What the Autopsy Shows

Friday, June 17, 2005

WHEN CONGRESS took the unprecedented step of intervening in the case of Terri Schiavo this year, Senate Majority Leader Bill Frist (R-Tenn.) addressed his colleagues "as a physician." The heart surgeon-legislator had never examined Mrs. Schiavo, but that didn't stop him from questioning the diagnosis of a persistent vegetative state, on the basis of which the Florida courts permitted her husband to remove her feeding tube. "I question it based on a review of the video footage which I spent an hour or so looking at last night in my office here in the Capitol. And that footage, to me, depicted something very different than persistent vegetative state," Mr. Frist said on the Senate floor. "Terri's brother told me that Terri laughs, smiles, and tries to speak. That doesn't sound like a woman in a persistent vegetative state." House Majority Leader Tom DeLay (R-Tex.) also felt qualified to opine: "Terri Schiavo is not brain-dead; she talks and she laughs, and she expresses happiness and discomfort."

In light of such rhetoric, the report of the Pinellas County, Fla., medical examiner on the autopsy performed on Mrs. Schiavo is especially instructive. The report does not conclude specifically that Mrs. Schiavo was in a persistent vegetative state, noting that this is a clinical diagnosis made on living individuals -- not something that can be confirmed or refuted with a postmortem exam. But the report makes clear that Mrs. Schiavo was not, as Mr. Frist and Mr. DeLay suggested, merely disabled. Her brain was "grossly abnormal," less than half the weight of a normal adult her age, significantly less than that of even Karen Ann Quinlan, who famously spent more than 10 years in a vegetative state. She was blind because of "damage and neuronal loss in her occipital lobes," and her "remaining brain regions also show severe . . . injury and neuronal atrophy/loss." In contrast to Mr. DeLay, who proclaimed in March, "It won't take a miracle to help Terri Schiavo; it will only take the medical care and therapy that all patients deserve, " Dr. Jon R. Thogmartin said this week that "no amount of treatment or rehabilitation would have reversed" the damage.

The report, in short, strongly supports the reasonableness of the Florida courts' adjudication of the matter. Its existence implicitly rebukes those armchair doctor-lawyers who -- convinced of a grave legal wrong to a patient they had never seen -- rewrote basic principles of federal law to rig the results of one family's tragic fight.


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