Terri Schiavo's CT scan another physician's opinion

The amount of medical misinformation put out about Terri Schiavo has been truly stunning. The testimony of Terri's physicians who believe that some recovery is possible has been largely dismissed. Judge Greer's court and the media in turn, have focused only on the pessimistic interpretations of the raw data of her CT scan.

A physician at a credible physicians' website  has analyzed Terri's CAT scan and concludes that it has been grossly misrepresented. There is some cerebral atrophy, but it is a completely inaccurate to characterize it as 'bag of water.' Furthermore, the author states that

'the most alarming thing about this image, however, is that there certainly is cortex left. Granted, it is severely thinned, especially for Terri's age, but I would be nonplussed if you told me that this was a 75 year old female who was somewhat senile but fully functional, and I defy a radiologist anywhere to contest that.'

In one of the definitive court battles in 2002, five physicians examined Terri to determine if therapy would be of further benefit. Two chosen by Terri's parents believed that she was not in a 'persistent vegetative state' and that some recovery was possible. Two chosen by Michael Schiavo held that she had no chance of recovery, as did the 'neutral' physician appointed by the court. This 3—2 decision was key in the 2003 attempt to pull her feeding tube. 

One of Michael Schiavo's medical experts was the right—to—die advocate Dr. Ronald Cranford, who has been an expert in a number other key court cases on our nation's slippery slope to euthanasia, including those of Nancy Cruzan and Robert Wedlund. But Dr. Cranford has made serious errors in other cases when prognosticating about the prospects of neurological recovery. Frederica Mathewes—Green states that Sgt. David Mack, who was shot in the line of duty as a policeman, was diagnosed by Cranford as

"definitely...in a persistent vegetative state...never [to] regain cognitive, sapient functioning...never [to] be aware of his condition."

Twenty months after the shooting Mack woke up, and eventually regained nearly all his mental ability. When asked by a reporter how he felt, he spelled out on his letterboard, "Speechless!" 

In fact, the entire field of diagnosing 'persistent vegetative state' or 'PVS' is fraught with inaccuracy.  Recent studies have shown the rate of misdiagnosis to be as high as 37%  or even  43%. PVS is a clinical diagnosis, meaning that it depends on the subjective judgment of the examining physician. Experts in the field cannot even agree on the usefulness of diagnostic imaging.

Dr. Ronald Cranford himself was upset about the articles showing the inaccuracy of diagnosis and prognostication about PVS. Childs and Mercer, authors of one of the studies citing the difficulties of diagnosing  PVS, took Cranford to task for 'zealously' promoting the concept of the "permanent vegetative state" despite the evidence of its problematic nature, and the regularity with which some patients recover from it   .

The nomenclature of 'persistent vegetative state' was coined in 1972 by Jennett and Plum in the prestigious medical journal The Lancet.  The original article, 'Persistent Vegetative State: A syndrome in search of a name' seems to have succeeded in its task as reclassifying severely cognitively disabled humans as non—persons — something akin to vegetables in the minds of many. Public perception of this highly—charged term predisposes many to dismiss the lives of human beings as no more significant than plant life. It is a brilliant, if chilling, masterstroke of propaganda, one which has been swallowed hook, line, and sinker.

This reclassification of non—terminally ill people has allowed for their dehydration and starvation deaths in Britain with a doctor's recommendation, and in many states in the USA with the family's wishes (or a patient's own advance directives). The medical literature is rife with arrogant pronouncements in editorials of learned journals, such as life itself not being of 'benefit' to someone in the PVS state. The echoes of current bioethics doublespeak resound in these journals.

In some respects the 'persistent vegetative state' is more a political than a medical diagnosis, as it allows its unfortunate victims to lose their right to life and be medically killed through withholding food and water. It is unfortunate that some of the experts on the side of the Culture of Death seem to have had the upper hand in Terri's fight, and have been portrayed by the media as reasonable and responsible members of the medical profession, rather than the zealots which, in fact, some of their own medical colleagues have branded them.

The amount of medical misinformation put out about Terri Schiavo has been truly stunning. The testimony of Terri's physicians who believe that some recovery is possible has been largely dismissed. Judge Greer's court and the media in turn, have focused only on the pessimistic interpretations of the raw data of her CT scan.

A physician at a credible physicians' website  has analyzed Terri's CAT scan and concludes that it has been grossly misrepresented. There is some cerebral atrophy, but it is a completely inaccurate to characterize it as 'bag of water.' Furthermore, the author states that

'the most alarming thing about this image, however, is that there certainly is cortex left. Granted, it is severely thinned, especially for Terri's age, but I would be nonplussed if you told me that this was a 75 year old female who was somewhat senile but fully functional, and I defy a radiologist anywhere to contest that.'

In one of the definitive court battles in 2002, five physicians examined Terri to determine if therapy would be of further benefit. Two chosen by Terri's parents believed that she was not in a 'persistent vegetative state' and that some recovery was possible. Two chosen by Michael Schiavo held that she had no chance of recovery, as did the 'neutral' physician appointed by the court. This 3—2 decision was key in the 2003 attempt to pull her feeding tube. 

One of Michael Schiavo's medical experts was the right—to—die advocate Dr. Ronald Cranford, who has been an expert in a number other key court cases on our nation's slippery slope to euthanasia, including those of Nancy Cruzan and Robert Wedlund. But Dr. Cranford has made serious errors in other cases when prognosticating about the prospects of neurological recovery. Frederica Mathewes—Green states that Sgt. David Mack, who was shot in the line of duty as a policeman, was diagnosed by Cranford as

"definitely...in a persistent vegetative state...never [to] regain cognitive, sapient functioning...never [to] be aware of his condition."

Twenty months after the shooting Mack woke up, and eventually regained nearly all his mental ability. When asked by a reporter how he felt, he spelled out on his letterboard, "Speechless!" 

In fact, the entire field of diagnosing 'persistent vegetative state' or 'PVS' is fraught with inaccuracy.  Recent studies have shown the rate of misdiagnosis to be as high as 37%  or even  43%. PVS is a clinical diagnosis, meaning that it depends on the subjective judgment of the examining physician. Experts in the field cannot even agree on the usefulness of diagnostic imaging.

Dr. Ronald Cranford himself was upset about the articles showing the inaccuracy of diagnosis and prognostication about PVS. Childs and Mercer, authors of one of the studies citing the difficulties of diagnosing  PVS, took Cranford to task for 'zealously' promoting the concept of the "permanent vegetative state" despite the evidence of its problematic nature, and the regularity with which some patients recover from it   .

The nomenclature of 'persistent vegetative state' was coined in 1972 by Jennett and Plum in the prestigious medical journal The Lancet.  The original article, 'Persistent Vegetative State: A syndrome in search of a name' seems to have succeeded in its task as reclassifying severely cognitively disabled humans as non—persons — something akin to vegetables in the minds of many. Public perception of this highly—charged term predisposes many to dismiss the lives of human beings as no more significant than plant life. It is a brilliant, if chilling, masterstroke of propaganda, one which has been swallowed hook, line, and sinker.

This reclassification of non—terminally ill people has allowed for their dehydration and starvation deaths in Britain with a doctor's recommendation, and in many states in the USA with the family's wishes (or a patient's own advance directives). The medical literature is rife with arrogant pronouncements in editorials of learned journals, such as life itself not being of 'benefit' to someone in the PVS state. The echoes of current bioethics doublespeak resound in these journals.

In some respects the 'persistent vegetative state' is more a political than a medical diagnosis, as it allows its unfortunate victims to lose their right to life and be medically killed through withholding food and water. It is unfortunate that some of the experts on the side of the Culture of Death seem to have had the upper hand in Terri's fight, and have been portrayed by the media as reasonable and responsible members of the medical profession, rather than the zealots which, in fact, some of their own medical colleagues have branded them.