Mickey Kaus, writing for Slate, correctly castigates NPR for its one-sided reporting on the Terry Schiavo case (pointer by Eugene Volokh), but concludes his piece with a glaring error. He states,
. . . isn't it possible that just occasionally a [family member will arrive] to find exhausted relatives and cost-conscious doctors ready to give up on a PVS or coma victim who still has a chance to snap out of it?
The arguments that are made by many of those who support the parents in their opposition to the husband's request that life-extending interventions cease in the Schiavo case are premised on the idea that "she may come around". The truth is that the chance that she will come around is precisely 0. Not a small chance, not a remote chance -- zero chance.
The Medical College of Wisconsin provides a good definition of "persistent vegetative state":
A persistent vegetative state, which sometimes follows a coma, refers to a condition in which individuals have lost cognitive neurological function and awareness of the environment but retain noncognitive function and a perserved sleep-wake cycle.
It is sometimes described as when a person is technically alive, but his/her brain is dead. However, that description is not completely accurate. In persistent vegetative state the individual loses the higher cerebral powers of the brain, but the functions of the brainstem, such as respiration (breathing) and circulation, remain relatively intact. Spontaneous movements may occur and the eyes may open in response to external stimuli, but the patient does not speak or obey commands. Patients in a vegetative state may appear somewhat normal. They may occasionally grimace, cry, or laugh.
It offers the following on prognosis, but does not provide any time frame:
Some patients may regain a degree of awareness after vegetative state. Others may remain in a vegetative state for years or even decades.
The Multi-Society Task Force on PVS, comprised of representatives from the American Academy of Neurology, Child Neurology Society, American Neurological Association, American Association of Neurological Surgeons, and American Academy of Pediatrics, comments:
Recovery of consciousness from a posttraumatic persistent vegetative state is unlikely after 12 months in adults and children. Recovery from a nontraumatic persistent vegetative state after three months is exceedingly rare in both adults and children. Patients with degenerative or metabolic disorders or congenital malformations who remain in a persistent vegetative state for several months are unlikely to recover consciousness.
This is consistent with the general rule that recovery from major neurologic events of all kinds will typically plateau within 6 months, 12 months at the outside. This woman, who has been in a PVS for 13 years, will never regain any function.
People will have differing opinions about whether it is ethical or moral to allow her to die in light of this condition, but none of these opinions should be premised on any hope of recovery.
Note -- A thoughtful and lengthy article on this issue from a Christian perspective, predating the current controversy, may be found at the Xenos Christian Fellowship site.
8:30:09 PM
|