Re: United States starting to execute the mentally impaired

a_weisman_at_yahoo.com
Date: 03/19/05 

Date: 19 Mar 2005 06:50:56 -0800

Frank, this case does NOT involve the United States "executing" anyone.

It is a dispute between her husband and her parents as to her wishes.

She did not create a "living will"

Her husband says that she didn't want to be kept alive if in such a
state.

However, here is an article I think is interesting when considering her
state of "consciousness" and it is NOT from a bunch of religious freaks
who are trying to USE her to advance their agenda.

You for example, have retitled this article to suit YOUR anti American
agenda.

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CarlZimmer.com
http://www.carlzimmer.com/articles/2003/articles_2003_WhatIf.html

What If Something Is Going On In there?
New York Times Magazine, September 28, 2003

Daniel Rios is 24 years old, with wavy black hair, a thick mustache and
a glassy stare that seems to look both at you and through you. One day
almost four years ago, while he was taking a shower, a blood vessel
ruptured in his brain, and he collapsed on the bathroom floor. After
emergency surgery, he lay in a coma for three weeks. When he finally
opened his eyes, he could not speak or move his body; his head simply
lolled. In the months that followed, the doctors monitoring him at the
Center for Head Injuries at the J.F.K. Johnson Rehabilitation Institute
in Edison, N.J., saw few signs that he had any meaningful mental life.
Sometimes he looked as if he were crying. Other times his eyes would
follow a mirror passed before his face. On his best days he was able to
close his eyes on command. But those days were rare. For the most part
he lay unresponsive, adrift in a neurological twilight.

One morning just over a year after his accident, Rios was taken to the
Sloan Kettering Institute on Manhattan's East Side. There, in a dim
room, a group of researchers placed a mask over his eyes, fixed
headphones over his ears and guided his head into the bore of an M.R.I.
machine. A 40-second loop of a recording made by Rios's sister Maria
played through the headphones: she told him that she was there with
him, that she loved him. As the sound entered his ears, the M.R.I.
machine scanned his brain, mapping changes in activity. Several hours
afterward, two researchers, Nicholas D. Schiff and Joy Hirsch, took a
look at the images from the scan. They hadn't been sure what to expect
-- Rios was among the first people in his condition to have his brain
activity measured in this way -- but they certainly weren't expecting
what they saw. "We just stared at these images," recalls Schiff, an
expert in consciousness disorders at Weill Medical College of Cornell
University. "There didn't seem to be anything missing."

As the tape of his sister's voice played, several distinct clusters of
neurons in Rios's brain had fired in a manner virtually identical to
that of a healthy subject. Some clusters that became active were those
known to help process spoken language, others to recall memories. Was
Rios recognizing his sister's voice, remembering her? "You couldn't
tell the difference between these parts of his brain and the brain of
one of my graduate students," says Hirsch, an expert in brain imaging
at Columbia University. Even the visual centers of Rios's brain had
come alive, despite the fact that his eyes were covered. It was as if
his sister's words awakened his mind's eye.

To the medical world, Rios and the hundreds of thousands of other
Americans who suffer from impaired consciousness present a mystery.
Traditionally, there have essentially been only two ways to classify
them: as comatose (eyes closed and responses limited to basic reflexes)
or vegetative (eyes opening and closing in a cycle of sleeping and
waking but without any sign of awareness). In either case, it has been
assumed that they have no high-level thought. But Schiff, Hirsch and a
small group of like-minded researchers are studying people like Rios
and finding that the truth is far more complicated. Their evidence
suggests that even after an injury that leaves a brain badly damaged,
even after months or years with little sign of consciousness, people
may still be capable of complex mental activity. "If I say, 'Touch your
nose,' and you touch your nose, and then I say 'Touch your nose' six
more times, and you don't do it, how do we account for the one time you
did?" asks Joseph T. Giacino, a neuropsychologist who collaborates with
Schiff and Hirsch.

Last year in the journal Neurology, Giacino and 10 co-authors accounted
for that touch of the nose -- and other enigmatic hints of awareness
they have observed -- by proposing a new category of consciousness: the
minimally conscious state. By their reckoning, a vast number of people
who might once have been considered vegetative actually have hidden
reserves of mental activity. And as the study of Rios suggests, brain
scans may be able to help scientists eavesdrop on their inner world.
"It's free speech for people who have no speech, " Hirsch says.

The implications of this research, both for medical ethics and
practical policy, are potentially huge. Traumatic brain injuries are a
significant health problem in the United States, but the study and
treatment of them are clouded with a sense of hopelessness, a feeling
that consciousness is too mysterious to be understood. When faced with
patients in a vegetative state, doctors can do little more than wait to
see if they wake up. No treatment has ever been definitively shown to
help patients recover consciousness, and doctors can't predict which
patients will emerge from a vegetative state and which won't. If
patients don't show signs of recovery in a few weeks, they usually wind
up at home with their families or in nursing homes, and they rarely see
a neurologist again. In 1976, in a famous court case, the parents of
Karen Ann Quinlan, a woman who had been in a vegetative state for about
a year, won the right to take her off a ventilator (after which she
lived until 1985). "There's a point where people give up" and
discontinue aggressive treatment, says Joseph J. Fins, chief of the
division of medical ethics at Weill Medical College. "The question is,
Are we giving up too soon on the ones who might become more
functional?" Schiff and his colleagues say that the answer, in too many
cases, may be yes.

A coma is what people tend to think of when they think of impaired
consciousness. But most comas don't last long. After a few weeks, those
who manage to survive a brain injury either wake up or shift to a
vegetative state. Last year, Pedro Almodovar's movie "Talk to Her"
introduced many viewers to the vegetative state, centering its story on
two women suffering from brain injuries. Their peaceful slumber,
unfortunately, doesn't capture the reality of the condition. People in
vegetative states may keep their eyes open for much of the day,
sometimes appearing to fix their gaze on you. They may startle their
loved ones with an occasional groan or sob. Their limbs may curl up in
spasms or swing around in constant motion. Some people eventually leave
the vegetative state and regain consciousness, while others live for
decades without showing any sign of awareness.

Nine years ago, when he was a young resident at New York Presbyterian
Hospital, Schiff began working under Fred Plum, one of the neurologists
who first recognized the "persistent vegetative state" in 1972. By the
early 90's, technology was becoming powerful enough to offer a glimpse
of what was happening in the vegetative brain, and Plum put Schiff in
charge of a project to scan vegetative patients. After a long, often
frustrating struggle to find patients to study, filling out reams of
paperwork and coping with suspicion and indifference, Schiff and his
colleagues published their results last year in the journal Brain.

Their findings were remarkable. Among other tests they conducted, they
used a technology known as positron emission tomography (PET) to
estimate how much energy the brains of their subjects were using. One
subject, a 49-year-old woman who had been in a vegetative state for 25
years, would say something every few days -- often a curse word.
Overall, the woman's brain was using less energy than the brain of
someone under deep anesthesia, but some regions of her brain were
running at close to normal, including the neural network that produces
language. Those regions were still producing words, long after the
woman's consciousness disappeared. Another subject was a 42-year-old
man who had been in a vegetative state for seven years; he would groan
and clench his teeth when he was touched or heard a loud noise but
appeared to be soothed on occasion by his mother's voice or soft music.
Schiff discovered that one area still functioning in the man's brain
was associated with listening to music and recognizing a voice's
emotional inflections. And in the truly exceptional case of one
25-year-old man who exhibited no physical responses at all, Schiff
found that the patient's brain used almost as much energy as that of a
conscious person.

The results of the study offered hints about the nature of
consciousness. High-level thought -- like language and memory -- occurs
in networks of neurons located at the surface of the brain in a thin
layer of tissue called the cortex. These networks also form loops,
however, that dip deep within the brain, where they converge and then
return to the surface. According to a theory proposed by Rodolfo Llinas
of New York University, a special set of neurons deep in the brain
synchronizes the activity of the loops of higher thought. The harmony
of all the different thought processes gives rise to a coherence that
we call consciousness. Schiff and his colleagues say they suspect that
when a number of these loops or the region that synchronizes them is
damaged, the brain slips into a vegetative state. Yet even after
extensive brain damage, they argue, some of the loops may still
function, though in isolation -- like fragments of mind.

In searching for subjects for his study, Schiff discovered the Center
for Head Injuries in Edison, where Rios is treated. Neuropsychologists
there have specialized in tracking how patients recover from brain
injuries, moving from comas toward consciousness. Joseph Giacino, the
lead author of the Neurology paper that defined the minimally conscious
state, is the center's associate director of neuropsychology. He is one
of the few doctors who focus on both the study and the long-term
treatment of patients with impaired consciousness. "You come in in a
coma, and you can get your treatment all the way to when you're back at
work and you still need some follow-up," he explained to me on a visit
to the center in July.

Giacino has spent the past 15 years developing ways to measure
objectively how people recover from comas. It's not enough for a father
to declare that his daughter is understanding everything he says; a
turn of the head or a squeeze of the hand can just as easily be an
unconscious reflex as an act of will. And pessimism can be just as
misleading as optimism: if a doctor overlooks a legitimate sign of
consciousness, he may peg a patient as a hopeless case.

At Giacino's center, patients repeatedly go through the same
standardized battery of tests. They are asked to look at objects -- a
plastic banana, for example -- and identify them. They are shown a
hairbrush and asked how to use it. They answer with a glance at cards
marked "yes" and "no," with a thumbs-up or, when possible, with their
voices. Giacino records whether his patients can communicate and
whether they communicate reliably. "If I ask you, 'Are you a man?' and
you say yes, and a few questions later I ask you if you're a woman, and
you say yes, you're not a reliable communicator," he says. Adding up
the results of his tests, Giacino gives each of his patients a score
indicating a diagnosis somewhere on a spectrum between coma and
consciousness.

Over months and years of administering and readministering his tests to
patients as often as every week, Giacino is able to chart patients'
scores in fascinating graphs. Some are straightforward climbs to
consciousness, others level off at less-than-conscious plateaus. Still
others form a series of conscious peaks and vegetative valleys. These
variegated landscapes were Giacino 's inspiration for the minimally
conscious state, which describes patients who show signs of awareness
but are still far from full consciousness.

Giacino works hard to tease out hints of awareness in a patient.
Sometimes he can actually coax patients into consciousness by working
his fingers deep into their muscles. Neurologists have found that the
stimulation of the nerve endings in the muscles can be powerful enough
to arouse activity in networks of neurons in the brain. Giacino has a
particular knack for the technique, and after a few seconds of muscle
work, he can get some minimally conscious patients to speak. Some tell
him their names, others tell him to leave them alone. As soon as he
removes his hands, they slip away again.

Marie Conniff has seen Giacino work this transformation many times. On
New Year's Day in 1998, her son Scott was on duty as a New York
policeman when a drunken driver rammed his car. Today, Scott sits in a
wheelchair, his gaze often drifting across the room. Sometimes he
laughs, sometimes he growls like a bear. He gives hard kicks to a big
orange beach ball hanging from the ceiling. When Giacino begins to work
her son's muscles, Conniff finds herself startled at how well Giacino
can bring Scott back, in the look on his face, the clarity of his
movements. "I see a lot of what I had before he got hurt," she told me.

Conniff raises a profound question: Is a part of her son still there?
Schiff began to gather some clues to this question when he switched
from studying vegetative patients to people in minimally conscious
states. He and Giacino selected a few patients at the Center for Head
Injuries whom Giacino had identified as minimally conscious. They
arranged for the patients to have PET scans to measure their brain
metabolism, as Schiff had done in his earlier study on vegetative
patients. But they also collaborated with Joy Hirsch to probe their
subjects' brains with M.R.I. scanners, which can measure
moment-by-moment changes in brain activity.

Rios provided some of the first astonishing results of this second
project. And when the researchers ran the same study on another
minimally conscious patient, they got even better results. "It
certainly raises the question that there's more 'there' there than
we've been giving them credit for," says Joseph Fins, who has been
exploring the ethical dimension of Schiff's new research. "It 's very
suggestive that there's consciousness."

Schiff is reluctant to declare prematurely that these images are
pictures of consciousness, but he and his colleagues are considering
two important clues. One is the overall metabolism of Rios's brain.
While undergoing an M.R.I., Rios 's brain became active in response to
sounds and touch in much the same manner as a conscious brain. But when
the researchers took a PET scan of his brain at rest, they got a very
different picture. A healthy brain burns a lot of calories even when
not processing any particular information from its senses. Rios's brain
at rest used about as much energy as someone in a pure vegetative
state.

The other clue emerged when the scientists played Rios the tape of his
sister 's voice backward. When uninjured people hear backward voices,
the regions of their brains that control language become more active
than when they listen to recordings played forward. Their brains
instantly recognize that the signal is unusual and respond by working
harder to decode it. But when Rios heard his sister's voice played in
reverse, his brain barely responded at all.

Schiff says he suspects that Rios's brain works very differently not
only from a vegetative brain but also from an uninjured one. Rios still
has a healthy number of loops of higher thought that the scans suggest
may be able to work in harmony when he hears his sister's voice. But
for some reason, it appears that these loops shut down in the absence
of familiar stimuli. His brain doesn't seem to have the strength, as it
were, to reflect continually on itself and its surroundings the way a
healthy brain does, ready to engage the world in an instant. An
ambiguous signal isn't enough to provoke him.

It's hard not to speculate about what it's like -- if that's even a
meaningful notion here -- to inhabit this sort of mind. You wake up
every morning but feel as if you're under a deep anesthesia. Images
enter your eyes, and sounds enter your ears, but most of them
reverberate through your brain without triggering any awareness. From
time to time, you join the outside world at the sight of a familiar
face or at the words of a loved one. Memories and meaning emerge. But
as soon as that face or those words disappear, you sink back into
darkness. Perhaps you can't even tell you're sinking -- perhaps your
awareness leaps from one isolated moment to the next.

Still, there are plenty of neurologists who doubt whether any of this
research on the minimally conscious state has any real significance.
Alan D. Shewmon, chief of pediatric neurology at the Olive
View-U.C.L.A. Medical Center in Los Angeles, has called Giacino's
category "an inaccurate name for an invalid concept." He argues that
there is no scientific way to draw a line between full consciousness
and minimal consciousness, and says he worries that the definition is
so broad that it easily encompasses people who are conscious but suffer
from other neurological disorders that impair their ability to
communicate.

Schiff and Giacino say that as more of their studies on people like
Rios are published, they will silence their critics. By understanding
the biology underlying the minimally conscious state, they say, it may
also be possible to help people in this condition expand their moments
of awareness. Drugs that boost the brain's supply of certain
neurotransmitters, for instance, might be able to keep their networks
turned on longer. Schiff says he hopes that within a decade researchers
will be able to experiment with implanted electrodes that act like
pacemakers for consciousness. By emitting regular pulses of
electricity, they could keep the brain's networks active and
synchronized. "What's got me still willing to do all this is that you
could help someone on the borderline to cross over," Schiff says. "To
live on their own at home, to have fun, to have a life."

In the years since Karen Ann Quinlan's parents had her taken off her
ventilator, courts have also acknowledged the rights of families to
remove feeding tubes from vegetative patients. And as research on the
minimally conscious state has emerged, the courts have been asked, in
recent cases, to judge whether the category describes a life that's
always worth living.

On one visit to the Center for Head Injuries this summer, I was
privileged to witness firsthand why Schiff and Giacino can be so
hopeful about a seemingly hopeless condition. I joined Schiff, Giacino,
Fins and some of their colleagues as they made rounds, and at noon we
reached Rios's room. More than three and a half years had passed since
he collapsed in his shower, and he was still considered to be in a
minimally conscious state. Physical therapists had been regularly
working Rios's limbs, and his sister had been caring for him at home on
some weekends. Even with this attention, the statistical odds were
against his ever reaching a higher level of consciousness. "He hasn't
crossed that line, " Giacino said before we went into the room.

Rios sat in a wheelchair, his hands curled to his chest, his left eye
drifting. He wore a broad, unchanging smile. Over the years, his walls
had become crowded with photographs, prayers and a map of Puerto Rico.

The doctors introduced themselves to Rios. "Do you remember me?" Schiff
asked. "I'm Dr. Schiff from New York. I saw you with your sister Maria
a couple times." Rios continued to smile.

Giacino stepped close in front of Rios. "So, Dan, if it's O.K. with
you, we want to do a bit of examination."

With his right eye, Rios was able to track a mirror that Giacino moved
in front of his face. "Dan, look toward my voice," Giacino said,
stepping to Rios's left side. Rios's eye moved left. "Now look away."
He looked away. Giacino showed Rios cards marked "yes" and "no." "Now
look at the card marked 'no."' Rios looked at the card marked "no."

The other doctors buzzed with excitement. "This is three years out,"
Schiff said. Giacino switched the cards and asked Rios to look at the
card that said "yes." Rios looked at the card. Giacino did the test a
third time, and Rios got it right again.

"That's a hundred percent," Schiff said. "Let's ask him some
questions."

"Dan, are you in a bathtub right now?" Giacino asked.

Rios looked at the "no" card.

"Are the lights on?"

Yes.

"He said yes, he mouthed it," Fins said.

"Do you feel sad right now?" Giacino asked.

Yes.

"Do you feel happy right now?"

Yes.

"He has both feelings," Schiff offered.

"At the same time," Fins added. "He's in the moment."

"Let me take it back down a level," Giacino said. He didn't want to
rely on interpretations to pinpoint Rios's level of awareness. He asked
Rios if his name was Bill. No. Giacino switched the cards between his
hands. "Is your name Jason? " No. "Is your name Dan?" Yes.

"Ask him if I'm happy or sad," Schiff asked. He put on a giant pout.

"Is Dr. Schiff happy?" No.

Schiff broke into a grin. Rios broke into his grin again. "I'd say he's
emerged now," Schiff said.

"O.K.," Giacino said. "I'm going to take it up a level." He wrote words
on two new cards: "happy" and "sad." He held them up in front of Rios,
and before he could ask a question, Rios looked at "happy." He moved
his lips, silently saying the word.

"Yeah, that's it!" Schiff said.

"Well, maybe," Giacino said. He kept his eyes on Rios. "I'm going to
ask you to look at the word that I say. Dan, look at the word that says
'sad."' Rios looked at "sad." Giacino asked him twice more; twice more,
Rios looked the right way.

"That's it," Giacino said. "He's reading."

He turned back to Rios. "How are you feeling inside? Look at the card
how you 're feeling."

Rios mouthed, "Happy."

By all measures, Rios had officially emerged from the minimally
conscious state. As the doctors said goodbye to him, filing out of the
room into the hallway, Schiff was already wondering aloud if Rios
should be brought back to the lab for study. He wanted to know what had
happened to Rios's brain, how his neural networks had reorganized
themselves into something closer to full consciousness. "I was just
thinking we should try to redo all those studies," Schiff said. "He's
got to be different."

"He was pushing us to go to a higher level," Fins said. "He's aware of
himself, he's happy, but it took a lot of skill to see it. If he ended
up in a nursing home and started doing things like this, no one would
have noticed."

Copyright 2004 Carl Zimmer

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Consciousness and the culture wars, part 2: Corante > The Loom >
http://www.corante.com/loom/archives/2003/10/23/consciousness_and_the_culture_wars_part_2.php

October 23, 2003
Consciousness and the culture wars, part 2
Posted by Carl Zimmer
After years at a slow burn, the controversy over Terri Schiavo has hit
the national news. Schiavo lost consciousness in 1990 after a cardiac
arrest, and her husband recently won a lawsuit to have her feeding tube
removed, over the objection of her family. Then on Tuesday, Governor
Jeb Bush ordered that her tube be reattached, using powers given to him
by the Florida legislature the day before.

If ever there was an argument for a living will, the Schiavo case is
one. She supposedly told her husband she wouldn't want to be kept alive
artificially, but never wrote anything down. If she had, the decision
to give or withdraw care might have been a simple one. Instead, her
husband and her family--and the country by proxy now--is in a muddled
shouting match over life, death, the right to die, consciousness, and
the soul.

There are several separate debates here, but people have been jumping
back and forth between them as if they were all one. One argument is
over the right for a surrogate to make a decision about whether someone
should refuse not only medicine but even food. This is controversial no
matter what state of mind a patient is in. (The Times points out today
that the Florida legislature, by taking over the decision about whether
Schiavo lives or die, has probably passed on unconstitutional law.)

The state of Schiavo's mind is the source of a second argument. Her
family has posted videos on their web site that they claim shows she
reacts to loved ones, smiles, and understands what they say. They also
say that she could respond to therapy and improve.

The family claims to have testimony from 15 doctors backing up their
claiims, but I can't find anything on their web site, so it's hard to
know what these doctors are saying. But I do know that Dr. Joseph
Giacino of the JFK Medical Center in New Jersey has taken a look at the
videos and hasn't found them persuasive. (See his remarks in a story
last week in Time.) Giacino is one of the top experts on the
rehabilitation of people with impaired consciousness. He also developed
an objective way to gauge the level of consciousness in people like
Schiavo. When I interviewed him for an Sept. 28 article for the New
York Times Magazine, he explained how people in vegetative states not
only have their eyes open, but also can assume disconcerting facial
expressions. He gave me a tour of the Center for Head Injuries, where
he works, and I could see how easy it is to read into a face what we
want to see.

Giacino and others have defined an intermediate stage of consciousness,
called the minimally conscious state. It's for people who show fleeting
signs of awareness. He and his colleagues have shown that people who
are diagnosed in a minimally conscious state are more likely a year
after their injury to have better functional outcome than those who
were diagnosed in a vegetative state. But the longer a person like
Schiavo is in a vegetative state, the less likely it is that any
recovery will happen.

It can be hard to accept this. I've been surprised to discover this
firsthand in the reactions to my article. In it, I wrote about how
brain scans of people in minimally conscious states can show
surprisingly complex responses to the sounds of voices and other
stimuli. People in chronic vegetative states show no such responses.
Yet I find my article keeps popping up as an exhibit in arguments that
Schiavo is actually responsive and could recover. The latest example is
a letter to the editor of the Tampa Tribune. In every case, people want
to mix up the results from minimally conscious patients and people in a
chronic vegetative state.

Living wills may help avoid future conflicts, but my talks with experts
makes me think that more is needed. We need a lot more research on how
to make accurate diagnoses for people with serious brain injuries. And
then we need to use that research to make sure that patients are
carefully observed for more than just a few weeks, with both rigorous
bedside exams and with brain scans. All this will be expensive, but
it's not as if our current state of neglect is a bargain. Hundreds of
thousands of people are in vegetative or minimally conscious states,
and their lifetime care can cost over a million dollars a piece. We can
do better.

PS--Steve Johnson also muses on the strange paradox of the Schiavo
case.

http://www.corante.com/loom/archives/2005/02/08/consciousness_and_the_culture_wars_part_three.php

February 08, 2005
Consciousness and the Culture Wars, Part Three
Posted by Carl Zimmer
Scientists studying people in minimally conscious states have published
the results of brain scans showing that these people can retain a
surprising amount of brain activity. The New York Times and MSNBC,
among others, have written up accounts.

I profiled these scientists for a 2003 article in the New York Times
Magazine, when they were at an earlier stage in their research. Things
certainly have changed since then. When my article came out, hardly
anyone had heard of Terri Schiavo, the Florida woman in a permanent
vegetative state who is at the center of a battle between her parents,
who want to keep her feeding tube in, and her husband, who wants it
taken out. Since then, her case has made national headlines, and a law
has been passed in her name. I for one will be keeping close attention
to how this new paper is received (and used) in the debate over Terri
Schiavo, because I had the displeasure of watching my article get
pulled into the debate and distorted for political ends.

The key point to bear in mind about this new research is that there's a
difference between people in a permanent vegetative state and people in
a minimally conscious state. Neurologists have developed bedside tests
to determine which state a given patient is in. People in minimally
conscious states show fleeting, but authentic, awareness of their
surroundings, for example. People in vegetative states do not.
Neurologists cannot make this diagnosis from the reports of family
members, because it is easy to see awareness in a loved one when there
is, in fact, none. That doesn't mean that family members are
necessarily wrong if they say a loved one is aware. It's just that a
doctor needs to test a patient objectively, using methods that don't
rely on his or her own interpretation.

Some people have argued that this test is circular: people are simply
defined minimally conscious if they pass a test for minimal
consciousness. But the designers of the test have shown that it does
have predictive power. For one thing, people who rise to a minimally
conscious state have a small but real chance of recovering
consciousness (although they may never return to their former selves).
People who stay in a permanent vegetative state for many years, by
contrast, almost never recover.

The brain scan findings now being reported also strengthen the notion
of a minimally conscious state. The researchers scanned the brains of
patients diagnosed as minimally conscious, playing the voice of loved
ones through headphones, scratching their skin, and doing other tests
to check for the function of their brain. They found that the patients
responded in important ways. Some patients responded to the recordings
with strong activity in regions of the brain involved in language and
memory, for example. But in the absence of stimuli, the brains of the
patients used less energy than a person would under anesthesia.

On the other hand, earlier scans of people diagnosed as being in a
permanently vegetative state showed at most only isolated islands of
activity in the cortex, where higher brain functions take place. So the
difference detected by bedside tests is mirrored by a difference
detected in the brain scanner.

It's crucial neither to overplay or underplay the importance of this
work. People who are coping with the staggering burden of a loved one
in a truly permanent vegetative state should not see this as evidence
that their loved one is conscious and simply "locked in" to an
unresponsive body. Nor should pundits raise false hopes by claiming
that this is the case.

But it is also true that people with impaired consciousness are not
getting the attention they deserve, starting with a good diagnosis.
Thirty percent of people in a permanent vegetative state may actually
be minimally conscious. It would be fantastic if some day doctors could
make a precise diagnosis of brain-damaged patients simply by running
them through some tests in a scanner. For now, though, only a handful
of people with impaired consciousness in the entire world have been
scanned at all. Eventually, it might be possible to use the knowledge
gained from these tests to start finding ways to help people recover
more of their consciousness, perhaps through brain stimulation. Today
there's nothing a doctor can do but wait and watch.

Unfortunately, people with impaired consciousness are more likely to be
simply warehoused, getting hardly any attention from a neurologist. Are
we, as a society, ready to give these voiceless people the care they
deserve?

Category: Brains

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Frank de Groot wrote:
> TERRI SCHIAVO SAYS SHE WANTS TO LIVE
> By The Empire Journal
>
>
> For more than 10 years, Michael Schiavo has said that his
neurologically
> impaired wife, Terri Schinder-Schiavo would not want to be kept alive
by
> artificial life support.
>
> On Friday afternoon, less than a hour after probate court judge
George W.
> Greer ignored federal subpoenas and ordered that Michael Schiavo
remove the
> feeding tube from Terri which will cause her death by starvation,
Terri
> Schiavo before multiple witnesses indicated that she wanted to live.
>
> According to attorney Barbara Weller, one of the attorneys
representing
> Terri's parents, Mary and Bob Schindler Sr., when her parents and
attorneys
> visited Terri at the Woodside Hospice where she resides to tell her
they
> were going to remove her feeding tube, Terri began to cry and tried
to say
> "I want to live."
>
> Attorney Weller said she had a difficult time calming Terri down.
>
> Greer, Schiavo and his attorney, George Felos, have consistently
maintained
> that Terri is in a persistent vegetative state and is not cognizant
or
> alert.
>
> The actions by Terri Friday afternoon clearly indicate that that is
not
> true.
>
> Earlier federal marshals had served Terri and other principals in the
case
> with federal subpoenas to appear before a Congressional committee on
March
> 28 to testify in the case. However, Greer refused to honor the
federal
> subpoenas and ordered that his death order be executed immediately,
> withdrawing her nutrition and hydration.
>
> Terri, 41, sustained serious brain damage in 1990 under mysterious
> circumstances. After her husband, Michael received some $2 million in

> insurance money, after telling a jury under oath that he would take
care of
> Terri "for the rest of my life", he then ordered that she not be
provided
> any therapy or rehabilitative services and petitioned the court for
her
> death.
>
> She left no living will. After receiving the money, Michael Schiavo
suddenly
> remembered that she had stated previously that she would not want to
be kept
> alive by artificial means.
>
> Congress was continuing to work to find a resolution to keep Terri
alive.
> Terri supporters were being asked to surround the hospice in protest
of
> Judge Greer's ruling to override the federal subpoena and cause her
death.
>
> Greer has refused to allow independent counsel to represent Terri and
has
> himself acted in the prohibited dual role of judge and guardian ad
litem.
> Although Florida Statutes require that as guardian he personally
visit the
> ward, Greer has NEVER personally visited Terri Schiavo and has never
> attempted to ask her himself if she wants to live.
>
> Those who cannot go to Florida are asked to call their U.S. senators.
>
> This story continues. For updates, continue to visit
> www.theempirejournal.com
>
>
> http://www.theempirejournal.com/031..._says_she_w.htm