After a dramatic two weeks of the ongoing legal wrangle between the
husband and the blood family of Terri Schiavo, Terri died at age
41. The unfortunate woman died on Thursday in the special medical
facility were she was lying in Pinellas Park, Florida. I heard
the news here in Baghdad at 6:00 PM, the Associated Press news said
that Terri has died few minutes ago.
The drama started on March 18th, when a local court ruled
in favor of the husband’s claim that his wife should be allowed to
die. The claim was that Terri is suffering from an untreatable
medical condition, she had absolutely no chance of recovery, and that
she should be allowed to die in dignity. According to the
husband, he was acting in accordance with Terri wishes having told him
sometime ago that she wouldn’t like to live with life supporting
devices. The court ordered on the advice of 18 highly respected
neurologists who have diagnosed the case as an irreversible advanced
vegetative state implying that she was in a definitely incurable
condition. Acting on the strength of this opinion and agreeing
with the husband’s story, the local court ordered the feeding tube to
be disconnected, in which the patient was receiving her nutrition and
water. This decision by the Florida court started a new and a
very heated round in the seven years old legal battle between the
husband who was her legal guardian and the blood family who insisted
that the tube should be reinstated. The removal of the tube was
tantamount to a death sentence, when Terri was still alive and there
was a reasonable hope of at least some recovery--in spite of the fact
that she has been in that state for fifteen years.
In my last
letter to this site I have tried to explain some of the basic facts
about the vegetative state, why it happens. I explained some of
the basic scientific facts involved in its occurrence, especially the
ones which are related to the brain’s structure, its metabolism and its
functions. My letter was received reasonably well, but also with
a good deal of criticisms and annotations which I accept and will try
to clarify now.
The brain is a very active organ its metabolic
activities require very high levels of oxygen and glucose, which have
to be provided constantly and very critically controlled. Any
interference with this vital supply even for extremely short periods
can result in very serious damage to the brain and consequently to its
functions. The different parts of the brain vary slightly with
its capacity to sustain such a deprivation, the dome shaped uppermost
part, the cerebrum and its cortex [the grey matter] is very sensitive
and cannot withstand its deprivation of the needed oxygen and glucose
for more than a few minutes, which results in the loss of its functions
the so called higher functions which I have described in my previous
letter. The part which lies below the cerebrum, the brain stem
can survive for slightly longer periods and its functions the
spontaneous, the more or less automatic ones like breathing and eating
can still go on. If someone has suffered a medical mishap that
has resulted in a brain deprivation long enough to damage the cerebrum,
but not long enough to damage his brain stem, he or she will end up in
what is called a vegetative state. In a vegetative state, the
sufferer looses the cerebral functions, but can breathe and eat
admittedly sometime with the help of minor gadgets like a feeding
device or a tracheotomy tube and the like. Someone in a
vegetative state is not dead, an individual is dead when his heart has
stopped beating and his breathing has stopped and when his brain
electrical activities have disappeared completely.
A vegetative
state is not a simple medical condition, someone in such a state is a a
very sick patient and needs very special care which usually takes very
long periods of time at the hands of specially trained personnel
usually in special centers which are well equipped to deal with such
conditions. A vegetative state creates unusual stresses and
engenders immense moral ethical and financial problems, but it is worth
it because there are very good records of patients in that condition
who have recovered sometimes very dramatically. Everything
depends on those very few minutes of the brain’s denial of the
essentials whose effects also vary from one person to another, there is
not one clinical type of the condition, there is a wide spectrum of
cases. Terri Schiavo has been in such a state for fifteen years,
which has caused a great squabble between her husband who as her legal
guardian wanted to terminate her life and her family who thought that
she was not dead and that she still had a chance of a reasonable
recovery. A squabble to which the judiciary system was drawn
during the last seven years.
On March 18th, a local
court in Florida in response to a petition by the husband that the
feeding device be removed. The court agreed and the tube was
disconnected, but the family retaliated by going through all the levels
of the judiciary system up to the Supreme Court, which upheld the
decisions of the lower courts and sealed the fate of the unfortunate
woman, and suddenly there was a small flicker of hope. In one of
the rare successes of the family, a federal appeals court agreed on
Wednesday of the second week to consider an emergency motion by them
requesting a new hearing on whether to reconnect the feeding
device. This proved to be no more than a mirage, because the same
court in the end endorsed the decision to keep it disconnected.
Again, the family returned to the Supreme Court, which once more after
less than two hours of deliberations rejected the parent’s latest
request to have the feeding tube be reinserted. The ill fated
woman has by then been without food and water for almost two weeks.
Terri
Shiavo died in her hospice in Florida at 9:05 AM Thursday, March 31,
2005. Her death plunged America in one of its most serious
internal crises of modern times. An already badly polarized
society became even more polarized. Terri has left an astonishing
legacy, her death has precipitated a great debate on the meaning of
life, who grated it, who is responsible for its continuation and who
has the right to terminate it.
Dr. Najeeb Hanoudi
Baghdad, April, 2, 2005
email:
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