AP Robert Schindler Obit Misrepresents Terri Schiavo Autopsy Results, Ignores Subsequent PVS Awakenings and Research
Robert Schindler, father of Terri Schindler Schiavo, has passed away. Condolences to his courageous family and friends.
Associated Press writer Kelli Kennedy’s coverage of Mr. Schindler’s death, and her recounting of the Terri Schiavo story, is a mixed bag.
On the one hand, she writes that “the feeding tube that had nourished her for years was removed according to her husband’s wishes.” I would expect that Michael Schiavo, who consistently said for years that withdrawing nourishment is what Terri would have wanted, and that he pursued that end “purely based on her wishes,” will be miffed at Kennedy’s assertion. Too bad, so sad, Mike. Your own words in the legal record say otherwise; Ms. Kennedy is correct.
But Ms. Kennedy erred in her single paragraph about Terri’s autopsy, continuing an incorrect media meme that has persisted for years:
An autopsy supported Michael Schiavo’s contention that she was in a persistent vegetative state with no consciousness and no hope of recovery.
It’s as if there was no support for contrary contentions. That implied assertion is patently false.
Michelle Malkin wrote a scathing June 16, 2005 critique of the developing Terri Schiavo media mythology. That critique stands up very well four years later:
You do not need a medical examiner’s license to see that the (autopsy) report raises many more questions than it answers, though from the (once again) misleading media coverage, we are led to believe that the matters of Terri’s life and murder are resolved. They are not.
(A BBC report states that) “An autopsy report on a brain-damaged woman at the centre of a long legal battle in the US has shown that she suffered no trauma before her collapse.”
But on page 4 of the M.E.’s summary, what the report actually says with regard to possible strangulation is this: ”Autopsy examination of her neck structures 15 years after her initial collapse did not detect any signs of remote trauma, but, with such a delay, the exam was unlikely to show any residual neck findings.”
….. in countless newspaper articles over the past 15 years, and during his successful malpractice trial against Terri’s primary care physician, Michael Schiavo stressed his wife’s bulimia-related low potassium level as the cause of her initial collapse. Schiavo won $1 million in damages on the grounds that Schiavo’s obstetrician had failed to diagnose bulimia.
Unquestioning journalists ran dozens of stories echoing the claim: “Eating disorder is real issue in Schiavo case.”
….. The autopsy report spends three-and-a-half pages debunking Schiavo’s claim, as well as the related claim that she had a heart attack (or, more medically precise, myocardial infarction). But if mentioned at all, the news reports I have seen have downplayed and buried these astonishing revelations (revelations which bear directly on Schiavo’s credibility regarding his claim that Terri would have wanted to die).
In Michael Schiavo’s favor, the autopsy report also casts doubt on the Schindler family’s long-held view that a 1991 bone scan indicated traumatic injury.
….. However, the report notes this caveat: “Without the orginal bone scan and radiographs from that period, no other conclusions can [be] reasonably made.”
Michelle went on to note the establishment media’s dogged insistence that the autopsy results supported the idea that Terri was in a “persistent vegetative state” (PVS).
But before Terri’s death, at least two prominent neurologists insisted that Terri was not in that condition. Additionally, the final sentence of Chief Medical Examiner Stephen J. Nelson’s report to the 10th Judicial Circuit of Florida (at Page 20 of the 39-page PDF) cautioned that:
Neuropathological examination of the decedent’s brain — or any brain, for that matter — cannot prove or disprove a diagnosis of persistent vegetative state or minimally conscious state.
Since Terri’s death, TerrisFight.org, the web site of the Terri Schindler Schiavo Foundation, has compiled a list of 14 people who have emerged from PVS. It also cites four sources of subsequently published information contending that PVS is often misdiagnosed, and that in any event recovery from it is more than a long-shot possibility. One of them from June 2007 leads with these two paragraphs:
New studies underline the importance of extreme caution in any decision to limit the life chances of patients during the acute phase of a vegetative state.
Around a quarter of patients in an acute vegetative state when they are first admitted to hospital have a good chance of recovering a significant proportion of their faculties, and up to a half will regain some level of consciousness, researchers from Belgium found out. Another study shows that around 40% of patients were wrongly diagnosed as in a vegetative state, when they in fact registered the awareness levels of minimal consciousness. Comparing past studies on this issue shows that the level of misdiagnosis has not decreased in the last 15 years. These studies should foster debate about appropriate standards of care for these patients, and about end of life limitations, experts said ….
It should also never be forgotten that Terri’s condition at the time of her death might have been very different had her care been adequate during the years after Michael Schiavo won his malpractice lawsuit. There’s more than a little bit of evidence that her care was far, far less than perfect.
Michelle Malkin’s bottom line is the real takeaway:
Terri Schiavo, a profoundly disabled woman who was not terminally ill and who had an army of family members ready to care for her for the rest of her natural life, succumbed to forced dehydration at the hands of her spouse-in-name-only.
Out of respect for Mr. Schindler, who would surely and correctly have disputed her write-up, the AP’s Kennedy would have been better off not mentioning the autopsy at all. Whether deliberate or not, its insertion and characterization come off as “let’s get one last dig in while we can” opportunism that at least used to be considered unbecoming of an alleged professional journalist writing an obituary.
Cross-posted at NewsBusters.org.
“But before Terri’s death, at least two prominent neurologists insisted that Terri was not in that condition.”
Only one of the people in that story was a neurologist.
Comment by Sans — August 30, 2009 @ 5:43 pm
#1, Author Steve Ertelt uses the plural version of “neurologist” twice in his report.
So, between Dr. Joseph Fins of New York Presbyterian Hospital/Weill Cornell Medical Center and Dr. William Cheshire of the Mayo Clinic in Jacksonville, which one do you have a problem with?
Fins is part of an outfit that “established its formal Division of Medical Ethics in the spring of this year to be a resource throughout the institution on such questions as cloning, physician-assisted suicide, managed care, and the regulation of clinical research in genetic engineering and the neurosciences.” Fins’s chops are plenty strong, given that:
Nature is a respected peer-reviewed publication (usually), doncha think?
Cheshire is apparently a neurologist in practice.
And here’s a third, in case you’re interested.
I would suggest that it’s likely you don’t have to be a practicing neurologist to be considered one. Even if that’s the case, the two gentlemen are both clearly neurologically knowledgeable, and you’re quibbling over absolutely nothing substantive. You are, however, welcome to prove either of them incompetent to say what they said. Good luck.
There is a third doc mentioned near the end: “Dr. David Stevens, the president of the Christian Medical Association.” No one said he’s a neurologist.
Comment by TBlumer — August 30, 2009 @ 7:24 pm
For the love of Pete, Tom, he’s down! He’s down!
Slamming/embarrassing your dissenters with THAT much truth will definitely yield “thumb hut feeeallwings.”
lol…
Comment by Rose — August 30, 2009 @ 8:50 pm
#3, I would have stopped at two but for the fact that he was going after the indispensable Mr. Ertelt at Life News, who wasn’t around to defend himself.
Maybe I should have recommended a few good nights with Levin’s “Liberty and Tyranny” as a parting gift.
Comment by TBlumer — August 30, 2009 @ 9:04 pm
The fact that Schiavo actually won his malpractice suit still boggles me after all these years.
Comment by zf — August 30, 2009 @ 10:57 pm
It’s so sad to hear this news. Obviously the horror of seeing his daughter starved to death contributed to Mr. Schindler’s death. It’s too bad they never performed a full investigation about the night Terri was injured.
Comment by Myblogspan — August 31, 2009 @ 2:14 am
“#1, Author Steve Ertelt uses the plural version of “neurologist” twice in his report.”
Then he would appear to be misrepresenting who he was referring to.
“So, between Dr. Joseph Fins of New York Presbyterian Hospital/Weill Cornell Medical Center and Dr. William Cheshire of the Mayo Clinic in Jacksonville, which one do you have a problem with?”
The first one, who doesn’t say he holds this qualification/speciality/expertise/practice experience in his own bio.
Quote:
————
Clinical Expertise
* Internal Medicine
* Medical Ethics
Medical Practice(s)
* Medical Ethics
————
The word only appears in his bio in a sentence which begins “His current scholarly interests include include ethical and policy issues in…”.
If this counted for anything then I’m a gynecologist.
Comment by Sans — August 31, 2009 @ 5:40 am
#7, as stated already, the gentlemen in question is a co-author of a neurologically-related research paper in Nature, a respected, peer-reviewed publication.
My central point stands:
the two gentlemen are both clearly neurologically knowledgeable, and you’re quibbling over absolutely nothing substantive. You are, however, welcome to prove either of them incompetent to say what they said.
You have not done that. I believe it’s because you can’t. Until you do that, you’re critique is meaningless rubbish.
Comment by TBlumer — August 31, 2009 @ 5:52 am
“Fins’s chops are plenty strong, given that”
Oh I see you’ve actually read the bio where he claims no such qualification, speciality or experience. Yet somehow you’ve taken that as an affirmation. How odd/dishonest.
“His current scholarly interests include ethical and policy issues in brain injury and disorders of consciousness, palliative care, research ethics in neurology”
Yes, the key phrase “his interests” being somewhat more pivotal than “neurology”. If we add “Smurfs” to the sentence he merely becomes interested in Smurfs rather than becoming one.
You’ll also note that his interest is in the policy and ethics issues relating to these topics. If it was cost/benefit analysis instead, then either you think the accountant becomes qualifies to study your brain or you don’t. You don’t. Nobody does. Because it’s a ridiculous claim.
“Nature is a respected peer-reviewed publication (usually), doncha think?”
I think this has no bearing on anything. If you believe the topic on which you write grants you qualifications in that field then you’ve got a great money saving tip for a lot of medical students. Come to think of it, they could just all become statisticians and become qualified in every field they crunch numbers on, medical findings included.
“I would suggest that it’s likely you don’t have to be a practicing neurologist to be considered one”
I would suggest this makes you spectacularly ignorant or dishonest. I’m beginning to suspect it’s the latter.
“Even if that’s the case, the two gentlemen are both clearly neurologically knowledgeable, and you’re quibbling over absolutely nothing substantive.”
You cited this article to substantiate a claim. I merely pointed out that claim was incorrect. If it’s insubstantial then remove it now that you know it is incorrect.
“For the love of Pete, Tom, he’s down! He’s down! ”
You appear to be posting in the wrong thread.
“#3, I would have stopped at two but for the fact that he was going after the indispensable Mr. Ertelt at Life News, who wasn’t around to defend himself.”
Stopped at two what? You’ve written nothing which disputes the man is not a neurologist. You’ve merely told us you’re willing to be dishonest and make yourself look like a complete fool in order to defend an incorrect claim which you deem insubstantial.
Comment by Sans — August 31, 2009 @ 6:04 am
#8, your comments are about as pathetic as I’ve seen in a while, and that’s saying something.
Once again, my central point stands, but I guess I need to emphasize it:
And I gave you a third gentleman’s link, in case you ever want to get to the substance of Ms. Schiavo’s condition.
Comment by TBlumer — August 31, 2009 @ 6:09 am
“My central point stands:”
“the two gentlemen are both clearly neurologically knowledgeable, and you’re quibbling over absolutely nothing substantive. You are, however, welcome to prove either of them incompetent to say what they said.”"
“You have not done that. I believe it’s because you can’t. Until you do that, you’re critique is meaningless rubbish.”
No, my critique stands since your point is irrelevant.
I haven’t disputed any claim that these men made. I’ve disputed you when you claimed they were both neurologists. I doubt anyone disputes that your responses here prove you incompetent to claim what you have. Specifically that you know what does/doesn’t make someone qualified in a given area of medicine.
Just out of interest, what other phenomenally complex areas of expertise which traditionally require years of study, the best part of a million dollars of tuition and continual competency based training to maintain qualifications for, can instead be attained instead by adding “I am interested in researching the ethics of…” to your bio?
Comment by Sans — August 31, 2009 @ 6:17 am
“And I gave you a third gentleman’s link, in case you ever want to get to the substance of Ms. Schiavo’s condition.”
Yes, I saw that. Like the neurologist from your initial link, that would appear to be a 2nd one we now have who didn’t conduct an examination of the subject in question who has expressed an opinion, now being suggested to be an informed assessment of her condition.
So no, that won’t get us to the substance of her condition.
What would however be insightful is subsequent comments/assessments these men have made since the release of the autopsy assessment which revealed her brain had decreased in mass an enormous amount. This being a rather pivotal piece of medical evidence.
If, as you wrote, the autopsy findings do not invalidate these previous assessments, we should expect to find the same arguments from neurologists repeated following the release of the autopsy results and claiming that these hypothesis were vindicated or at least not invalidated by this evidence.
So, got any of them links for us ?
Comment by Sans — August 31, 2009 @ 6:32 am
zzzzz …..
zzzz …. I don’t CARE about the difference between two neurologists and two, really three, neurological experts, who for all I know have every right to call themselves neurologists. It’s irrelevant. Stop wasting my time, and yours. …. zzzzz
Comment by TBlumer — August 31, 2009 @ 6:38 am
For example:
James Gebel, your third link:
“The parts of Terri Schiavo’s brain which would allow her to perceive pain, here thalami, were clearly
intact and visible on her CT scan images”
Wiki:
“Examination of Schiavo’s nervous system by neuropathologist Stephen J. Nelson, M.D., revealed extensive injury. … Microscopic examination revealed extensive damage to nearly all brain regions, including … the thalami…”
…
“There was marked damage to important relay circuits deep in the brain (the thalami) – another common pathologic finding in cases of PVS. The damage was, in the words of Thogmartin, “irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons.”"
Comment by Sans — August 31, 2009 @ 6:46 am
It should also never be forgotten that Terri’s condition at the time of her death might have been very different had her care been adequate during the years after Michael Schiavo won his malpractice lawsuit. There’s more than a little bit of evidence that her care was far, far less than perfect.
Even if I conceded every petty argument you’re making (which I don’t), nothing changes what I just noted.
You’re welcome to comment on other posts on other topics. Please don’t waste any more time here. You have no point to make relevant to the topic of the post, which was that the AP’s characterization of the autopsy is wrong, and remains wrong, despite your hyperventilation.
zzzzz …..
Comment by TBlumer — August 31, 2009 @ 6:52 am
“I don’t CARE about the difference between two neurologists and two, really three, neurological experts, who for all I know have every right to call themselves neurologists. It’s irrelevant. Stop wasting my time, and yours.”
You appeared to care about the relevance of the autopsy results and their characterization as having upheld the assessment that the subject was in a PVS. It’s actually the title of your post here.
Now other cases of PVS diagnosis are fine, but they really don’t compare to someone assessing the Schiavo case in the wake of the autopsy findings, now do they. Particulary not when that’s the entire premise of your post.
That somewhere there is an assessment of the Schiavo autopsy which disputes what the AP wrote. Either that’s the case or it isn’t. If it is, where’s that neurologist. Because until we find him, you don’t have 2 or 3 contradicting the autopsy findings, you have none.
So, again, where’s them post June 15th 2005 links ?
Comment by Sans — August 31, 2009 @ 6:59 am
Again, I don’t care.
The post stands quite nicely, their contentions experts are what they are, and your whining doesn’t change that.
Maybe you read the post. If you did, you would know that the MEDICAL EXAMINER HIMSELF denied the validity and implied certainty of what AP claims:
Neuropathological examination of the decedent’s brain — or any brain, for that matter — cannot prove or disprove a diagnosis of persistent vegetative state or minimally conscious state.
In that sense, the neurological experts are icing on the cake. Very tasty icing, I might add.
You are welcome to comment on other posts. You are no longer welcome on this one. If you attempt to comment on this post again after your total refutation and humiliation (visible to everyone but yourself), I will ban your IP. I don’t have time for foolishness such as this.
Comment by TBlumer — August 31, 2009 @ 11:46 am
Sans pointed out an inarguable factual error in your post. Wouldn’t a simple acknowledgement and correction be the better course?
Why attempt humiliation when it is humility that is the virtue?
Comment by Al on Main — August 31, 2009 @ 11:26 pm
#18, there is no “inarguable factual error” in the post, no matter how hard Sans or you try to spin it.
There is little doubt that the two people cited are “inarguably” neurological experts. Whether or not they are technically “neurologists,” is not crystal clear to me, but Steve Ertelt said they were, and I’ll lean on his reporting until someone proves him wrong. No one has.
This is totally a matter of a distinction without a substantive difference.
What Sans did, and what you insist on extending, is what people do when they have no substantive argument. He has no substantive argument, as has been demonstrated — nor, apparently, do you.
I don’t hesitate to say “I was wrong, I am sorry” when warranted. When it’s not and someone insists that I do, I don’t just sit there and take it.
Comment by TBlumer — September 1, 2009 @ 8:07 am
#18 and everyone else, just to show how intellectually shallow the argument over “neurologists” is — this is from two weeks before her death by court-sanctioned starvation and dehydration:
Almost 50 neurologists all say the same thing: Terri should be reevaluated, Terri should be reexamined, and there are grave doubts as to the accuracy of Terri’s diagnosis of PVS. All of these neurologists are board-certified; a number of them are fellows of the prestigious American Academy of Neurology; several are professors of neurology at major medical schools.
An exam of Terri while she was still alive could have proven something. But, as the CME said in his own report (“Neuropathological examination of the decedent’s brain — or any brain, for that matter — cannot prove or disprove a diagnosis of persistent vegetative state or minimally conscious state”), post-mortem examination can’t prove anything.
There is virtually no doubt that more than a few of the 50 neurologists cited would have supported the post-mortem issues raised by the two doctors Steve Ertelt cited and identified as neurologists in his article.
Sans and Al are welcome to contact the 50 and prove me wrong. “Sans” that, their quibble over the two people Ertelt cited has been proven irrelevant to the central point of the post, which is that AP erred in giving readers the impression that Terri Schiavo had “with no consciousness and no hope of recovery.”
Comment by TBlumer — September 1, 2009 @ 8:51 am
Much can be learned from these thoughtful posts:
http://www.theness.com/neurologicablog/?p=351
http://www.theness.com/neurologicablog/?p=358
Comment by Al on Main — September 1, 2009 @ 10:29 am
#21, thanks for the links. They appear to be inadvertent windows into Mr. Novella’s soul.
He acts as if the autopsy results were certain, even though (and I’m going to repeat it until everyone gets it) the CME said that “Neuropathological examination of the decedent’s brain — or any brain, for that matter — cannot prove or disprove a diagnosis of persistent vegetative state or minimally conscious state.” It would seem that someone who ignores that reality is determined to do so in the name of ultimately making mental arguments for ridding humanity of inconvenient people.
Despite Novella’s nice and relevant academic discussions, the facts are that:
- The FIFTY neurologists cited in #20 disprove Novella’s assertion that Hammesfarb, regardless of the validity of his suggested therapy, was an “outlier.” He was anything but that on the issue of whether Terri was even in PVS.
- The second link has this direct quote — “A number of neurologists examined Terri Schiavo over the years and they all felt, to a high degree of confidence, that she was in a PVS.” Well, fine. That’s also an acknowledgment that there’s room for doubt, because of course ….
- ….. people have awakened from PVS or what was diagnosed as such. One of the TerrisFight links indicates that a doctor changed the diagnosis after one of them woke up, in effect creating a neurological research memory hole.
- Terri had a loving family willing to care for her for the rest of her life, yet the courts deliberately chose to frustrate their life-affirming wishes.
- Michael had no evidence other than his own word that Terri would have wanted to die in her circumstances. His adulterous actions should have presumptively disqualified him from making that call.
- We can’t know the toll taken by roughly 12 years of neglect, and sometimes aggressive neglect, by Michael after he won his lawsuit.
The six listed items are objectively indisputable facts.
Thoughtful enough for ya?
Comment by TBlumer — September 1, 2009 @ 12:43 pm