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Syndicated columnist Ellen Goodman's opinion entitled "More shades of gray amid, life, death" which appeared Sept. 15 in The Seattle Times attacked the recent British study concerning a 23-year-old woman who had been diagnosed in a persistent vegetative state.
Karen Ward, a registered nurse from Florida, takes issue with Ms. Goodman's opinion in this open letter to the columnist:
Dear Ms. Goodman,
In your recent Boston Globe article, More shades of gray amid life, death, you write of Terri Schiavo and PVS almost flippantly by relating her story to a game of tennis.
http://seattletimes.nwsource.com/html/opinion/2003259049_goodman15.html
This is what I make of it all. You state Terri had no cortex. That is simply untrue. Unless Terri had psychosurgery such as a lobotomy, her cortex was still there. How functional it was is the issue we cannot answer. The reason this study is important is that the results show a degree of cognitive awareness. Many argue there is a fine line between PVS and the MCS. See the pdf article for a description.
http://www.fmri.org/pdfs/NS2001.pdf
Terri was in an unresponsive condition, AKA coma, for 6-7 weeks, and not 15 years as you state. For a thorough description of unresponsiveness and the criteria assessed and scored, view the web site below.
http://www.medal.org/visitor/www%5CActive%5Cch17%5Cch17.01%5Cch17.01.10.aspx
If you had done a thorough job with your facts, you would know PVS is contentious within medicine, and has been since its inception in 1972. The 3 doctors Felos used in court does not make a panel of experts. What do all the neurologists, especially the neurosurgeons in the country have to say about PVS?
If you are aware Terri had no inner life, when did you assess Terri? I would like to know, as I have some specific medical questions for you. If you are going by what others say, where is your critical thinking?
Please define and explain the "bell curve of consciousness." Is that a new medical term, or something the bioethicists use? This terminology is unfamiliar to me.
With head injury, including lack of O2, there is no certain prognostication. Your comparison of a 23 year old accident victim and 88 year old stroke victim as having different prognoses shows how little you know of medicine. A stroke is not uniform for all people. The 88 year old may have a mild stroke with speech, ambulation, and fine motor movement intact. The 23 year old may have a head injury affecting her cerebellum and certainly end up worse than Terri Schiavo.
Since Art Caplan was used as a reference, the reasons you believe people do not want to live like this is no surprise. The Art Caplan's of the world are but one view, and their theory that PVS patients are brain dead or dim witted, or who would want to live like that is unraveling. I suppose the alternative is to disregard new studies and leave neurosurgery in the dark, as it has been for the past 30 years. This way, the RTD advocates can still preach death with dignity and kill off the elderly, the brain injured and others who are unable to speak. All the Ellen's in this country will think that is fine, until it happens to them.
There is no test, no treatment, no divining rod, no ESP, nothing, that can tell us if a patient wants to "live like this" unless they have something in writing.
If we all believed as you, Ellen, none would have hope.
The science you mock may someday save your life or that of your loved one.
KAREN WARD, RN
Naples, Florida 9-16-06
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© 2006 North
Country Gazette
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