Monday, March 21, 2005

The Debate Over Schiavo

I hate how this case has forced itself into the public limelight. I hate how I have an opinion over the life (or death) or a woman I've never met, am never going to meet, and who has been in a vegetative state for more than half of my lifespan. Nevertheless, I am dismayed to find I have something to say. Before I delve into that, however, let me digress briefly into a medical overview of the situation. As I'm sure has been posted on nearly every blog from here to the end of time, the definition of a persistant vegitative state is:

PERSISTENT VEGETATIVE STATE This term is commonly, but incorrectly, referred to as "brain-death." It can follow a coma. People in a persistent vegetative state cannot think, speak or respond to commands and are not aware of their surroundings. They may have noncognitive functions and breathing and circulation may remain relatively intact. They also might move spontaneously and even grimace, cry or laugh. Some people might regain some awareness after being in a persistent vegetative state, but others might remain in the state for decades.

Source: National Institutes of Health

The advantage of being a bio major is that I have a basic idea of what this definition means. Unfortunately, the vast majority of mainstream media outlets do not have medical correspondants onhand, or otherwise have done a pretty bad job of explaining how something like this can occur. So, without being too presumptive, let me do a quick and dirty explanation of what's going on, for all the laypeople who perhaps majored in a different (if equally important) field... like political science. Here' s a picture of your average human brain (courtesy of the University of West England):

Okay, keeping in mind that I'm no MD, here's how it works. Your brain is divided into two basic parts: the cerebrum and the cerebellum. Your memory, your thinking, your personality, and basically everything that makes you you takes place and is stored in your cerebrum -- these are what's called your higher brain functions (probably both because it's 'higher' in the brain and because they're considered to be more 'advanced' brain functions... the stuff that distinguishes you from the average tuna).

Meanwhile, tucked at the back of your brain, beneath the cerebrum is your cerebellum. This area is striated rather than covered in curvy brain folds, and it and the spinal cord store all 'lower' brain functions -- the stuff in your body that happens without conscious thought. You can consciously control some of the reflexes that are wired through these areas, but usually, you're not bothering to think about it. Put another way, you don't have to think to get your heart to beat or to take every breath, or even to swallow or move away from painful stimuli. Although you can do some of these things at will, if you had to consciously do all of these things all the time, you would be too busy thinking about keeping yourself alive to think about much else.

In Terri Schiavo's case, her cerebrum is not functioning and she is essentially 'brain-dead', but this is not an accurate term because her cerebellum and her spinal cord are still working; her cerebrum is inactive but her cerebellum is busy doing all those things that don't need the cerebrum. That means that she will have reflexive reactions to some stimul, such as blinking when her eyes are dry, and she may even make noises and move around as her synapses fire at random, but Terri Schiavo's CAT scans have indicated severe deterioration of her cerebrum indicating lack of activity. Basically, everything about Terri Schiavo that made her Terri died 15 years ago, leaving only her body alive.

Cerebrocat, a blogger commentor on ALAS noted:

Regarding the CAT Scan of Terri Schiavo's Brain (follow the link for CAT scan images)

Let me tell you: if you are sufficiently familiar with brains and brain images, you do not need an MRI to tell you how severely the brain in the pictured CAT scan is damaged, nor do you need to see more slices than the one depicted here. This single image shows a very severely damaged brain. The large “blue blobs” in the middle are ventricles, also present in healthy brains (you can see the two little dark crescent shapes in the brain on the right) that have expanded to such a large size because the overall brain volume is so low. Cranial space that would otherwize have been filled by gray matter is now filled with cerebrospinal fluid. And yes, that’s what the blue space is: cerebrospinal fluid that is filling up space left behind by necrotic brain tissue that has been scavenged and removed by the body. The white squiggly things are white matter - connective tracts that have the loose, uncoiled look about them that they do because, again, the grey matter that once compressed them is no longer there, so they “float” loosely in CSF. The gigantic ventricles, expanded white matter, and undifferentiated blue space in that scan all point to the same thing: massive loss of grey matter in the cerebral cortex.

That being said, the Terri Schiavo case isn't actually about Terri Schiavo, nor is it actually about 'brain-dead' patients, Terri Shiavo's loving parents, or her husband. Incidentally, I think Michael Schiavo has gotten a rotten deal in this whole thing. Frankly, I find the fact that Mr. Schiavo has a fiancee and children by her irrelevant to the case, and yet the hyper-moral Christian conservatives cite this as proof irrefutable that he's some sort of Scott Peterson wannabe out for blood. Forget the fact that he's just trying to do what his wife wanted, it's been fifteen years since Terri Schiavo collapsed -- I hardly think it bizarre for him to have moved on in his own life. What I found remarkable is that he actually continues to fight for what she stated her desires were -- putting his own life on hold to continue pursuing Terri's wishes. Meanwhile, regardless of how much the Schindlers love their daughter, I find the dragging of Michael Schiavo's name through the mud to be incorrigible.

This case has quickly devolved into a despicable violation of personal rights and the unconstitutional intrustion of the federal government into private affairs. Last night, I watched as both the House and the Senate passed a bill to send the Schiavo case back to federal court, citing a violation of Terri Schiavo's due process. (Okay, last I checked, this case has been in litigation for nearly 10 years, has gone through 12 courts of varying levels, and even the Supreme Court agreed with the lower court rulings. What more due process could we really be looking for? Isn't it a general misapplication of the justice system if you continue to litigate until you hear not the decision that is fair, but the one that you want to hear, regardless of how many judges have decided against you?)

Despite the fact that this bill deliberately tries not to set precedence, the precedence is already there: the federal government has now established its willingness and ability to intervene in personal affairs. Even if the particular bill cannot be used as precedence, what's to stop other distraught family members from approaching Congress to write another 'case-specific' bill to apply to their injured family member?

More importantly, I can't comprehend how the party of small government, who decry the involvement of the government in most matters of the private sector could possibly be the ones behind this government actions. The conservative party smells more like the liberals, and I for one am starting to feel too libertarian for the room., a conservative blog, writes:

We're not supposed to be the ones calling for government to get involved - yet it was those who want to keep her alive that dragged the government into the mix. We're not supposed to be the ones calling for the federal government to get involved in what is a state matter - yet they did. We're supposed to resist the temptation to have Congress stick its nose into every last thing - yet it is the conservatives in Congress who are trying to pass laws and issuing ridiculous subpoenas to have her testify. What do they expect to do, drag her hospice bed up to Congress, then threaten her with contempt if she doesn't answer the questions? We're supposed to be the ones upset at judges making things up as they go along instead of following what is a pretty clear law. We're supposed to be the ones calling for an end to the creative use of the courts to continually rejudicate what has already been decided over and over and over again. We're not the ones who are supposed to be all for having Hillary's village stick their nose into what is supposed to be a decision for her husband to make (he may be an a**, but he is still her husband), yet we're out there demanding the village do just that.

I might disagree with the rest of ThoughtsOnline's liberal-bashing, but the blogger has noted the same hypocrisy that I have. Again, Bush's 'compassionate conservatives' have wreaked havoc with the limits of the government, and even I, a democrat from Canada feel the politicians have overstepped their bounds. Hell, this is like the Marriage Amendment to the Constitution, all over again -- once more, Bush and his cronies completely ignore the core ideals of the Republican party in favour of pandering to the vocal Christian fundamentalists in their base and end up completely abusing the powers of the government in the process.

Well, thankfully, it seems the majority of America is seeing through this little ploy. ABC News reports that nearly two thirds of Americans felt the Bill that Congress passed last night was inappropriate. Furthermore, 67% of Americans don't buy the faux-concern of politicians like Tom DeLay -- they believe that the motivation of the lawmakers is entirely political, compared to a mere 19% who believe that politicians are genuinely working in Terri Schiavo's interest.

Frankly, I think Terri Schiavo should be allowed to die: she has expressed her desire not to be kept in such a vegetative state (an expression that has time and time again been upheld in court), her parents have had nearly a decade to try and prove their case and have failed to do so every time, and I think it would not only be physically humane for Terri to have her life ended but also to maintain what little dignity she has left and end her surely unwilling affair with the public spotlight. Hell, I'll go a step forward and advocate active right-to-die action rather than the passive removal of her feeding tube, which is the only available option available to Michael Schiavo (Contrary to the argument that he's some sort of sadist who wants to see her suffer, Mr. Schiavo can't legally do anything else to help Terri Schiavo die). Let the doctors give her a quick and painless lethal injection rather than let her suffer through starvation and dehydration (even if I'm sure they'll administer pain-killing morphine).

But, the bottom line is that my, and everyone else's opinions are meaningless. As it happens with the thousands of cases like this one that occur every year, the final decision rests with the family, and it's no one's business, not even Bush's, to intervene.


Blogger phillyjay said...

The whole thing to me is just politics.I think it's really a shame the way she is being used by people outside of her family.

3/22/2005 01:30:00 AM  
Blogger Jenn said...

Absolutely, and I couldn't have said it better myself. At this point, she doesn't have a shred of human dignity left -- she's being paraded around by both sides of her family and her self-serving politicians like some sort of political pinata.

It's kind of disgusting. And yet, like a car wreck, none of us can seem to turn away...

3/22/2005 10:34:00 AM  
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