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« Terri Schindler-Schiavo: Michael's center of the self... | Main | Federal Vote Charges Filed In Milwaukee »

June 22, 2005

Schiavo: Dr. Sherry Eros too...

Filed in: Bioethics, Current Affairs, Politics

So, you think I jumped the gun? Spoke out too soon? Should I just apologize and move on?

Dr. Sherry Eros (M.D.), on her blog Eros Colored Glasses, weighs in with a long post on the autopsy of Terri Schiavo. The post begins with:

By reference to the medical literature adduces evidence that a substantial portion of the loss in Terri's brain weight observed postmortem may have been due to the dehydration to which she was subjected.

And follows in her discussion with:

With respect to the question of PVS, Terri's autopsy is perfectly incapable of providing instructive answers. While a marked loss of brain weight or volume after surgery or other brain insult is "consistent with" PVS, it is equally "consistent with" a minimally conscious state or even a fully conscious state. The level and state of consciousness is a function of a variety of factors most of which are not meaningfully illuminated by an autopsy--or brain weight. Most hemispherectomy patients return to a fully conscious state, with restoration of cognitive and other abilities, despite suffering loss of half, or nearly half, of their brain weight. At least as important as the brain's weight is the determination of which areas of the brain are lost to surgery, trauma or other forms of insult.

And notes this paper which reports that PVS diagnosis may have an error rate as high as 43%. The referenced paper presents these key messages:

Many patients who are misdiagnosed as being in the vegetative state are blind or have severe visual handicap; thus lack of eye blink to threat or absence of visual tracking are not reliable signs for diagnosing the vegetative state
Any motor activity, no matter how slight, that can be used for communication by the profoundly disabled patient should be identified at an early stage and repeated at regular intervals

Identification of awareness in the presence of profound and complex neurological disabilities requires the skills of a multidisciplinary team expe- rienced in long term management of disability due to brain damage

Dr. Eros' post is worth the long read.

The truth will be known.

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