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June 16, 2005
The Schiavo Finale, Lacking Finality

With the release of the autopsy results for Terri Schiavo, we now know much we didn't before, and much that we simply couldn't. Other questions went unanswered, and the coroner even created a new mystery that necessarily will go unsolved:

Although the meticulous postmortem examination could not determine the mental state of the Florida woman, who died March 31 after a judicial and legislative battle over her "right to die," it did establish the permanence of her physical condition.

Schiavo's brain damage "was irreversible . . . no amount of treatment or rehabilitation would have reversed" it, said Jon R. Thogmartin, the pathologist in Florida's sixth judicial district who performed the autopsy and announced his findings at a news conference in Largo, Fla.

Still unknown is what caused Schiavo, 41, to lose consciousness on a winter morning in 1990. Her heart beat ineffectively for nearly an hour, depriving her brain of blood flow and oxygen.

A study of her organs, fluids, bones and cells, as well as voluminous medical records, failed to support strangulation, beatings, a drug overdose, complications of an eating disorder or a rare molecular heart defect. All had been offered as theories over the past 15 years. Thogmartin said the cause will probably never be known.

The most hysterical charges involving Terri's husband were proven false, including the notion that he had injected Terri with insulin at some point to kill her. Some of the most well-publicized assertions about her activities also were shown to be wishful thinking, such as an ability to eat and drink without the feeding tube and Terri's following visual cues, which she seemingly did in the video released by her family. With her vision center destroyed, she had cortical blindness. In the opinion of the coroner after examining the brain, Terri's condition would never have improved.

However, other issues remain unresolved. An autopsy cannot determine the existence of PVS, as the coroner went out of his way to remind everyone. Dr. Thogmartin's careful analysis could find no evidence that Terri had been abused, relying on contemporaneous medical records as well as his autopsy, but could determine no cause for her collapse. That's unfortunate, as the lack of finality on that point will mean that speculation will endure forever.

What we have left are the issues that started the debate in the first place. Unlike today's New York Times editorial's assertion on the subject, this was not a "right to die" case. Terri had never requested to die, not with any transparency or formality. All we had for witnesses on her state of mind was a husband who waited until after he had won a substantial lawsuit to recall a conversation in which Terri made an offhand comment about not wanting to live on a respirator, and two of his relatives who corroborated him. The husband had a conflict of interest in the matter, having started a new relationship with another woman and fathering two children. On the other side, Terri's parents and siblings were willing to take over her medical care and the responsibility for its costs.

Amd most of all, as the coroner affirmed yesterday, Terri was not dying.

Despite all of this, Florida decided that it would deliberately kill Terri on the basis of her husband's wishes, without any living will or formal indication of her state of mind. As Rick Santorum said yesterday, such a ruling should have been allowed to receive a de novo hearing in federal court for a review, just as any death-penalty case would get. Without that, essentially Terri's fate rested on two men, Michael Schiavo and Judge George Greer, who refused to release the case to another court at any point in order to get a new hearing on the merits in front of another judge. And when the state decides to kill someone who isn't dying on their own -- as opposed to stopping artificial breathing/cardiac support for those who lack any ability to survive without it -- it should have more substantial oversight before doing so, and it should have more to rely on than an estranged husband's belated recollection of a superficial, general conversation as its basis.

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Posted by Ed Morrissey at June 16, 2005 5:03 AM

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