Fwd: cruzan v schiavo what a difference a decade makes

I originally posted this just to Jack intending to be the whole list.
Here's my post, with jack's reply to follow.

Iain.

---------- Forwarded message ----------
From: Iain Strachan <igd.strachan@gmail.com>
Date: Thu, 24 Mar 2005 11:01:32 +0000
Subject: Re: cruzan v schiavo what a difference a decade makes
To: jack syme <drsyme@cablespeed.com>

Jack,

I'll freely admit I've wavered between both sides of the argument. At
first sight, I sided with those who want to save Terri - it seemed
cruel and inhumane - I was too easily persuaded by the emotional side
of the argument.

Then as I worked my way through the thread, I was beginning to be
persuaded by your arguments.

Then on reading the lawyer's testimony, I started to swing back the
other way. I agree with you that you don't know how much of what the
Schindlers' attorney said was accurate - and she is not an expert.

However, I came across this one today:

http://www.terrisfight.net/documents/032305cheshire.pdf

... again admittedly from a propaganda site, but this time from a
practising neurologist. Unfortunately the quality of the pdf is poor.
 He argues that very often relatives of PVF patients have false hopes
because of the occasional responses they see. However, he argues that
from his observations (much as the Schindler's attorney argued, and I
have said here as well), of consistent emotional responses to loved
ones, expressions of delight (e.g. when listening to music) etc, that
a more valid diagnosis would be a "Minimially conscious state", rather
than PVS, and that as a result, Terri can feel pain, and very likely
also experience pleasure. He also argues that the last time Terri had
a neurological examination, the "minimally conscious" diagnosis had
not emerged as a separate condition, but that medical science had
advanced since then.

I suppose part of my gut feel here is influenced by some of my own
voluntary work which involves talking to people who are suicidal, and
often suffering from suicidal depression. When severe, and in a
suicidal state, such people have lost the ability to experience
pleasure and to see anything at all positive about life. The
organization ( UK Samaritans) actually supports peoples' right to
commit suicide ( something that I have some difficulty with), but in
the Schiavo case, I see, on the face of it, and now with the opinion
of a neurologist, a person capable of experiencing pleasure and pain,
who is having the decision to commit suicide made for her (her partner
decides that she would not want to live on in this state - I would
take "not wanting to live on" as a suicidal desire). If she were
without doubt PVS, then (as the neurologist in the above article has
said also), there would be no problem IMO in withdrawing the feeding
tube. But it seems to me there is reasonable room for doubt. After
all the experts weren't unanimous - it was only 3 out of 5. I don't
know why the judge chose to think the other two weren't valid - maybe
because they were chosen by the Schindlers?, but then you could
equally say it's suspicious that the two exports chosen by Michael
Schiavo were in favour of the PVS diagnosis.

I hope no one minds my dragging this up again.

Iain

On Wed, 23 Mar 2005 20:01:03 -0500, jack syme <drsyme@cablespeed.com> wrote:
> oops i meant to post that to the entire list.
>
> But that is what I mean. How much of that observation in accurate? There
> is no way to know. I do know the qualifications of the people that examined
> her. So I am taking the testimony of three professionals over this
> anecdote. There are things that I have heard that would be inconsistent
> with PVS, but I have not examined her. I doubt that the 3 individuals have
> an ulterior motive, and I doubt that the judge has an ulterior motive when
> he thought the other two were not as credible.
>
> On the other hand, does it make that much difference if she has 1% or 10%
> or 50% of her cortex vs zero? I think that if her condition is such that
> her appropriate surrogate thinks that she would not want to continue in that
> condition, then I think withdrawing is appropriate.
> ----- Original Message -----
> From: "Iain Strachan" <igd.strachan@gmail.com>
> To: "jack syme" <drsyme@cablespeed.com>
> Sent: Wednesday, March 23, 2005 7:16 PM
> Subject: Re: cruzan v schiavo what a difference a decade makes
>
> > Jack,
> >
> > Thanks for taking the time to write this explanation. My only
> > connection with things neural is my research into Artificial Neural
> > Networks, which only tangientially pay lip service to the biology.
> >
> > It's clear the article is written in a way to manipulate you into one
> > way of thinking, as I said in the post. However, there is one point
> > I'd take issue with. You stated:
> >
> > But the cortical functions are lost with the death of cortical neurons,
> > the
> > ability to speak, understand, remember, think, plan, comprehend ones self,
> > recognize loved ones, any of those functions that you associate with a
> > person, and with thinking. So a person in a PVS opens their eyes, has
> > reflex grimacing and smiling, wakes up, goes to sleep, breaths without a
> > machine. But cannot swallow, use their limbs, or interact with the
> > environment in any consistent or meaningful way.
> >
> > ... but it seems to me that some of what the article was describing,
> > e.g. the following ritual with the "lemon face" when Dad went to kiss
> > her with his mustache, was evidence of remembering, recognizing a
> > loved one and being consistent.
> >
> > ---
> > When her father greets her, he always does the same thing. He
> > says, "here comes the hug" and hugs her. He then says, "you know
> > what's coming next---the kiss." Her father has a scratchy mustache and
> > both times when he went through this little joke routine with her, she
> > laughed in a way she did not do with anyone else. When her father is
> > ready to plant the kiss on her cheek, she immediately makes a face her
> > family calls the "lemon face." She puckers her lips, screws up her
> > whole face, and turns away from him, as if making ready for the
> > scratchy assault on her cheek that she knows is coming. She did the
> > exact same thing both times that her father initiated this little
> > routine joke between the two of them.
> > ----
> >
> > This doesn't seem to agree with your definition of PVS. On the face
> > of it, this looks like a remembered joke, rather than a random reflex
> > that only has the appearence of purposefulness. That's why I posted
> > the article ... despite the emotionalism, and manipulation of the
> > reader, there seemed to me to be some real observations of behaviour
> > that differed from what one might expect.
> >
> > Iain.
>
>

--
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There are 3 types of people in the world.
Those who can count and those who can't.
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-- 
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There are 3 types of people in the world.
Those who can count and those who can't.
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