Posted on 03/23/2005 5:19:45 AM PST by KidGlock
Schiavo Feels No Pain
By Peggy Peck , MedPage Today Staff Writer
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.
March 22, 2005
CLEVELAND-Patients in a persistent vegetative state like Terri Schiavo are a subgroup who suffer severe anoxic brain injury and progress to a state of wakefulness without awareness.
It is judged to be permanent after three months if induced nontraumatically. After 3 months, recovery is rare and life expectancy is approximately 2 to 5 years.
Patients in a persistent vegetative state do not feel pain, nor do they "suffer," says Michael De Georgia, MD, head of the neurology-neurosurgery intensive care unit at the Cleveland Clinic Foundation here.
Pain, as well as suffering, requires consciousness, which is lacking in a person in a persistent vegetative state, says Dr. De Georgia.
"Certainly these patients don't suffer," he adds. "Suffering is really that whole emotional aspect of pain: fear, anxiety, panic surrounding pain. You have to have consciousness to experience these emotions. So just as a person in a persistent vegetative state can't experience pain because of a lack of consciousness, they also don't suffer."
The issue of the potential pain and suffering of Schiavo, 41, the Florida woman who doctors say has been in a persistent vegetative state for 15 years, has become a national cause celebre. On Friday doctors at a Florida hospice removed Ms. Schiavo's feeding tube after a Florida judge approved the action. Since then President Bush signed a rapidly approved law that puts her fate in the hands of a federal court judge. A federal judge in Florida then refused to order doctors to reinsert the feeding tube, and the Schindlers' lawyers said they intend to appeal immediately to the 11th U.S. Circuit Court of Appeals based in Atlanta.
This marks the third time Ms. Schiavo has been taken off parenteral nutrition during a long and contentious legal battle between her husband - Michael Schiavo who says his wife would want the tube removed - and Ms. Schiavo's parents who steadfastly maintain that their daughter would not want the tube removed. The parents, Bob and Mary Schindler, say their daughter responds to them and is not in a persistent vegetative state.
Dr. DeGeorgia says that a patient in a persistent vegetative state can experience arousal, meaning that the patient's eyes may be open and the patient may laugh, cry or appear to track someone who is in the room.
And that is what can be confusing for people, especially relatives, he says. "For example, a patient in persistent vegetative state will grasp your hand. In fact if you put anything into the patient's hand, the hand will grasp it. But this is a very primitive reaction. A newborn baby will grasp your finger, but there is no consciousness."
It is consciousness that determines whether one can "feel" pain in the sense that most people understand when they talk about feeling pain.
This doesn't mean that a patient like Terri Schiavo won't respond to pain stimulus - if you pinch her arm, she is like to flinch away. "That is called nociception," De Georgia says. "Tissue is damaged by the pinch, this generates a response in a receptor, which sends an impulse along the peripheral nerves. This impulse travels to the thalamus, which directs the arm to withdraw," he said. It is what is commonly called a reflex.
Pain, on the other hand, is the recognition of nociception by the nervous system, which sends the impulse to regions of the brain where consciousness exists. In the case of a severely brain injured person - one in a persistent vegetative state - those areas of consciousness have been destroyed, and as result "they don't 'feel' pain."
Which does NOT include Terri Schiavo.
Bravo Sierra meter pegged all the way over on this.
Correct. They kind of blew away the article on the first line.
Of course, we aren't allowed to see her to see if this is true.
Neither does Teddy the K - let's pull HIS feeding tube, OK?
Last night FOX had a RN who was Terri's LPN for several years - 24/7 care. She claims Terri would verbalize "pai" without the n sound to indicate that she was in pain.
It's too bad. In Florida, she would have had better protection from a death sentence from Greer if she had been a pig, alligator or a lobster.
This has the making of a "my doctor can beat up your doctor" thread.
Like they say, if you are going to lie, lie big.
And put it right out there where everyone can see it.
So when does life begin and end then?
This is another lie. This so called medical person does not know what she is saying.
"A newborn baby will grasp your finger, but there is no consciousness."
What the hell?!! Am I reading this right? What a monsterous thing to say.
If they don't feel pain then why was Terri getting pain medication?
Depends on whether it is a WANTED life or and UNWANTED life.
They can bring out 500 more "experts" to try and justify what's happening, but the fact of the matter is that Terri is being killed because she's "inconvenient" to her "husband" (gag) and the culture of death proponents.
Huh?!
Makes killin' 'em that much easier, dontcha know...
So, if she lives far longer than this the diagnoses is wrong, isn't it?
Baloney.
Some doctor called Rush yesterday to protest Dr. Frist (Bill Frist) for trying to save Terri's life because Dr. Frist never saw Terri to make a proper diagnosis.
The hypocrisy of it was that this doctor supported killing her and he never saw her! Rush also pointed out that there are doctors, psychiatists, psychologists, etc. that make "diagnosis" all the time as "experts" on one case or another, without ever having seen the person they are "diagnosing". How many "expects" come out of the woodwork, telling us that some kid who went on a murderous rampage is a psychopath or something?
Good catch.
I couldn't get past the first line of the article.
Remind me never to go to this doctor.
Because it is a lie. Terri feels pain.
Coming soon to a hospital near you!
And the dehumanizing continues.
And if the patient is trying to talk, how can she fall within the PVS definition of "a state of wakefulness without awareness."
Exactly. Because some judge declares that she's PVS doesn't make it so.
Everybody here who has felt pain after a doctor has said, "You won't feel a thing," please raise your hand.
From Gallery Slaves Blog:
I refer readers, again, to the invaluable work of Wesley J. Smith, who detailed the case of Kate Adamson, a woman who, was diagnosed to be in a persistent vegetative state (like Terri Schiavo) and had her feeding tube removed (like Terri Schiavo). It turns out that she wasn't in a PVS and, luckily, she lived to tell us exactly what being dehydrated to death feels like.
Appearing on The O'Reilly Factor, Adamson was asked if having her feeding tube removed was painful. She replied: "Oh, absolutely. Absolutely. To say that--especially when Michael [Schiavo] on national TV mentioned last week that it's a pretty painless thing to have the feeding tube removed--it is the exact opposite. It was sheer torture."
Here is Smith's account of Adamson's story:
In preparation for this article, I contacted Adamson for more details about the torture she experienced while being dehydrated. She told me about having been operated upon (to remove the bowel obstruction) with inadequate anesthesia when doctors believed she was unconscious:
"The agony of going without food was a constant pain that lasted not several hours like my operation did, but several days. You have to endure the physical pain and on top of that you have to endure the emotional pain. Your whole body cries out, 'Feed me. I am alive and a person, don't let me die, for God's Sake! Somebody feed me.'"
Unbelievably, she described being deprived of food and water as "far worse" than experiencing the pain of abdominal surgery. Despite having been on an on an IV saline solution, Adamson still had horrible thirst:
"I craved anything to drink. Anything. I obsessively visualized drinking from a huge bottle of orange Gatorade. And I hate orange Gatorade. I did receive lemon flavored mouth swabs to alleviate dryness but they did nothing to slack my desperate thirst."
Apologists for dehydrating patients like Terri might respond that Terri is not conscious and locked-in as Adamson was but in a persistent vegetative state and thus would feel nothing. Yet, the PVS diagnosis is often mistaken--as indeed it was in Adamson's case. And while the courts have all ruled that Terri is unconscious based on medical testimony, this is strongly disputed by other medical experts and Terri's family who insist that she is interactive with them. Moreover, it is undisputed that whatever her actual level of awareness, Terri does react to painful stimuli. Intriguingly, her doctor testified he prescribes pain medication for her every month during the course of her menstrual period.
In other words, the Times did a story on what being dehydrated to death feels like, but ignored one of the only people alive with first-hand knowledge of the matter.
http://galleyslaves.blogspot.com/2005/03/schiavo-and-times.html
I guess Terri is just a ineart piece of flesh like an unborn child.
BULLSHIT, and don't forgive my french on this one. Ask anyone who suffers from severe dehydration what it feels like.
Is that incredible or what? I am simply stunned.
Herr Doktor DeGeorgia must be an abortionist.
. . .and a newborn does not feel pain??? Right.
The more they explain; the farther from the truth of the matter they get.
These explanations remind me of the common and 'self-serving' beliefs once held; that animals; because they lack 'consciousness' do not feel pain.
A woman was on Fox or 'Larry' the other night . .talking about her 'vegetative state'; she felt pain and fear.
Also a nurse stated that Terri felt pain during her period and would say the word; just was not able to articulate the final consonant. . .
This doctor says:
"It is consciousness that determines whether one can "feel" pain in the sense that most people understand when they talk about feeling pain."
And
"A newborn baby will grasp your finger, but there is no consciousness."
So, therefore, by his own logic, a newborn baby doesn't feel pain? This guy's a NAZI in the making.
I think that line is more frightening than rest of the article. So where does it begin? When the baby starts to talk, walk, pay taxes? the implications of that statement are staggering.
Or a "born child" who cannot grasp something with her hand.
imo
I hope this person is in a hospital unable to communicate while medical people just like this person work on them.
Oh, good. Then maybe people will shut up about how we need to "end her suffering."
"But this is a very primitive reaction. A newborn baby will grasp your finger, but there is no consciousness."
Yeah, because newborns are brain dead. Let's start killing them with impunity, too. After all, they can't *really* feel pain, because there is no consciousness.
These people are utterly vile. Hell will be full to brimming one of these days.
Precisely! If I recall correctly, part of the protocol is an order for morphene. Why would that be needed if there is NO pain. Crap!
I'm so glad they give the definitive explanation.
Now, can they explain why there are a couple of children born with just brainstems, no brains, completely fluid filled craniums who are walking, talking miracles?
Which nurse?
Here, here!
Amnesty for high school girls who who dump their newborn baby in the toilet.
MD's all over the country are disagreeing with the PVS dianosis.
Seems if you want to Kill a disabled person all you have to do is shop around for the right doctor.
Impression:
The patient is not in coma.
She is alert and responsive to her environment.
She responds to specific people best.
She tries to please others by doing activities for which she gets verbal praise.
She responds negatively to poor tone of voice.
She responds to music.
She differentiates sounds from voices.
She differentiates specific people's voices from others.
She differentiates music from stray sound.
She attempts to verbalize.(!!!!!)
She has voluntary control over multiple extremities
She can swallow.(!!!!)
She is partially blind
She is probably aphasic and has a degree of receptive aphasia.
She can feel pain.
On this last point, it is interesting to observe that the records from Hospice show frequent medication administered for pain by staff.
With respect to specifics and specific recommendations in order to carry out the instructions of the Second District Court of Appeal:
From a neurological standpoint: The patient appears to be partially blind.
She needs a full opthamological (eye) evaluation and visual evoked potentials done to flash and checkerboard patters. The opthamological examination is to evaluate her retina and her ophthalmic nerve to try to determine the cause of her visual limitations and if any treatment exists. The evoked potentials looks at the nerve between the eye and the visual centers in the brain, to see if there is treatable damage and the type of damage, if any in these areas.
This is important, as for individuals to interact with her...
*snip*
Communication: She can communicate. She needs a Speech Therapist, Speech Pathologist, and a communications expert to evaluate how to best communicate with her and to allow her to communicate and for others to communicate with her.
Also, a treatment plan for how to develop better communication needs to be done.
*snip*
ENT: The patient can clearly swallow, and is able to swallow approximately 2 liters of water per day (the daily amount of saliva generated). Water is one of the most difficult things for people to swallow. It is unlikely that she currently needs the feeding tube.(!!!!!) She should be evaluated by an Ear Nose and Throat specialist, and have a new swallowing exam.
*snip*
Her physical exam and videotapes also suggest a spinal cord injury is also present, as she has much better control over he face, head, and neck, than over her arms and legs.
This reminds one of a person with a spinal cord injury who has good facial control, but poor use of arms and legs. It is possible that a correctable spinal abnormality such as a herniated disk may be found that could be treated and result in better neurological functioning. This should be looked for, as may be treatable.
Thus, there may be an injured disk or spinal cord; the disk injury is more treatable, the spinal cord injury, if present without a disk injury, may be more difficult to treat.
A person with a spinal cord injury and hypoxic encephalopathy will need different treatment and rehab recommendations than one who just has a hypoxic encephalopathic.
Interestingly, I have seen this pattern of mixed brain (cerebral) and spinal cord findings in a patient once before, a patient who was asphyxiated.
*snip*
____________________________ William M. Hammesfahr, M.D.
Dr. DeGeorgia says that a patient in a persistent vegetative state can experience arousal, meaning that the patient's eyes may be open and the patient may laugh, cry or appear to track someone who is in the room.
Very interesting article (followed by some of the usual emotings). I can buy the part about the baby's grasping the finger being an involuntary reflex, and the difference between stimulus response and actually feeling pain. But, involuntarily tracking someone across a room? Hmm... I remain skeptical.
Too bad Terri isn't a lesbian - then they'd be for saving her.
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