Posted on 04/29/2004 9:12:53 AM PDT by cyn
LIFE AND DEATH TUG OF WAR -- 5 teeth removed from brain-disabled woman.
It's been exactly one month since Robert and Mary Schindler last saw their daughter, Terri, the brain-disabled woman whose right to live is at the center of a major euthanasia battle being fought in the Florida courts between her estranged husband, who wants to remove her feeding tube so she will die of starvation, and her parents who are doing everything they can to prevent that from happening.
Since then, the only news the Schindlers have received about their daughter's medical condition is that in the week following Easter, an unnamed oral surgeon examined Terri's mouth and extracted five of her back teeth because of their discoloration. Her remaining teeth were scraped and said to appear healthy.
Word of the impromptu tooth-removal was faxed April 20 to the Schindlers' attorneys by Deborah Bushnell, who represents Michael Schiavo – Terri's estranged husband and legal guardian – in an ongoing legal battle with his parents-in-law. According to Bushnell, the oral surgeon attributed the deterioration of Terri's teeth to "non-use over the years" and advocated their removal "to avoid problems."
That the incapacitated woman, who cannot speak though she tries to, endured oral surgery all alone without her parents present to comfort and reassure her came as a shock to her family and friends.
"It's simply unbelievable," said Pamela Hennessey, volunteer spokesperson for the Schindler family. "They've extracted five teeth from her head without much explanation and no notification."
However, Hennessey exclaimed, she shouldn't be too surprised.
Par for the course
"It's really just par for the course; it's how this woman has been treated from the beginning," she said. "There's nothing fair in anything that's happened to Terri from the time she collapsed. Nothing."
As WorldNetDaily reported, Terri collapsed under unexplained circumstances in February 1990 at the age of 26. Oxygen to her brain was cut off for several minutes, leaving her severely brain-disabled and dependant upon a feeding tube for sustenance.
Schiavo insists his wife told him at some point that she would never want to be kept alive "through artificial means," and four years ago he convinced probate Judge George Greer to allow him to remove her feeding tube. Her parents do not believe Terri made the statements attributed to her, and through a series of legal maneuvers have managed to keep the case and their daughter alive. Their options appeared to have run out last year when the 2nd District Court of Appeal made a final ruling in Schiavo's favor and the Florida Supreme Court refused to hear the case.
In October, Terri endured six days without nourishment and hydration before Florida lawmakers passed "Terri's Law" that allowed Gov. Jeb Bush to intervene and order her feeding tube reinserted, an action immediately challenged by Schiavo's attorney, George Felos, a well-known "right-to-die" advocate. That case is being litigated. If the appeal court strikes down Terri's law as unconstitutional, her feeding tube could be removed again.
The lengthy legal battle between the Schindlers and their son-in-law entered a new phase in the late afternoon of March 29, when a nursing assistant discovered what appeared to be "needle marks" on Terri's arm and the police were notified.
Without informing the Schindlers, Felos sent a statement to the media that came just short of accusing them of sticking needles in Terri either to inject something or withdraw "fluids" from her body. The marks had been spotted by an aide "immediately after a 45-minute visit from her parents" and Terri was in a "disheveled state," the attorney wrote.
Exercising his power as his wife's legal guardian, Schiavo banned her parents and others from visiting her at the Park Place Assisted Living Facility in Clearwater where she has been residing since mid-December.
Toxicological tests were conducted at once and came back negative, an indication that no one had injected Terri with any drugs, and her doctor admitted to the St. Petersburg Times that the marks could have been caused by jewelry or someone's fingernails. Moreover, it became quickly apparent that the discovery had been made several hours following the Schindlers' visit, not "immediately after."
Nonetheless, Schiavo ordered the ban remain in place until the Clearwater Police Department completed an investigation of the incident, which likely won't occur any time in the foreseeable future.
Wayne Shelor, public affairs spokesperson for Clearwater PD, refuses to release the slightest piece of information to the media regarding the progress of the investigation, but did tell WorldNetDaily that three detectives have been assigned to the case, with Detective Sgt. Doug Barry in charge.
"[The investigation] will continue until it's complete," is all Shelor will say.
Schiavo's ban on family visits may have been prompted by a growing public awareness of Terri's condition – the neglect of her health and hygiene and an observed decline in her care. Mary Schindler has complained on numerous occasions that since being moved to Park Place, her daughter's hair was not being washed as frequently as it should be, that she was not kept clean and had developed a bedsore on her buttocks, the first she'd ever had.
Recently, Terri lost two teeth – hardly a surprise since she has not received even minimal dental care for years and the teeth in question had become black before breaking off at the root. The Schindlers have been kept in the dark as to what became of the teeth. Did they fall out of her mouth or did Terri swallow them? No one will say.
It is not clear from Bushnell's letter whether any of the teeth extracted were those which had broken off.
Bushnell did not return WorldNetDaily's phone call.
Neglect, pure and simple
Jan Craddock, a Tampa dentist specializing in teeth restoration, had sharp words to say about the lack of care Terri has received as evidenced in Bushnell's letter. In addition to maintaining a busy practice, Craddock has served as an expert witness in a number of malpractice cases and developed forensic expertise working with law enforcement.
First of all, that Terri is fed through a tube into her stomach and does not chew her food would not cause her teeth to blacken and deteriorate, he told WorldNetDaily.
"I would like to find an oral surgeon who would suggest that deterioration of the teeth was due to nonuse," he exclaimed. "Teeth don't deteriorate from nonuse. Except in the case of certain systemic developmental disorders, which Terri did not have, teeth only deteriorate from decay or are lost because of gum disease. Both of these are preventable with proper hygiene. This is a case of neglect, pure and simple."
Said Craddock: "I have never, ever heard of anybody suggesting a disease process that would initiate the breakdown of normal, healthy teeth because of nonuse. The only way teeth break down is through demineralization and a breakdown of the enamel and the dentin, that is, the hard, physical structure of the teeth. The only thing that I've seen that would break the teeth down to the point where they might require extraction are plaque, bacteria and the byproducts that are produced by the bacteria in the plaque, which are what eat the hole in the tooth and make the cavity."
Secondly, normal healthy teeth would not be extracted "to avoid problems" in the future.
"Those five teeth were apparently already causing problems," he said. "That's why the oral surgeon extracted them – because they were either infected, the supporting tissues were infected, or they were so badly broken down that they couldn't be fixed. It's not a matter of nonuse."
Craddock said that without examining Terri's teeth he couldn't say specifically what caused them to turn black or discolor, but he speculated it was either from internal decay within the tooth structure or it was something that would build up on the teeth – like calculus, which is calcified plaque.
Plaque, he explained, transforms from a soft, gooey matrix into a hard deposit because of the calcium in the saliva. These hard deposits must be removed with instruments. That is why for over half a century the American Dental Association advocates brushing one's teeth twice a day and seeing a dentist – for a professional cleaning – twice a year.
Yet according to her medical records, Terri has not had any dental work since at least 1996, despite pleadings by the Schindlers.
Craddock said he couldn't fault the oral surgeon for the extractions without knowing what the state of Terri's mouth and teeth were like and what the options were in treating the problems.
"The oral surgeon may have been outraged by her lack of dental care and refused to have anything more to do with it – and refused to allow his name to be released by Bushnell because he wouldn't want anyone to know he'd been associated with it," Craddock surmised.
The bottom line is that the tooth extractions would not have been necessary had Terri's dental needs been attended to as her parents requested time and again, and as would have been dictated by any reasonable plan of care for a patient with her disabilities.
"She was supposed to get regular dental care," Craddock declared. "There was no reason for her not to get regular dental care just like any other person. If she is truly in a persistent vegetative state that they claim she is, it would be the easiest thing in the world to clean her teeth. She is certainly not going to resist, and from what I've read about the case, she has always responded to anything that tasted good. I think she would have enjoyed getting her teeth cleaned.
"Her teeth should have been cleaned every six months for the last six years and before that. Had it been done every six months, which is an ADA standard that has existed for 60 years, she would not have needed those extractions.
"This isn't something somebody decided last week; this is common knowledge," Craddock concluded. "It's the standard of treatment that applies to everybody, even people with disabilities like Terri. You take them to get their teeth cleaned twice a year. And had she had that done she would not have lost those five teeth."
By what authority?
News of the tooth extraction, which revealed long-standing neglect, was one more outrage to add to a growing list of injuries concerning Terri. That – and the month-long denial of visitation rights to the Schindlers – prompted attorney Patricia Anderson to file a writ of quo warranto Monday on behalf of Bob and Mary Schindler.
Quo warranto means "by what right" or "by what authority" – and it boils down to the fact that Schiavo has never had an annual care plan for Terri in place so that he could carry it out.
"I'm asking the judge to have a hearing and determine that Michael has been acting without authority and to restore visitation," said Anderson.
Specifically, the action asks Judge Greer to direct Schiavo to "demonstrate his authority to act on behalf of the Ward or in derogation of her rights retained under Florida law." Ultimately, the Schindlers want the court to rule that Schiavo is not authorized to act on Terri's behalf.
Anderson explains in her brief:
As Guardian of the Person, [Shiavo] is mandated by the Code to file with and obtain approval from the court for an annual care plan for Theresa Marie Schiavo for the coming year. No guardian may exercise the delegated rights of his ward except pursuant to such a plan. Since 1990, Respondent has never received approval for a care plan on a prospective basis. [He] last obtained approval for a care plan on May 8, 2002, filed Feb. 1, 2002 – for the year ending June 30, 2001, nineteen months late. Respondent has not even filed a proposed care plan since then, relying instead on a series of deadline extensions.
The annual plan, as required by the Florida statutes, "must specify the current needs of the ward and how those needs are to be met in the coming year." It must provide plans for medical, mental health and rehabilitative services in the coming year, plus a description of the ward's attempts at communication and visitation and a description of her social needs.
No provision is made for the elimination of rehabilitative services or medical treatment, or elimination of visitation.
Anderson draws particular attention to the recent tooth extraction – pointing out to Greer that the "discoloration" of Terri's teeth mentioned in Bushnell's letter was first raised before the court in a hearing in February 2002, which was addressing the inadequacy of the proposed care plan.
"[Schiavo] has no right to deny {Terri] 'necessary services and rehabilitation' in connection with these and possibly other, unknown maladies, " Anderson writes.
Information, including court filings, are posted on the Schindler family website.
-----------------------------------------------------------------------
Read WorldNetDaily's unparalleled, in-depth coverage of the fight to save Terri Schindler-Schiavo.
------------------------------------------------------------------------ Sarah Foster is a staff reporter for WorldNetDaily. -- sfoster@worldnetdaily.com
I would really like some direction from those closest to Terri, who best know her needs -- ie, the Schindlers -- especially in light of recent additions to her legal team: Ken Connors in Dec or so, George Tragos last month.
GOAL: Immediate removal of Terri from her unfit guardian and return to the care of her famiy. She remains in great danger until that is done.
What is MOST needed? And what is MOST helpful to accomplish that need? iow, positive, effective actions for Terri and her family.
Yes, it does. And they all know better, too. That is a great and simple truth you've put your finger on, joe. H'mm. . .
This is indeed the health care of the future -- alluva sudden, whoa, we can't take care of all these people! We can no longer afford to give the SIMPLEST, most BASIC care to our elderly and disabled.
Both points make me think of what the atmosphere might have been like in Nazi Germany: the many complicit in atrocities and the seemingly rational arguements for their inhumanity.
Because of discoloration? Huh? Sounds to me like this guy just bought a new car and saw a way to make the payments for the next few months.
Recently, Terri lost two teeth – hardly a surprise since she has not received even minimal dental care for years and the teeth in question had become black before breaking off at the root.
ProLife Ping!
If anyone wants on or off my ProLife Ping List, please notify me here or by freepmail.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.