this profound isolation, that these people are there, that they've been there all along, even though we've been treating them as if they're not," said Dr. Joseph Fins of New York Presbyterian Hospital-Weill Cornell Center. He was not involved in the report but collaborates with its authors on other projects.

We learned that from Sarah. It was widely reported that although she still felt like she was 18, she knew a few things about modern life. She knew, for example, as Boston.com reports,

Family members say Scantlin's understanding of the outside world is mostly from news and soap operas that played on the television in her room.

On Saturday, her brother asked whether she knew what a CD was. Sarah said she did and knew it had music on it.

Then there's the case of "Kimmie."

Kimberly Anne is a 28 year old school teacher from Manhattan, Kansas. She worked hard for her Master's Degree in teaching and her "kids" adored her. She and her fiance have been together since she was 18 years old. He finally proposed to her last Christmas. He bought her the Jeep as a surprise birthday present last New Year's Eve (her birthday). He "wanted her to be safe"...and oddly enough, he probably saved her life...and her brother's. The Jeep has "side crumple zones" and a sturdy construction...that is most likely the only thing that saved her...the Jeep took most of the impact instead of her.

In June, 2001 Kim sustained severe brain injuries ... shearing of the brainstem & diffuse brain injury mostly from the initial impact, some from the swelling afterwards. These injuries left Kimberly in a very deep coma, unable to sustain her own breathing, etc. She was placed on life support. . .

Kimmy is now awake, alive, well and teaching. Read her story at Kimberly Anne.com At the bottom of that page you'll find interesting comments about the Terri Schiavo case.

The rest of the story in the Omaha Herald goes more deeply into the research that was recently published.

Other scientists cautioned that the new research was more suggestive than conclusive - and that it did not mean that unresponsive people with brain damage were more likely to recover or that treatment was possible.

Still, they said the study opened a window on a world that has been neglected by medical inquiry.

"This is an extremely important work, for that reason alone," said Dr. James Bernat, a professor of neurology at Dartmouth.

Bernat said findings from such studies would be relevant to cases like that of Terri Schiavo, a Florida woman with brain damage whose relatives are disputing whether she should be kept alive.

The patients in question have significant brain damage. Between 3 million and 6 million Americans live with the consequences of serious brain injuries, neurologists say. . . . A better understanding of brain patterns in minimally conscious patients also should help cut down on misdiagnosis by doctors, Fins said. He said one study found that up to 30 percent of patients identified as being unaware, in a persistently vegetative state, were not. Instead, they were minimally conscious, like the men in the imaging study.

Moreover, mental states can change over time, and some patients have almost completely recovered function after being thought vegetative. Brain imaging would be one way to track these changes.

"The most consequential thing about this is that we have opened a door, we have found an objective voice for these patients, which tells us they have some cognitive ability in a way they cannot tell us themselves," Hirsch said.

The patients, she said, are "more human than we imagined in the past, and it is unconscionable not to aggressivey pursue research efforts to evaluate them and develop therapeutic techniques."

Can a humane society, based on human rights and respect for life, do less than support life over death? The question Terri's attorneys should be looking at is a right-to-life one rather than a right-to-die.


Jude Thomas said...

I was thinking about this case again today. I'm not sure which side has Terri's best interests at heart since I am no judge of hearts, only actions. What I see is two groups of people fighting over another human being ad nauseum (3 if you count the civil authorities, maybe 4) as if SHE were property. It seems they already see HER as an IT. This all could have been averted had Terri actually put a living will in writing and had it notarized. I realize she was young when she ended up in her current state, but it's good to have. She seems to be cognizant to me and doesn't really need to die, but at the same time, does she want to live? Will we know?

Sunnye T said...

I know, Jude -- it would have been easier if she had left a living will. But she didn't. We can learn from her mistake; and hope we don't change our mind once we're acutally in the situation.

There have been several indications that Terri wants to live. The most recent was reported this week. She actually stood for a moment when someone whispered into her ear that if she didn't stand, they would remove the tubes.

She was sitting in a chair at the time and struggled to her feet. She actually stood alone for a very short while.

I think the important thing here is that she is a living, responsive person and for that reason she deserves life. With life, there's hope medical science -- or a miracle -- will make her well.

With death, she is gone forever and there is no hope.