Schiavo - Let's Hear From Some Liberals

Mary Johnson draws a connection between Terri Schiavo and rights for the disabled at Common Dreams and the Baltimore Sun.  From the Sun:

THE CASE of brain-damaged Terri Schiavo, a woman who cannot speak for herself, has politicians intoning about the "sanctity of life" and right-to-die advocates insisting it should be a private family matter.

But for the organized U.S. disability rights movement, the issue is one of civil and constitutional rights.

...Most of us who are not disabled cannot imagine living like Mrs. Schiavo. But the disability rights movement is made up of individuals who are living lives that they may not have previously imagined, either. Individuals who can communicate only via high-tech means have told me they were long thought to be unable to think or feel. People who have experienced aphasia - the loss of the ability to speak or understand spoken or written language - people who have had strokes and people with brain injuries say similar things.

To these people, the case of whether Mrs. Schiavo should be kept alive looks very different. And who better to understand the issue than those whose lives hinge on the same question?

..."Disability groups don't think guardians should have carte blanche to starve and dehydrate people with conditions like brain injury, developmental disabilities - which the public calls 'birth defects' - and Alzheimer's. People should have the right not to be deprived of life by a guardian who feels that their ward is as good as dead, better off dead or that the guardian himself or herself would be better off without the ward."

More than two dozen national disability rights groups have been concerned about the Schiavo case. Two years ago, disability groups urged the Florida courts to "require a genuine application of the due process standard" and require "that Terri's wishes be proven by clear and convincing evidence, consistent with the Cruzan standard set forth by the U.S. Supreme Court," according to a brief filed by Not Dead Yet. It didn't happen.

..."There are a lot of people in the shadows, all over this country, who are incapacitated because of a disability," Sen. Tom Harkin told reporters Saturday.

The Iowa Democrat, who has worked on disability rights issues for decades, said, "There ought to be a broader type of a proceeding that would apply to people in similar circumstances. ... Where someone is incapacitated and their life support can be taken away, it seems to me that it is appropriate - where there is a dispute, as there is in this case - that a federal court come in, like we do in habeas corpus situations, and review it and make another determination."

A writ of habeas corpus is used to bring a person before a court or judge to decide whether that person is being unlawfully denied his or her freedom.

It's past time for Congress to pass a law providing for federal habeas corpus review of disputed state court rulings that order the withholding of food and water from legally incapacitated persons who did not leave a written advance directive or who did not choose their own substitute decision-maker.

More from the disabled here:

Conservative Christian groups have called for mass vigils outside the hospice caring for brain-damaged Terri Schiavo but many of the few dozen who have shown up said they were drawn for personal reasons unrelated to organized religion.

Eleanor Smith of Decatur, Georgia, sat on Tuesday in a motorized wheelchair in front of the hospice, baking in the sun, with a sign on her lap reading, "This agnostic liberal says 'Feed Terri."'

Her background was a far cry from the evangelical right wing more generally seen as the lobbying force behind the U.S. Congress' scramble over the weekend to draw up a special law to try to prolong Schiavo's life, and President Bush's decision to cut short a Texas vacation to sign it.

Smith, 65, had polio as a child and described herself as a lesbian and a liberal who had demonstrated before in support of the disabled and causes supported by the conservative establishment's archfoe, the American Civil Liberties Union.

"What drew me here is the horror of the idea of starving someone to death who's vulnerable and who has not asked that to happen," Smith said.

She said she thought that people who left written instructions to withhold medical treatment should have those wishes honored but that withholding water and nutrition from Terri Schiavo, who left no such written instructions, was tantamount to murder.

The LA Times gives us more about Tom Harkin:

While the push for the Schiavo bill came from Republicans, a prominent Democrat, Sen. Tom Harkin of Iowa, is considering introducing legislation that would allow a federal judge to review cases in which people had written no living will or left other instructions specifying their medical wishes if they became incapacitated and in which there is a dispute about the patient's wishes.

"The more I looked at the Schiavo case, the more I thought, Wait a minute. There are a lot of people in similar situations — maybe not in her specific situation — but because of a disability cannot express themselves or cannot in any way make their desires known," Harkin said last weekend.

Dupes and pawns of Tom Delay and the religious right, I guess.

Still my favorite protest sign: "Execution - not just for criminals anymore".

UPDATE:  We hear from some neurologists, not all of whom remember that mostly dead is partly alive:

"This is as severe brain damage as I've ever seen," said Dr. Leon Prockop, a professor and former chairman of neurology at the University of South Florida College of Medicine in Tampa, upon viewing the scans.

Dr. Walter Bradley, chairman of neurology at the University of Miami's Miller School of Medicine, added: "I doubt there's any activity going on in the higher levels of her brain."

The assessments came as a neurologist for the state who saw the CT scans and examined Schiavo said he saw signs of awareness in her behavior and concluded that more extensive tests should be done to see if she has any brain activity.

...It's the latest example of specialists disagreeing over Schiavo's condition. A doctor appointed by the court and two hired by her husband, Michael, who favors disconnecting the tube, concluded she is in a "persistent vegetative state" and with no chance to recover.

But her parents, who want to reconnect the tube and keep her alive, brought in two doctors who observed Schiavo and say they see hope she could recover at least basic functions.

...The neurologists said they can't tell from a CT scan whether remaining tissue is functioning, but all three said they doubted that the neurons - brain cells responsible for thought - could survive the prolonged loss of oxygen that Schiavo sustained."I'm almost certain it has no neurons in it...

...the doctors said there's little chance Schiavo's brain improved since then.

..."The chance that this person is going to recover is about zero," Pulley said...

Emphasis added.  If I had to bet, I would bet she will never recover.  But remind me why we need to take a chance here?

UPDATE:  Frequently Unasked Questions - what if Terri Schiavo were black?

Are you kidding?  Would Dems be telling an angry black family that (a) states rights are paramount; (b) the Florida courts can be trusted; and (c) the medical community can be trusted to have the best interests of black people in mind?  Uh huh.

Well, she is not black.  Just asking.

STILL MORE:  OK, now I have Ralph Nader on my side.  I am leaving when Paul Krugman join in.

Comments

[The Apologist]

I tell ya, the more I learn about this case - the more it breaks my heart. I hope her parents can heal afterwords. This has got to be terrifying for them.

[The Apologist]

No pun intended.

[ed]

Hmmm.

I think what's going to happen is that Terri is going to die, and then we're going to get to the truth.

It's ugly now and it's bound to get much uglier.

[Bill Arnold]

I am aware that Cranford has a "history", and perhaps this has already been posted here and discussed at length, apologies if so:
http://pekinprattles.blogspot.com/2005/03/schiavo-dr-cranford-offers-reply.html
and
http://pekinprattles.blogspot.com/2005/03/dr-cranfords-complete-terri-schiavo.html

Which frankly look convincing to me (a layperson), though a current MRI/fMRI would be more convincing. Note that Cranford says that "an MRI scan on July 24, 1990", and that "the MRI is contraindicated because of the intrathalamic stimulators implanted in Terri's brain." He dances around the PET scan question a little saying "the only PET scan center in the country I would trust right now for doing the PET scan for the determination of PVS is New York-Cornell Medical Center with Niko Schiff."

[TM]

I'm with Ed on getting uglier.

This has the perfect makings of a Waco like, or Vince Foster like cult (I say that as a recovering Wacoholic).

Too many unanswered questions, and a weirdly non-responsive "due process".

If she dies on Easter Sunday, heaven help us.

[Meep]

We're all going to die someday... I'd put each of our chances of survival in the long run at zero.

My question is: why the hurry?

[Joel B.]

The Corner was thinking Good Friday TM.

[Jamie]

The problem I have with the Pekin Prattles posting (I read the "complete report" but don't have time to read the "offers reply") is that Dr. Cranford makes several assumptions that are open to question, and that he leaves out what I can't escape feeling are significant factors in Michael Schiavo's behavior. He assumes that the Schiavos would only want their daughter to live if she could improve or recover - he states, "So this family, cruelly misled by blatant distortions of fact and thoroughly unprofessional advice, believes that letting Terri die now takes away any opportunity, any slim chance, that she will receive 'appropriate' treatment in order to recover. They feel like they are the last chance that Terri will ever have, and they are acting according to these strong (but unfortunately terribly mistaken and ill informed) beliefs." Correction: they know that they are the last chance that Terri will ever have, with or without any degree of recovery. Without them, she would be dead.

He further assumes that Terri's "right to privacy" is violated by her parents' desire for her not to die, taking as given that Michael Schiavo's representation of her wishes is correct. My husband and I have been married for twelve years and dated for three years before that. We have a great relationship and have never been estranged in any way. We don't have living wills (but we will now, you betcha). I was shocked to find that he believed things about what I would want in Terri's situation that I absolutely would not want. He made assumptions about me that were incorrect - and he unquestionably loves me.

What was it, seven years into Terri's ordeal before Michael Schiavo suddenly remembered that she wouldn't want to live "this way"? If I'm doing my math correctly, he had already been involved with his current girlfriend (it quacks like a duck and waddles like a duck - she's his wife) for several years by then, he'd received the malpractice settlement, he'd withdrawn treatment from Terri including basic physical therapy and apparently common care like having her teeth cleaned. Why is his, his brother's, and his sister-in-law's testimony as to Terri's carefully considered wishes if she were ever incapacitated - oh, pardon me, their recollection of her comments at a couple of funerals and after a Karen Ann Quinlan movie - so compelling?

Something about Terri's "reflex smiles." I am obviously no expert in PVS, but I do know what a newborn's reflex smile looks like. It's fleeting, ephemeral - terribly sweet but not involving the rest of the face, any particular stimulus (gas, for instance), or duration beyond a second or two. The videotape of Terri smiling at her mother doesn't look reflexive to me; it involves her whole face rather than just her mouth, it lasts, it appears when her mother's face comes into her field of vision (British Med Journal study I saw this week indicates that a significant majority of seriously brain-damaged people in apparent PVS have profound visual deficits) and seconds after her mother starts talking. If the reflex smile of a person in the PVS is the same as that of a very young infant, I don't see the similarity here.

And then there's Cranford's "history," about which much has been said.

[MattR]

Tom - If Terri was black, nobody would know her name

[TM]

If Terri was black, nobody would know her name

C'mon, this is "Cheers" nation. And I have heard of Tawanna Brawley.

If there are really 30,000 folks in America in a permanent vegetative state, and only one is in the news, I have to say that Terri S. was the perfect storm.

I would think finding a black evangelical woman (who could rally pro-life support) in a coma might be manageable; finding her with a divided family might be a lot tougher; finding them in court, a total longshot.

Well, as I said, we only have this one case even now.

[ConsumerMan]

WASHINGTON, March 24 /U.S. Newswire/ -- Consumer Advocate Ralph Nader and Wesley J. Smith, author of the award winning book "Culture of Death: The Assault on Medical Ethics in America" call upon the Florida Courts, Governor Jeb Bush and concerned citizens to take any legal action available to let Terri Schiavo live.

"A profound injustice is being inflicted on Terri Schiavo," Nader and Smith asserted today. "Worse, this slow death by dehydration is being imposed upon her under the color of law, in proceedings in which every benefit of the doubt-and there are many doubts in this case-has been given to her death, rather than her continued life."

Among the many injustices in this case, Nader and Smith point to the following:

The courts not only are refusing her tube feeding, but have ordered that no attempts be made to provide her water or food by mouth. Terri swallows her own saliva. Spoon feeding is not medical treatment. "This outrageous order proves that the courts are not merely permitting medical treatment to be withheld, it has ordered her to be made dead," Nader and Smith assert.

The medical and rehabilitation experts are split on whether Terri is in a persistent vegetative state or whether Terri can be improved with therapy. There is only one way to know for sure- permit the therapy. That is the only way to resolve all doubts.

The court is imposing process over justice. After the first trial in this case, much evidence has been produced that should allow for a new trial-which was the point of the hasty federal legislation. If this were a death penalty case, this evidence would demand reconsideration. Yet, an innocent disabled woman is receiving less justice.

The federal and state governments are spending billions on what we are told will become miracle medical cures for people with all sorts of degenerative conditions, including brain damage. If this is so, why not permit Terri's parents and siblings who want to care for her do so in the hope that such cures are discovered?

Benefits of doubts should be given to life, not hastened death. This case is rife with doubt. Justice demands that Terri be permitted to live.

[Jamie]

And I keep forgetting to point out, to Dr. Cranford and others who say that she's a "carrot" (wasn't that Schiavo's lawyer's term? I want THAT guy on my team), she's been in a flippin' sensory deprivation chamber for some twelve years. Astronauts - among the healthier among us, I'd wager - experience muscle atrophy if they don't exercise daily in low gravity. Kids with broken arms end up with one arm visibly smaller than the other when the cast is removed after just a few weeks. Elders who start doing crossword puzzles and other brain-stretching activities show improved cognition. People can exercise their eyes, for heaven's sake, to improve their vision (but not me so far, darn it). Chris Reeve began to regain control of his limbs before his untimely death.

Terri Schiavo, on the other hand, has been disallowed even from having music played in her room and having her limbs stretched and straightened since 1992 or so. Even if she had significant chance to regain some level of cognition, is it any wonder she isn't showing it now?