|
Eighteen months ago this week, the feeding tube of Terri Schindler Schiavo was withdrawn for the last time.
Thirteen days later, she died.
Tragically, during the past 18 months and in particular the past two months, there have been astounding medical revelations and discoveries about the cognitiveness and recovery/improvement of brain damaged individuals using functional magnetic resonance imaging (fMRIs) as well as findings concerning new medical treatment involving the use of the drug ambien, also known as zolpidem. These findings have dramatic implications for life-and-death decisions concerning patients who have been diagnosed as being in a persistent vegetative state.
The new studies, especially the British study recently published in Science magazine dispelling the persistent vegetative state diagnosis of a 23-year-old victim of a traffic accident, have caused people to revisit the Schiavo case and people are increasingly questioning her premature death, this new medical research creating disturbing questions about the moral status of the Schiavo death and the medical treatment of brain damaged patients.
http://www.northcountrygazette.org/articles/090706PVSAware.html
No longer is Terri Schindler Schiavo dehumanized as many tried to do, labeled as a "vegetable" with no chance for recovery, existing in body only. Now there is credible medical evidence that people like Terri may have been misdiagnosed as PVS, do have brain activity, are aware and can communicate in their own way, that they are not a "vegetable" but a human being, a person who deserves to live and establish their own quality of life.
"This new case is not surprising to our family", Terri's father, Bob Schindler Sr. says when learning of the  British woman. "We are seeing a growing amount of evidence indicating that the diagnosis of persistent vegetative state (PVS) is often misdiagnosed, resulting in dangerous and potentially fatal consequences for people with brain injuries, as documented in this new account of a brain injured woman. The danger of this diagnosis is that it is being used as a reason to kill innocent people with disabilities, like Terri. We believe that this PVS diagnosis is inhumane and it should be abolished."
As Terri's brother Bobby Schindler says, regrettably, it will never be known if such testing and treatment could have aided in the recovery of his sister.
  
That's because that Michael Schiavo (above left), his attorney George Felos (above center) and Sixth Circuit Probate Court Judge George W. Greer (above right) were determined not to allow any new testing for Terri, apparently to insure that the original death order and determination that she was in a persistent vegetative state not be reversed.
Michael Schiavo consistently said he would do anything for Terri.
But his actions said exactly the opposite.
He broke his promise.
Michael Schiavo broke his wedding vows by living in adultery with another woman and fathering two children, neglecting and even allegedly abusing his wife in her sickness, even admitting under oath that he withheld medical treatment from her, knowing that it would result in her death.
That established an intent to kill, a premeditation, an element for first degree murder.
There is no statute of limitations for murder in the State of Florida.
Broken vows, broken promises.
From the time he became the heir to the jury award from the 1992 medical malpractice trial, Michael Schiavo set about trying to end Terri's life, first by trying to withhold medical treatment from her and then by court order.
He just didn't think it would take a dozen years to kill her and even in death, her autopsy showed that she wasn't terminal, that she would have lived another decade or more. Had Michael Schiavo allowed new testing and treatment for Terri, it's likely that not only would she be alive today, but she might even be showing signs of improvement and recovery and telling the world what really happened the night of Feb. 25, 1990.
Michael Schiavo said that he would do anything for Terri but for a dozen years, he withheld all rehabilitative services from her, consistently refusing to allow new testing and kept her virtually locked away from society, a prisoner, to keep the world from seeing just how alive and aware she really was.
Sincerity is not an attribute of Michael Schiavo.
If Michael Schiavo had been honest and sincere in his actions and comments about his ward, Terri would not have died a premature death in such a horrific manner. It seems obvious that neither Michael Schiavo nor George Greer wanted to know if Terri had been misdiagnosed and Greer, without any medical license or experience, diagnosed her as PVS and ordered her death by dehydration, an irreversible fate, an accessory to homicide.
Both have the blood of Terri Schindler Schiavo and thousands of other brain damaged people who have been labeled PVS on their hands.
Terri Schindler Schiavo suffered brain damage in still unexplained circumstances on Feb. 25, 1990, at the apartment she shared with her husband, when she experienced a loss of oxygen to the brain.
Schiavo sued a general practitioner and a gynecologist who had been treating Terri for medical malpractice, claiming that they were negligent. He wanted $20 million.
On Nov. 10, 1992, on their eighth wedding anniversary, a jury awarded him what netted out to be about $300,000 for loss of consortium and about $750,000 for medical care for Terri which was to include therapy and rehabilitation.
He had told the jury that he was starting nursing school because he was going to take care of Terri for the rest of his life.
Q. Why did you want to learn to be a nurse?
A. Because I enjoy it and I want to learn more how to take care of Terri.
Q. You're a young man. Your life is ahead of you. When you look up the road, what do you see for yourself?
A. See myself hopefully finishing school and taking care of my wife.
Q. Where do you want to take care of your wife?
A. I want to bring her home.
Q. If you had the resources available to you, if you had the equipment and the people, would you do that?
A. Yes, I would, in a heartbeat.
Q. How do you feel about being married to Terri now?
A. I feel wonderful. She's my life and I wouldn't trade her for the world. I believe in my wedding vows.
Q. You believe in your wedding vows, what do you mean by that?
A. I believe in the vows I took with my wife, through sickness and health, for richer or poorer. I married my wife because I love her and I want to spend the rest of my life with her. I'm going to do that.
On virtually the very day that the court finalized the jury award and Michael Schiavo had the money in hand, on Feb. 14, 1993, he told her parents, Mary and Bob Schindler Sr., that they would never see their daughter again after Bob Schindler pressured Michael about beginning rehabilitative services for his daughter.
Shortly thereafter, Schiavo issued a do not resuscitate order on Terri and tried for the first time to withhold her medical treatment for a urinary tract infection, admitting later under oath at trial that he knew, due to his medical training, that without treatment she would die by sepsis.
In the days following the second withdrawal of Terri's feeding tube by court order on Oct. 15, 2003, when he believed that death was imminent, he signed a release that was issued to the media.
SCHIAVO NEWS RELEASE OCT. 2003
"For years after this happened to Terri, I tried desperately to find a cure for her", Schiavo's signed statement said. "I went from one doctor to another…any doctor that gave me a glimmer of hope that some new treatment or therapy would work was given free reign with Terri. I would do anything to make her well".
So he said but when the Schindlers and their attorneys petitioned the court for new testing, evaluations and treatment for Terri, Schiavo, Felos and Greer blocked virtually every attempt. The minimal testing that Greer did opt to allow produced results for only brain structure, not function.
If Michael Schiavo had signed his statement under oath, he could have been subject to arrest for perjury or making a false statement.
Several months ago, astounding results were announced about the use of zolpidem, also known as ambien, in the treatment of a brain-damaged man, Louis Kiljoen, in South Africa. Dr. Wally Nel, a general practitioner, began administering the drug to the man who suddenly "awakened" and was able to communicate with his family. "Something strange and wonderful is happening here, and we have to get to the bottom of it", Dr. Nel said. "Since Louis, I have treated more than 150 brain-damaged patients with zolpidem and have seen improvements in about 60% of them. It's remarkable".
Percy Lomax, chief executive of ReGen Therapeutics, the British company funding the South African research involving zolpidem, says that many stroke victims, patients with head injuries and those who brains have been deprived of oxygen, have reported significant improvement in speech, motor functions and concentration after taking the drug.
In an article appearing in the British publication, The Guardian, the case study of a 32-year-old brain damaged woman who improved after taking zolpidem is highlighted. This woman had suffered four cardiac arrests and hypoxia, a lack of oxygen to the brain. Four years ago, the hospital apparently failed to diagnose a gall bladder problem which resulted in the woman contracting septicaemia.
Prior to taking zolpidem, the woman could barely stand, her arms were in spasm, she could not speak and the left side of her face drooped. According to the report, less than 15 minutes after Dr. Nel administered zolpidem to her, the left side of her face no longer drooped and she was smiling broadly. "At 5:02, her arms have relaxed enough for her to fold them and she is laughing with her parents. Ten minutes later, she stands up, stretches to her full height and claps her hands".
http://www.guardian.co.uk/medicine/story/0,,1870279,00.html
According to the article, the woman was able to use a card keyboard, responding that she could use the keyboard more quickly with the medication and that she felt an improvement. "I am not falling over. I am not coughing so much. I can swallow easier. I feel my limbs are much more relaxed". When asked what she is hoping for, she responds, "To talk again. I'd love to be able to call my cats to come to me".
At 5:22 p.m., less than an hour after she had ingested the drug, she hollered "Wall-eee", Dr. Nel's first name, and hugs him.
Michael Schiavo had had Terri's beloved cats euthanized when he moved in with girlfriend Cindy Shook-another broken vow.
Terri Schindler Schiavo deserved the chance to have received treatment with zolpidem. She deserved the chance to have received an MRI to determine if she really was in a persistent vegetative state.
Although Michael Schiavo claimed he would do anything for his wife, allow any new testing available, he consistently blocked all attempts to do so, with the help of Felos and Greer.
During redirect testimony of Michael Schiavo during the Jan. 27, 2000, guardianship trial which resulted in Greer determining that Terri Schiavo was PVS and his issuance of his first death order, Michael Schiavo continued to insist that he would allow new testing, saying one thing while doing another.
Jan. 27, 2000 Trial, pgs. 898-899
Q. I believe Mrs. Schindler testified that she got hope for a Dr. Yingling who had come from California about a year after the implants. Were you here with Dr. Yingling? (questioning about the platinum electrodes which had been implanted in Terri's brain in late 1990 in experimental surgery at the University of California at San Francisco)
SCHIAVO: Yes. I was.
Q. Was there anything hopeful that occurred as a result of Dr. Yingling's visit?
SCHIAVO: No. There was not.
Q. To your knowledge, is there any treatment at Shands Hospital that can help Terri?
SCHIAVO: No. There was not.
Q. Are you aware of any treatment anywhere that can help Terri?
SCHIAVO: There is no treatment anywhere that can help Terri. No.
Q. If there were, what would you do?
SCHIAVO: I would be there in a heartbeat.
Terri Schindler Schiavo was never given MRI or PET (Positron Emission Tomography) scans because Michael Schaivo repeatedly refused to consent to one, a fact that many neurologists consider neglect and should have by itself constituted grounds for removal of him as guardian.
http://www.northcountrygazette.org/articles/091006PrematureDeath.html
With Schiavo's attorney George Felos and Judge Greer likewise blocking all efforts for MRI and PET testing, it seemed clear that they didn't want to learn the truth about Terri's cognitiveness and if she was PVS as they claimed, or aware and able to communicate, in a minimally conscious state, as the Schindlers and numerous medical professionals believed.
Many medical professionals have stated that before they could make such a diagnosis of PVS, particularly in a situation such as Terri Schiavo, a life or death decision, that they would have felt ethically obligated to perform MRI and/or PET scans. In Terri's case, only CT scans were done, (Computer-Aided Tomography). CT scans are less expensive and do not provide such comprehensive data as an MRI. According to neurologists, a CT scan is often the test used in an emergency room setting to initially determine the extent of brain damage but if the damage has been caused by lack of oxygen to the brain, such as in Terri's case, a MRI and PET scan are necessitated.
Without the benefit of MRI and PET scans and simply on the basis of an antiquated CT scan of Terri, Felos, Schiavo and Greer along with Dr. Ronald Cranford, Dr. Peter Bambikidis and Dr. Melvin Greer maintained in 2002 that Terri's cerebral cortex had "liquefied" and that parts of her cerebral cortex had been replaced by fluid. However, medical professionals say that a CT scan can't produce the kind of detail needed to make such a determination.
Felos and Schiavo had argued that an MRI couldn't be performed on Terri because of the platinum electrodes which had been implanted in her brain in late 1990 by Dr. Yoschio Hosobuchi of the University of California at San Francisco.
Those electrodes were never removed and had remained in Terri's brain for 15 years but Mary Schindler, Terri's mother, says that after Hosobuchi's assistant, CD Yingling made the determination that the electrodes weren't working and failed to send Terri to Shands Health Care Center in Gainesville, Fla., for additional testing, the electrodes should have been removed. She says that Yingling had stated that the electrodes should not have been left in Terri's brain for more than a year.
Medical experts have said that leaving the electrodes in her brain could have caused infection and medical complications. However, as guardian Michael failed to have the electrodes removed which the Schindlers maintain is further evidence of his abuse and neglect of their daughter.
According to the medical observations of Terri recorded after the experimental surgery, she was showing improvement. But less than four months after the surgery which neurologists consulted by the Schindlers say was inadequate time, Yingling, who had no medical license and whose field of expertise was allegedly interpreting EEGs or brain scans, traveled to Florida.
Thereafter, the sensory stimuli treatment was ceased and her therapy was reduced to once a week although he admitted probably six months or more would be needed to see improvement and he failed to obtain a machine needed for testing of Terri.
In a November, 1993, in a deposition, Michael Schiavo said under oath that Yingling failed to obtain equipment that he needed to conduct testing of Terri, had "loads of wine" at dinner and spilled it all over the couch at Schiavo's home.
"Terri was at Mediplex-he came out and did some testing, and he needed a CP-900 machine or something from Shands, and it wasn't available, and he said it wasn't no big deal. He told me he had---he didn't see any evident sign that the stimulator was working", Schiavo testified in a proceeding brought by the Schindlers to remove him as guardian.
Thereafter, despite the medical reports of marked cognitive awareness by Terri Schiavo, Felos repeatedly misled both the public and the court by stating that "tests show that she is in a vegetative condition and has no consciousness". He claimed that "there has been nothing new brought up in this case for years now" and that her condition has been "essentially the same as it has been the past 13 years". Although CT brain scans were later introduced and said to be Terri's, they failed to show the platinum electrodes which were still implanted in her brain, raising question if the scans produced were those of Terri Schiavo or some other individual.
Felos, Schiavo and Greer worked together to insure that there was "nothing new brought up" in the case for years.
Felos had claimed that "Terri's cerebral cortex has atrophied. It's gone. She had no consciousness", Felos told the public on Fox TV.
But the medical reports that did exist contradicted Felos and raised serious questions as to the level of awareness that Terri Schiavo may have reached had her therapy not been discontinued for over 10 years following a determination by non-physician Yingling, a refusal by Michael Schiavo to allow Terri to be given therapy and rehabilitation and failure to remove the electrodes even after Yingling and Hosobuchi instructed Michael Schiavo to have the electrodes removed.
The determinations of Cranford and Bambikidis that Terri was PVS was done without any medical testing with Cranford examining Terri on one occasion, for about 45 minutes, and Bambikidis' exam lasting about a half hour, cursory examinations.
In the British study, the findings released earlier this month, neuroscientists used a brain scanning technique called functional magnetic resonance imaging (fMRI) to detect signs of awareness in the 23-year old woman in addition to a dozen volunteer control patients. This is the first time that scientists have been able to do so with a PVS patient and the technique is likely to become a standard way of determining the level of consciousness of brain injured patients.
Steven Laureys, a neurologist at the University of Liege and co-author of the British study which appeared in "Science", says that the technique is "extremely important. It's the difference between life and death".
When attorneys for the Schindler family presented a motion to Greer in February 2005, specifically requesting permission to conduct a fMRI on Terri, Schiavo and Felos opposed and Greer denied the request as he had consistently denied all requests for testing of brain function following his determination that Terri was PVS.
But Michael Schiavo had said he would do anything to make her well.
"When you have signs of consciousness, you cannot decide to stop hydration and nutrition", Laureys says.
The Schindlers and their attorneys, all of whom had personal contact with Terri, maintain that she was cognitive and could communicate and interact with them.
Judge George Greer, who served in the self-appointed and conflicting role as guardian ad litem, had never personally seen Terri or visited her and had no personal knowledge of her condition. There is some question in that he is legally blind that he could even have viewed the videotapes of Terri shown in court.
In May 2002, Patricia Fields Anderson, former attorney for the Schindlers, submitted a motion to Greer requesting 25 new medical tests including EEGs, a MRI and other testing. She also requested copies of the full medical records collated including those at the hospice where Terri was a resident, a videotape of neurological exams which should including activity procedures to be determined by the physician at the time, including verbal stimulation of choice such as having her mother present and music of choice or other sounds.
MAY 2002 MOTION FOR TESTING
With opposition from Schiavo and Felos, on July 15, 2002, Greer denied virtually all testing for brain function including a MRI and PET scan as well as the other requests and allowed only three tests---an ultrasound of carotid arteries, a SPECT scan and a transcranial Doppler study.
JULY 2002 NOTICE OF COMPLIANCE
A SPECT scan is used to diagnose Alzheimer's and other neuron-degenerative diseases, stroke, seizure and to evaluate memory loss. Brain SPECT scans may also be used to evaluate brain injury. A SPECT scan is primarily used to view how blood flows through arteries and veins in the brain.
In his September 2002 report to the court, Felos said that "many medical institutions in the community refused to perform such tests on the ward, delaying completion of the tests". The ultrasound was conducted July 30, 2002 at Morton Plant Hospital, the hospital where Michael Schiavo was employed from 1996 until 2004 when Pinellas County Sheriff Everett Rice hired him to be a nurse in the inmate division at the county jail.
NOTICE OF COMPLETION OF SCHIAVO TESTS 9/02
While Michael Schiavo was saying that he would do whatever he could for Terri Schiavo, including new testing and treatment and was in a position to insure that such testing and treatment be conducted in his position at the Morton Plant-Mease Hospital, he was instead consistently attempting to block new testing in the courtroom of George Greer.
Days after his October 2003 statement, his euphoria of Terri's imminent death was dashed when Terri's Law was enacted and Terri was taken for rehydration from the hospice to the emergency room of Morton Plant Hospital where Michael was employed as an emergency room nurse, according to his resume, with the duties of supervising and coordinating emergency department staff and coordinating patient care with co-related departments.
However, instead of keeping his promise and doing "anything he could do to make her well", he and Felos were busy trying to block the reinsertion of Terri's feeding tube and were instead seeking an injunction against Gov. Jeb Bush's order. In his book, "Fighting For Dear Life", David Gibbs III of the Gibbs Firm relates the almost obsessive acts of Felos angrily treading the corridors of his client's employer, Morton Plant Hospital, threatening staff with litigation if they complied with Gov. Bush's order to reinsert Terri's feeding tube in October, 2003.
Felos' September 2002 report to the court said that on Aug. 16, 2002, "the guardian brought the ward to St. Joseph's Hospital" for the Doppler. Repeated applications were done but did not yield results because of the ward's skull thickness and rigidity of her head which prevented necessary manipulation".
The SPECT scan was performed on Aug. 26, 2002, at Largo Medical Center but at the time of Felos' report, the results had not yet been received, according to him. He said the guardian, Schiavo, had been informed by the radiology department that the scan had not been read because of a limited number of doctors equipped to do so.
The Gibbs Firm, representing the Schindler family, had filed a motion with Greer on Feb. 23, 2005, following the release of a new study involving brain imaging conducted at the New York Presbyterian Hospital using fMRIs.
The motion requested "contemporary medical, psychologist, rehabilitative, neurological evaluations of Theresa Marie Schiavo".
Feb. 2005 Medical Test Motion
The motion noted that all previous evaluations were outdated and that the PVS diagnosis had been determined by Greer in 2000.
"It has been at last three years since her mental and physical condition has been exhaustively evaluated", the Schindlers argued, and "11 years since she was provided with any rehabilitative services or any care whose focus was to improve her condition".
"No rehabilitation, no socialization, no therapy, little communication, in a room by herself, without family pictures, sometimes without light. In essence, she has resided sensory-deprived in astoundingly good health in light of her neglect with her food and water being provided to her through a tube that was twice withheld from her that is at all times threatened with immediate permanent removal".
The Schindlers pointed out to Greer that even Michael Schiavo's "expert", Dr. Ronald E. Cranford testified in 2002 that "there has been concerns (sic) about the misdiagnosis of a vegetative state both in terms of false positives and false negatives" (2002 Tr. 1098) He admitted that there are occasions when a patient may be diagnosed as being "in a vegetative state" they'll never recover and they later, six months or a year later, they start recovering and they recover a lot" (2002 TR 1099) Another misdiagnosis he was concerned about was in diagnosing a person as being "in a vegetative state and you examine them and fund out they're not in a vegetative state, they're really minimally conscious or they have more interactivity with their environment or they're even locked in….so obviously diagnosing a patient being in a vegetative state where they're unconscious versus a patient who is locked in who is fully conscious would be a drastically terrible thing to do (2002 Tr. 1099-1100)".
Dr. Joseph Fins, chief of medical ethics division of NY Presbyterian Hospital Weil-Cornell Medical Center stated in February 2005 that "one study found that as many as 30% of patients identified as being unaware in a persistent vegetative state were not , they were minimally conscious.
A 1993 study published in the Neurology Journal found the misdiagnosis rate to be as high as 37%.
A 1996 study conducted by the director of medical services, the senior clinical psychologist and two senior occupation therapists of the Royal Hospital for Neurodisability in London, England resulted in the disturbing finding that "of the 40 patients referred as being in the vegetative state 17, (43%) were considered as having been misdiagnosed, seven of these had been presumed to be vegetative for longer than a year, including three for over four years. Most of the misdiagnosed patients were blind or severely visually impaired. All patients remained severely physically disabled but nearly all were able to communicate their preferences in quality of life issues---some to a high level.
The Schindlers were and are content their daughter had been misdiagnosed as having no prospect of recovery or improvement or that she had moved out of that state and into minimally conscious or locked in stated and that her continued disability was the result of the unconscionable neglect she had suffered at the hands of the guardian, which continued throughout with his repeated refusal to allow new treatment or new testing.
On Feb. 23, 2005, the Schindlers submitted a motion to Greer requesting that Terri be administered the same exact brain function test, the fMRI, that is the focus of the new British study.
The Schindlers petitioned for "extraordinary authority" for the ward to undergo experimental treatment. The request was to grant authority of guardian ad litem to allow Terri to undergo experimental treatment by functional magnetic resonance imaging (fMRI) to determine if she was in fact in a persistent vegetative state or rather in a minimally conscious state and also to receive therapy using the VitalStim swallowing treatments.
The motion referred to the study chronicled in the February 2005 issue of Neurology that revealed the new diagnostic method of discerning that true nature of a neurological challenge. This study conducted at the New York Presbyterian Hospital examined two adult male patients who were in minimally conscious state along with seven healthy volunteers. The test revealed through function magnetic resonance imaging (MRI) that the MCS patients had brain activity that was remarkably similar to their health counterparts when they were subject to memory stimuli. The study revealed that there is a new method of determining brain functions and cognition that was not available in the past.
Schiavo and Felos opposed the motions although Schiavo was still continuing to try and convince the world that he was acting in the best interests of his ward, continuing to maintain that he would seek out any new hope for Terri "in a heartbeat" and maintaining that she wouldn't want any new testing, that she would want to die.
FEB. 2005 MOTION FOR TESTING
Of course he was also claiming that the government was intruding in the life and death decision of himself, Felos and Greer when it was he and Greer that had brought the government into the matter initially when he went to the judicial branch in 1998 seeking an order to kill his wife. He was also trying to maintain that the Schindlers were invading their daughter's right to privacy when it was him on the Larry King show telling a national television audience intimate details about his wife's gynecological condition.
On March 9, 2005, just nine days before Terri's feeding tube would be withdrawn for the last time, Greer refused to allow any attempts to determine if the PVS diagnosis was in error, denying all requests for treatment and testing, saying that the Schindlers' motions were not legally sufficient.
GREER DENIAL ORDER 3/05
Terri Schindler Schiavo deserved the chance to have received treatment with zolpidem. She deserved the chance to have received an MRI to determine if she really was in a persistent vegetative state. Had she had the chance to receive zolpidem, she might have been able to emphatically tell the world what her wishes were, in a clear and convincing matter, rather than based on the self-serving hearsay of Michael Schiavo and the rather obvious concocted belated "memories" of Scott and Joan Schiavo.
 The family of Terri Schindler Schiavo argued in court, pleaded to the public and the media, and petitioned lawmakers to allow similar tests to be preformed before making the irreversible decision to end Terri's life by starvation and dehydration in a torturous manner.
Michael Schiavo didn't keep his promise as he engraved on Terri's gravestone.
He broke his vows, he broke his promise. 9-19-06
All rights reserved. This material may not be published, broadcast, rewritten or redistributed by anyone without the express written permission of the publisher. This article is copyright protected and Fair Use is not applicable.
© 2006 North
Country Gazette
|
