Thursday 24 March 2005

In Re: Terri Schiavo

A Brain link, and a rather tragic one. My comments over at Rocket Jones from a few days ago.
From what I've read, no MRI or PET scan has ever been performed on the lady in question. There's some serious questions about *this case* that means you can't go by general principles. Ny initial reaction of "For God's sake, let her go in Peace!" has been changed by what research I've done, and I'm not sure now what the position is or should be.

Now it's become a political cause celebre the details and facts about what should have been a difficult but straightforward medical and ethical decision have become blurred by misinformation.
Or, as the Legal Blogger Par excellence, Eugene Volkh said at the time :
I know nothing about the Schiavo matter, and despite that have no opinion.
This is getting Icky. Really Icky.

For those with a stronger stomach than mine, I recommend the University of Miami Ethics Page on the subject.

There's one good thing: the ruckus about the "Big Picture" on great Ethical Issues is unlikely to make any difference to Ms Schiavo.

From Alas, A Blog :
It is true that given the poor resolution of this image, it's possible that some cortical tissue has been spared. But that doesn't matter. Whatever wisps of cortex we might be missing in this image are not enough to sustain behaviors that could differentiate Terri Schiavo from any other vertebrate. All the neural equipment you need to do ocular following and emotional responses is subcortical. All the neural equipment you need to be a self-aware, reasoning, behaving human being is cortical. And since i gather this image was made some time ago, the present condition of the brain can only be worse.

There is no way any qualified brain doctor or scientist could look at this image and suggest that significant recovery of function is possible. The fact that we could have all this discussion on the subject is a triumph of politics over science. Tragic for Terri Schiavo, and really for us all.
The poster's qualifications?
I am not a medical doctor, and I do not evaluate human brain images as part of my daily work. I AM a recent behavioral neuroscience PhD, a research fellow in a neurophysiology lab at a major institution, and I took clinical neuroanatomy in the medical school of my graduate institution as part of my coursework; neurology rounds and clinical evaluations of CAT and MRI scans were part of the curriculum. In addition, the jewel in the crown of my graduate program was a research-dedicated MRI, which meant that many of my peers did imaging work and I had to sit through countless (zzzzzzz) departmental colloquia featuring functional brain imaging. So, no argument from me - I am not the most qualified person to evaluate Terri Schiavo’s status from one small CAT picture on the web; that would be someone who evaluates scans professionally (or at least, regularly). But part of the point of my post was that I don’t have to be - I know how brains work (I mean, up to a point, obviously), I know what healthy ones and sick ones look like, and I know what I’m looking at when I look at a brain image. Schiavo’s damage is so severe that it doesn’t take an *expert’s* eye, but merely an *educated* eye, to understand the basics of her status. That’s why I’m so amazed that her prognosis is being discussed as if it were controversial.

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