Terri Schiavo's New Tenant
Well, I read the whole thing. I asked questions of both sides, I watched the video, I listened to the audio, I looked at the CAT scan, I watched Congess on CSPAN, I read neurologists' reports.
I noted that the bloggers I most respect, Joe Katzman, Charles Johnson, Wretchard, Razib Khan, avoided the issue like the plague. It is messy, ugly and invasive. Only the abortion issue raises this kind of hatefilled furious invective on both sides. People that disageed (even mildly) at blogsfor terri were called "stupid/ignorant" and "spawn of the devil". Some were deleted and banned for expressing alternative opinions. Doesn't that usually only happen on the other side of the blogverse?
It is really no one's business but the family's. Or is it?
All the wrangling over whether Michael Schiavo and Judge Greer (and actually anyone that disagrees with the "terri-life" position) are killer-monsters is sort of irrelevent to me. I want to know who terri is now.
Here is what it boils down to, for me.
I believe that Terri said that she didn't want to be kept alive on life support. Haven't you said that? I've said that dozens of times. It's my worst nightmare. To be trapped in a flesh coffin with no interface. But I was never inspired to get a living will made up until I saw what happened to Terri.
What makes a person who they are? I believe that the personality, "soul", whatever you want to call it, is an energy pattern created by the bio/electro-chemical properties of neural connections in the brain, the neo-cortex to be specific. Who you are is an edifice built of thought and memory, unique and unreproducible.
If you look at the CAT scan, the center of terri's brain is a crater filled with dark fluid. You can argue about about what functionality remains to her, or how much she can relearn, but I don't think you can argue that she is the same person that she was. She is not. A big chunk of that person is gone. This is bourne out by empirical data. The new Terri, the diminished Terri, can't really speak intelligibly. I don't think she has good enough control over her voluntary muscle groups to learn a gestural protocol, or they would have taught her one. I don't think the diminished Terri can understand abstract concepts like life and death. But the new Terri is alive, and not just in the brainstem sense. She recognizes and reacts to environmental stimuli. She can move in response to stimulus, but not consistantly. She can make sounds. She is a tenant in the house formerly occupied by Terri Schindler Schiavo.
My question is, does this house belong to the tenant now? If the old owner is gone, and even if the old owner left instructions to have the house burned down if it became unuseable to her, doesn't the new tenant deserve to live?
I don't actually have an answer, but I think this question should be asked.
I read this great new book by Ramez Naam, More Than Human, about all the marvelous new transhuman technologies that are trembling on the event horizon. Soon, we may be able to fix people like Terri, to restore the original tenant . So here's my other question-- given new technology, will the State decide to keep my body alive contrary to my wishes, if my family petitions to override my living will on the basis of technological advances or partial recovery? I never agree with Barney Franks on anything, but he's right on this-- "a can of worms".
I noted that the bloggers I most respect, Joe Katzman, Charles Johnson, Wretchard, Razib Khan, avoided the issue like the plague. It is messy, ugly and invasive. Only the abortion issue raises this kind of hatefilled furious invective on both sides. People that disageed (even mildly) at blogsfor terri were called "stupid/ignorant" and "spawn of the devil". Some were deleted and banned for expressing alternative opinions. Doesn't that usually only happen on the other side of the blogverse?
It is really no one's business but the family's. Or is it?
All the wrangling over whether Michael Schiavo and Judge Greer (and actually anyone that disagrees with the "terri-life" position) are killer-monsters is sort of irrelevent to me. I want to know who terri is now.
Here is what it boils down to, for me.
I believe that Terri said that she didn't want to be kept alive on life support. Haven't you said that? I've said that dozens of times. It's my worst nightmare. To be trapped in a flesh coffin with no interface. But I was never inspired to get a living will made up until I saw what happened to Terri.
What makes a person who they are? I believe that the personality, "soul", whatever you want to call it, is an energy pattern created by the bio/electro-chemical properties of neural connections in the brain, the neo-cortex to be specific. Who you are is an edifice built of thought and memory, unique and unreproducible.
If you look at the CAT scan, the center of terri's brain is a crater filled with dark fluid. You can argue about about what functionality remains to her, or how much she can relearn, but I don't think you can argue that she is the same person that she was. She is not. A big chunk of that person is gone. This is bourne out by empirical data. The new Terri, the diminished Terri, can't really speak intelligibly. I don't think she has good enough control over her voluntary muscle groups to learn a gestural protocol, or they would have taught her one. I don't think the diminished Terri can understand abstract concepts like life and death. But the new Terri is alive, and not just in the brainstem sense. She recognizes and reacts to environmental stimuli. She can move in response to stimulus, but not consistantly. She can make sounds. She is a tenant in the house formerly occupied by Terri Schindler Schiavo.
My question is, does this house belong to the tenant now? If the old owner is gone, and even if the old owner left instructions to have the house burned down if it became unuseable to her, doesn't the new tenant deserve to live?
I don't actually have an answer, but I think this question should be asked.
I read this great new book by Ramez Naam, More Than Human, about all the marvelous new transhuman technologies that are trembling on the event horizon. Soon, we may be able to fix people like Terri, to restore the original tenant . So here's my other question-- given new technology, will the State decide to keep my body alive contrary to my wishes, if my family petitions to override my living will on the basis of technological advances or partial recovery? I never agree with Barney Franks on anything, but he's right on this-- "a can of worms".
posted by jinnderella at 6:29 AM
23 Comments:
If Terri Schiavo's personality is dead, and she no longer exists in that body, then no harm can be inflicted on her by delaying termination until the case has had further scrutiny.
If a "living will" did exist, it would simplify things considerably. But - it can't be pointed out too often - no such will exists. There is only the sharply conflicting recollections of her family, among which the Florida judges (mainly a single judge) have chosen sides. That judgment might be faulty, or prejudiced. Or a federal court might concur - what's the harm in finding out?
Even when actual wills exist, their execution is sometimes delayed for years because of litigation. This does no harm to the dead. The only possible harm is to the living relatives, for whom the consequences might be devastating.
The legal term for what you appear to be writing about is “competence”. Under the law the current Terri is not competent to make decisions involving her own welfare.
Jinnji--
Time to make your move. If there is not a lawyer among your multitudinous sibs, go to Legal Zoom. It's a quick and dirty way to get do your living will. One that will stand up against what everyone else might want for you in the event...
I wonder if the 'real' us, the one that disappears in the onslaught of trauma against the brain, somehow stays around watching us wring our hands and dither. After this dies down, it might make a good short story.
If Terri Schiavo's personality is dead, and she no longer exists in that bodyBut then who does? Guyz, I think we can agree that what is left is a subset of terri. For the sake of argument we'll accept the state of florida ruling that the husband is the legal guardian and operating on terri's wish. (i know that may not be true) My question is, does a diminished person, a disabled person, an incompetant have a right to live superceding the wishes of the person inhabiting that body before the accident?
Glen, i have no problem with waiting to find out, and very probably more tests and treatment should have been offered terri. From everything i've read, for example, i believe they tried to teach her a gestural protocol, but she doesn't have consistant control over her voluntary muscle groups. Physical therapy could have helped. Speech therapy may have helped her speech, which is quite unintelligle. But still her ability to grasp abstract concepts, ie, do you want to live, is gone. I think more tests would have helped-- but look at the CAT scan-- superset-terri-original is long gone. I certainly think the new terri is alive, not just in the brainstemmed sense, and responds to stimuli. But what i want to know is, who owns the house?
I guess i think, ethically, subset terri should own the house now. superset terri can't use it anymore. But legally that may not be true.
I think religiously, subset terri gets the house also.
Any other opinions?
I agree, it's a can of vicious worms. At least you've taken the time to examine the scientific evidence, which is more than you can say for most people, who nevertheless presume to know more than the 19 judges who've examined the case. To say nothing of presuming to know what 'Terri' would want.
It's possible for people with real moral integrity to also be engaged in serious psychological displacement
I just heard that this is the seventeenth judge to read on Terri.
Here is how i see the legal question. Does the state have a right to intervene against the wishes of the incapacitated individual? A lot of the argument seens to be that therapy and testing could improve terri's condition. But everyone agrees she cannot be restored to full function. So does the nanny state get to intervene, and do what is best for subset terri? And what happens when transhuman therapies are available, that can make even greater improvements, and revive even more desperate cases?
Dymphna, my dad is an orthopeadic surgeon. ;)
Becoming a lawyer, dating a lawyer, or even thinking about becoming a lawyer or dating a lawyer was grounds for immediate excommunication from our clann. ;)
Does the state have a right to intervene against the wishes of the incapacitated individual?
Not under Florida law. But it's exactly the wishes of this individual that are in doubt, else this case would never have made it to any court. And the insistence on the absolute sovereignty of the husband in this case is peculiar - it may be the law, but any law that doesn't allow for exceptional circumstances is a bad law.
... everyone agrees she cannot be restored to full function.
But the difference between a brain-dead Terri Schiavo and a less-than-fully-functional Terri Schiavo is vast. It raises the argument to an entirely different plateau, where disturbing aspects of euthanasia come into view.
I have no answers here, and this is all a digression, but I do know for sure that Ramez ripped off Theodore Sturgeon for the title of his book. Sturgeon's book was written 50 years ago, and found the next step in evolution as a group of people (human gestalt --if my mental hubble can see that far back in my brain correctly) who individually were pretty worthless, but together formed more than the sum of their parts, as they say.
Maybe I spent too long in Asia, I don't know, but I am a little wary of all these "human rights" we enjoy so much, partially because as we all get more interconnected we all tend to bump up against one another a little more. I know, I know, your right to swing ends at the tip of my nose, but it just doesn't always work this way, anymore, if it ever did.
Since "I" is changing every moment of every day anyway, I am beginning to wonder about my "rights" to make decisions affecting my future self, and wonder if that future self is going to make decisions that respect the current "rights" of the current "I." I don't need to get into a vegetative state. I am just talking about my own gestalt over time.
Do I have the right to go out, get drunk tonight, make some baaaad decisions, and forever besmirch the past and present I's, not to mention make life very difficult for future I's? The I over time hopes not, but I suppose the individual I can do as it wants.
And this completely ignores everyone external to me!
Ahh...spring is in the air! I am feeling like a sophomore in philosophy class again! I wish that I could only think and write more clearly!
But maybe someone has an inkling as to what I am trying to think and say, as it might help jinn figure out her questions, too.
(I suppose I should tack a statute of limitations onto my comments. Maybe about an hour...I don't want to besmirch the past and future koas with anything too embarrassing...)
I've got questions but no anwers.
I think you equate "soul," and "personality." And these result from a biological process in the cerebral cortex. These processes are ongoing. Wouldn't then our souls and personalities change from instant to instant?
What makes up our human being that remains over time?
If Terri's tragic disability has made her a new tenant, then wouldn't supposed improvements in cognition also leave a new tenant? If I learn French should I change my name? Am I a different human being when I'm drunk? (Some would say I'm not a human being at all.)
I think it's tough to understand our humanity through biology alone, but I'll stop now. The water is awfully deep, and I'm just a fair swimmer.
>If you look at the CAT scan, the center of terri's brain is a crater filled with dark fluid.
Are you a doctor? Do you have nay idea how to read a CT scan? Do you know what contrast was used? Have you seen the variety of healthy cranial CT scans using various contrasts? Or what unhealthy ones look like in people still conscious and able to live good lives?
Or are you just making an uninformed assumption?
Here is a little food for thought in the cranial CT and MRI department:
http://www.medschool.lsuhsc.edu/neurosurgery/cases/case53.asp
http://www.medschool.lsuhsc.edu/neurosurgery/nervecenter/NPH.html
http://www.medschool.lsuhsc.edu/neurosurgery/cases/case35.asp
http://www.medschool.lsuhsc.edu/neurosurgery/cases/case58.asp
Many MRIs will look similar to your supposed picture of her CT in the normal brain, depending on what you are looking at.
Try out this whole brain atlas:
http://www.med.harvard.edu/AANLIB/home.html
Click on Normal Anatomy in 3-D with MRI/PET (Javascript)
Then choose CSF / Vascular and choroid plexus from the drop down boxes. You'll see what looks like a big hole in the brain. But its normal.
Then try it with the different contrasts (T1/FDG or T2/FDG for example).
I would not assume that you have any idea what that image you linked means.
Old dad! You sound just like my old dad! Or at least my old dad on a good day. One day I will be an old dad, too. I hope to steer a path to old dadhood that avoids the sadness and pain that he has seen, while reaching a similar destination. Fate is not something I have a human right to control, though.
What makes up our human being that remains over time?
I didn't want to muddy the water with this earlier, but I am trying to accept that there is no time, that it doesn't flow, and that all moments are separate universes that exist at the same time for every possibility. Like separate cels on a filmstrip, all the I's in all the universes are separate, but fool themselves into thinking they are one.
So, yes, we have the superset of I's "through time" over your life which is a subset of the superset of I's "through the multiverse."
It's going to take more than some swimming skills to navigate these mucked up waters!
liberty, umm, sorry but i don't get your argument. Are you saying there is no brain damage? All twenty-something neurologists agreed there was. they differ on the amount.
Sure, fMRI would yield more data. I love that sensor, it is very information dense! We'd use it in ATR (automatic target recog) if we could figure out how to pass a giant magnet over the TOI (target of interest). ;)
I think you mistake me. I believe the subset terri has a moral and ethical right to live. I'm afraid the superset terri's percieved legal rights will trump that position.
koa:
The time out of time idea is impossible to explain discursively, but it's a very good thing to keep trying, because--heaven forfend--human experience just might be able to escape the prison house of language. I think great poetry does, but I can't prove it. It's important to prove things, but what if you can't? Prove that anyone loves anyone else. But we know we do.
Jinn,
Thanks for the image of the brain scan. It is going straight up on a link to my site. I have a new post regarding marriage rights in this case, but now I see that I need to combine the too and ask if Michael Schiavo, or if anyone, would have the right to speak for "Terri".
I found this comment very interesting.
Old Dad,
You have opened up another conflict. I have two answers, and a final third.:
1.The time idea I swiped from David Deutsch, who thinks about such things more, and deeper, than I can. Perhaps it is his lack of little kids running around the house. Double slit experiments in time now begin to show that quantum time does indeed happen all at once. And love-- why fMRI's light up in a very specific area of the brain. Serotonin drops, dopamine increases, it is a very familiar pattern, and a reproducible result. What more proof could you want?
2.I know the struggle of which you speak! The bondage of language! The piercing, sharp pain of desire to be free, and yet be ruled by the urgency of the moment! The overwhelmingly powerful undertow of love! Spinning and tumbling me, over and over, endlessly! My very existence is proof enough!
3.If I have this conflict in me right now, right here, is it any wonder everything else is so difficult to decide? My apologies to jinn in this digression from Terry. Have you ever written love poetry, old dad?
>liberty, umm, sorry but i don't get your argument. Are you saying there is no brain damage? All twenty-something neurologists agreed there was. they differ on the amount.
No. I am simply saying that unless someone is a medical doctor - a neurologist, in fact - I would not use the scan in order to make an argument. It may not indicate exactly what you think it indicates. For one thing, it almost certainly is not proof that she has fluid where brain should be.
Here is a medblog entry on the scan. In part it reads:
Thanks to reader "primer" I've been directed to the University of Miami Ethics program website where they posted this image from a CT scan of Terri Schiavo's brain in 1996.
...
Second, Terri's cerebral cortex has not been replaced by fluid. That is inaccurate. The cortex is thinned and the sulci are enlarged. There is a difference.
Third, and most importantly, given the amount of atrophy on this image I disagree with the court's inadequately considered conclusion.
First of all, the University of Miami's appellation for this scan is inaccurate. "Cortical regions" are not and can not be filled with spinal fluid. The sulci (spaces between cortical ribbons) are enlarged secondary to cortical atrophy and these sulci are filled with cerbrospinal fluid.
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.
So, this medical profession, looking at the CT, thinks that it could be the CT of a fairly healthy, but elderly, somewhat senile woman. And this is evidence that we should kill her because she has no brain left?
And this is evidence that we should kill her because she has no brain left?
No, liberty. I think everyone agrees there are much better tests available that she could have. If it was up to me, I'd love to see subset terri get to live. But it is not. The reason she will not live is legal.
I base my assessment of her condition more on the fact that they have not taught her a gestural protocol, even tho the Schindlers and various neurologists claim she is responsive to stimuli. I think this means she does not have consistant control of her voluntary muscle groups, even of her eye tracking. Look-here-for-yes is a simple one she should be able to handle. Even very small children can learn sign language. That they cannot teach a gestural protocol argues for random movement, at least part of the time.
I'm sorry, but I just don't think there is much hope for subset terri. And not because of the lack of fMRI data, but because of states rights and our judiciary system.
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