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The Schiavo Tragedy: The end and the legacy PDF Print E-mail
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Sunday, 03 April 2005 10:47
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
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