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I am not a doctor but I read that as much as 60% of those diagnosed as being in a persistent vegetative state. I understand there's a great deal of difference between a terminal patient on life support being allowed to die by withholding nutrition or pulling the plug and a brain-damaged woman who is otherwise healthy, who interacts with her parents and who requires only nursing care and food and water. Removing food and water from such a person is painful and excruciating shocks the conscience. After all we do not allow death by starvation for convicted murderers or terrorists or dogs.

Reverend Robert Johansen writes that he has affidavits or spoken to 50 board-certified neurologists who are willing to testify that Terri should be re-evaluated. http://www.nationalreview.com/comment/johansen200503160848.asp.

All the time her husband has been guardian, he has allowed no rehabilitation therapy and has not appeared to have acted in her best interests. Sufficient questions have been raised about the judge, the husband and the attorney and their interlocking ties to question their motivations. However, since such great deference is afforded family and probate court judges, their rulings are very rarely overturned by appelate courts except on matters of law.

The Congress has given the federal courts jurisdiction to review whether state courts have afforded due process to individuals claiming under the 14th amendment, This has been an important venue during the civil rights struggle and for criminals. What you are now seeing is the Congress looking to expand habeas corpus protection to incapacitated people whose life support is about to be removed by judicial order and who have left no written directives.

I for one support this important but narrow expansion of federal jurisdiction, this one last look before a person is condemned to death by starvation. I write more about this at Legacy Matters www.estatevaults.com/lm

Why has no MRI or PET scan been performed to have exact certainty of the state of Terry Schiavo's brain? This would end, one would hope, all debate and retrenchment over her condition.

It was my understanding that there have been numerous MRIs and PET scans performed, the problem is that the interpretation of these scans is up for debate.

There have been no MRIs or PET scans for Terri. The husband hasn't wanted them. Judge Greer hasn't ordered them.

First some ethical thoughts, then some legal/policy thoughts:

Clearly, death by starvation is miserable to anyone who can feel "hunger pangs" and other, more clinically severe sensations that go along with the process of dehydration and starvation. So the question with a PVS patient is, is there anybody home to feel that?

It does not follow that, in order to suffer, one has to have the facility of memory, or cognition or emotion.

It seems to me that in the absence of overwhelming evidence to the contrary (does such evidence exist?), it should be assumed that a PVS patient can feel, and therefore, if you're going to facilitate death, painless, quick euthanasia ought to be substituted for starvation.

Now as for the legal- my gut bothers me at the notion of Congress interceding at such a basic level. However, in order to pass constitutional muster (which I'm still not sure it will be found to have done) this bill is extremely narrowly tailored.

All it does is give jurisdiction to the federal courts for a de novo factual review. In other words, instead of arguing various legal abstractions based on constitutionality or a particular error, the case can be reviewed from scratch with new testing and new evidence. That's something that has not been done in (I believe) about 8 years.

The -facts- of this case have had two hearings, both in front of the same judge, and then there were appellate hearings after each one (I'm not 100% on that procedural history, but that's what I understood from a quick review of various sites and blogs).

However, in Debember of 2003, a Ph.D. J.D. "guardian", appointed by governor Bush made an exhaustive review of the case, consulting with family members, physicians, legal experts and bioethicists, and going through over 30,000 pages of documents. I read through that report last night. This guardian concluded (in a heartfelt and fairly well-thought-out argument) that the facts of the case had been clouded and obscured by the enmity of the parties.

This guardian recommended that new medical testing be done, and applied for a renewal of his commission to continue working with the family. As it turned out, the guardian's application was denied, because a court ruled that the governor had no constitutional business appointing the guardian, to begin with.

As much as I hate to see this issue as a political football, and as much as I am troubled to see Congress working at this level, I have to say that I think a de novo factual review, controlled by a no-nonsense federal judge would not be a bad thing, in this particular case.

Of course, there are many like Terri Schiavo, who are not getting this kind of press. I don't know what the policy ramifications are of removing cases of this sort (no living will; disputed state-of-consciousness) to federal court.

Ought we to give these cases death penalty process, letting them wend their way through the state ranks, then to the Supremes, and then bounced down to the Federal track, to make their way back up again? Few patients would live that long, and what torture for the families! I am sure that such a policy should not be decided upon in an emotion-charged weekend.

My own intuition--what about just keeping them in the state court system, but perhaps making it easier for new facts to be introduced at later stages, or for a de novo hearing to be ordered. That might speed up process and avoid redundancy, without all this hand wringing over being stuck with an eight-year-old set of disputed facts.


Really, the courts are an absolute last resort for things like this. They belng in the hands of families, medical professionals, -invited- clergy, and talented bioethics-trained counselors and mediators.

Once you get into the battlegrounds of court, the family has lost, no matter who "wins".



A commenter over at Volokh Conspiracy supplied a link to this website

http://www.realcities.com/mld/krwashington/11175622.htm

There is an excellent interview with the guardian to whom I referred in my comment. His voice is the most trustworthy of all I have heard in this struggle... too bad he didn't have constitutional standing to finish what he was doing. Perhaps the federal judge will continue along these lines, do a bit of fact-gathering, and bring this scenario to a merciful end.

I commented earlier on the ethics of starving a PVS patient. Apparently it is fairly well-established that they do not suffer. Here's the link to a good article on the issue.
http://www.washingtonpost.com/wp-dyn/articles/A58175-2005Mar22.html

The only people debating the results of the tests are doctors being paid by the parents who can't accept the loss of their daughter. It apalls me that the governor, congress, and president have pandered to the conservative constituancy by their actions. The husband should be allowed to carry out her wishes without legislative interference.

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