Terri Shiavo

[Jenifer]

Originally posted by Snow@Mar 21 2005, 11:10 PM

PD,

I think it is misguided to compare this to a criminal case. There is no crime involved. Heaven forbid that the same standard apply to health care decisions of private parties.

There was a 2 hour hearing today in Federal Court. The judge found nothing that would indicate that Terri's rights have been violated. As to a new hearing... keep shopping till you find the answer you like? I would say (if it were me or my family)... YOU (the govt.) Stay out of my life. It is not up to you. If you want the govt to make your healthcare decisions, then put that in your living will. However, allow me and my family to make our own decisions. That's the issue, not whether those in her condition should have there lives terminated, but rather can families make their own decisions.

The more I learn about this the more I think that the spouse or ex-spouse (whatever he is) is right. The family or those on the side of the family have so distorted the whole thing to suit their own ends. They claim that the spouse has withheld an MRI and refuses rehab. They say that the video shows that she is alert and oriented. According to ABC News tonight rehab therapy and treatement, including and MRI and including experimental therapy was attempted, with no results for 4 years. The MRI showed that the critical part of her brain was mush. Those that have actually seen the whole video that was shot say that the family has only extracted the key parts that give the illusion of cognition but a complete viewing indicate that there is no cognition (like in surverys showing that 3 out or 4 dentists prefer toothpaste x - what they do is get a population of 100s of dentists, divide them up into groups of 4 and survey them, they keep asking until at least one group of 4 has 3 dentists choosing toothpaste x, even though almost all other dentists in the population could choose anything but x). An individual, I didn't catch his role for sure but he appeared to be a disinterested 3rd party (and attorney) sent by the court to review the case. He spent 6 weeks, reviewed 30,000 pages of court and medical and related records and spent hours and hours every day with Terri and he says that she didn't show any cognition... he also talked about the extensive rehab she had received... all to no avail.

No kidding. What is the use in living, if one is not living? Personally, I'd rathar be dead than living in a lifeless shell.

The next thing you know, people will be campaigning against killing vampires and zombies. DON'T murder the poor ZOMBIES! We can make them not empty shells again!

[Jenifer]

Think of the VAMPIRES! They have feelings too! Don't murder the poor VAMPIRES!

[Marsha]

Originally posted by Snow@Mar 22 2005, 02:26 AM

Besides being just the spouse, he is the legal guardian. Of course he can make decisions without her other family. Think about it. Your mother and father don't pay joint taxes, don't raise your kids, don't share your bed, don't have any standing in your marriage.

I was outraged when this hit the news again. It would be hard to just let a loved one die.

Has the news reported how long they were together before she got ill? I haven't heard. Months, Years?

I have to agree with Snow on this one. It is up to her spouse to make the decision. Even though he went on with his life, he has obviously included Terri in it by making the decisions for her for the past 15 years. He could have divorced her long ago but chose not to, even at the begging of her parents to.

I can't imagine being in any of their shoes. My prayers go out to the entire family.

Marsha

[StrawberryFields]

Originally posted by Marsha@Mar 22 2005, 05:58 AM

Has the news reported how long they were together before she got ill? I haven't heard. Months, Years?

Even though he went on with his life, he has obviously included Terri in it by making the decisions for her for the past 15 years. He could have divorced her long ago but chose not to, even at the begging of her parents to.

Even though he is still married to her he has left her emotionally.

Did anyone see Nightline News last night?

[StrawberryFields]

Terri Shiavo's website

http://www.terrisfight.net/

Check out the timeline link...

[StrawberryFields]

How was Terri injured in the first place?

http://journals.aol.com/justice1949/JUSTIC...AVO/entries/328

There are just too many questions surrounding Michael Shiavo's intentions and motives.

[StrawberryFields]

Originally posted by Marsha@Mar 22 2005, 05:58 AM

Has the news reported how long they were together before she got ill?  I haven't heard. Months, Years?

Terri was born in 1963.

She was married by the time she was 21.

She collapsed in her home in 1990.

[MBASS]

To answer curvette yes I do have children. I think in a similar situation I would let my son return to his Heavenly Father. I think that a better place than in a hospital here. I definately think that the Husband is sketchy and has ulterior motives though.

[StrawberryFields]

Terri has not had any real chance to be rehabilitated and Michael has seen to this. She deserves a chance in spite of his efforts to hide his mistakes. Wonder what I am talking about? Look at the number of times he has tried (and succeeded) in keeping her from getting better in this link http://www.terrisfight.net/ click on timeline.

She has a chance http://www.lifenews.com/bio748.html

Brain injury does improve with therapy as I have witnessed this for myself.

Here is another case http://www.katesjourney.com/

[Guest TheProudDuck]

Snow -- I recognize this isn't a criminal case. The "clear and convincing evidence" standard in cases like this isn't quite as strong as the criminal standard of "beyond reasonable doubt," but it's more stringent than the ordinary "preponderance of the evidence" standard.

The ordinary presumption is that an incapacitated person would want medical treatment to continue. Evidence can prove otherwise. The best evidence is a written document. Absent that, other evidence is admissible.

One problem I have with Michael Schiavo is that he first "remembered" Terri's alleged statement of a generalized wish not to be a burden or hooked up to respirators, etc. in 1998 -- five years into litigation he'd initiated to get her dead. Litigation which, incidentally, he commenced almost immediately after winning a $1.2 million medical malpractice judgment which was awarded largely on the basis of his representations that he wanted to care for her for the rest of her life.

I hate to make ugly assumptions about people -- but as Michael Jackson probably knows (assuming he really doesn't molest little boys), if you don't want to be suspected of dirty pool, don't conduct yourself in a way that naturally leads to unsettling inferences.

If Michael Schiavo truly is acting out of a selfless desire to honor a promise to his nominal wife, then he's a good man to stay the course in the face of hostility and suspicion, and the circumstances which cast shadows on his motivations are just bad luck. It does cast him in a good light that he's suggested he'll donate the remainder of the $1.2 malpractice award (most of which has been expended on legal fees trying to get treatment stopped, rather than on treatment) to charity, although (1) who knows whether he'd follow through with that; he's changed his mind before (see above re: the malpractice award), and (2) he won't say whether he has an insurance policy on Terri's life.

Litigation tends to take on a life of its own, particularly when you've got an activist attorney like Felos who's heavily invested in "right to die" cases. As I said before, there are some people who never saw a plug or tube they didn't want to yank; it all ties in with a generalized ideology of defining life as narrowly as possible so as to recognize the fewest possible moral duties.

As I see this, this isn't a straightforward case of "intrusive government frustrating family's wishes." This is a case where the government must necessarily be involved either way -- either in favor of allowing parents to continue their daughter's treatment and preserve what little life she has, or allowing her husband to end that remnant of life. It's the government that decides who gets to make the choice, and it is that decision that Congress determined should be subject to federal review, just like other life-and-death determinations.

[Guest TheProudDuck]

Also, Snow -- I may be wrong (who knows, since everybody commenting on this case seems to have different facts), but everything I've seen states that Terri Schiavo has had a CAT scan, not an MRI. The CAT scan does seem to show a brain that looks a lot different from a normal brain, but if I could read a CAT scan properly, I'd be healing people instead of boring myself suing them.

I'm still thinking about your earlier comment suggesting that the fact that it is modern technology that is keeping Terri marginally alive, which would not have been possible a few decades ago, is relevant to the ethical questions presented by this case. Not that I derive my philosophy from comic books, but the Spiderman quote "With great power must come great responsibility" (that's the original Stan Lee line, not the movie version) comes to mind. Assuming that preserving life is a moral duty, if our ability to preserve life expands, so does the duty.

Think of it this way: Before the invention of CPR and defibrillation, if a person didn't have a pulse, he was effectively dead. In an old cowboy movie, you'd hold his wrist for a couple of seconds and if there was no pulse, your only moral duty was to plant the stiff. Now, because of increased knowledge and technology, that would be morally irresponsible.

Of course, there may come a point where nominal life is being preserved so artificially that it can't really be said to be life. A truly brain-dead person -- one without any brainwave activity -- who's being maintained on a respirator isn't alive; his body is basically just part of a machine for pumping oxygenated blood. Things get fuzzy fast once you move away from that absolute.

[Maureen]

Originally posted by TheProudDuck@Mar 22 2005, 01:03 PM

Think of it this way: Before the invention of CPR and defibrillation, if a person didn't have a pulse, he was effectively dead.

It is still true today even with CPR. The main reason for using CPR is to see if you can bring someone back from the dead.

M.

[Guest TheProudDuck]

Originally posted by Maureen+Mar 22 2005, 02:39 PM--></span><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Maureen @ Mar 22 2005, 02:39 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin--TheProudDuck@Mar 22 2005, 01:03 PM

Think of it this way:  Before the invention of CPR and defibrillation, if a person didn't have a pulse, he was effectively dead.

It is still true today even with CPR. The main reason for using CPR is to see if you can bring someone back from the dead.

M.

Is that right? Can a person be pronounced dead just because she's code blue?

If so, call me a miracle worker with a .500 batting average.

[Maureen]

Originally posted by TheProudDuck+Mar 22 2005, 03:24 PM--></span><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (TheProudDuck @ Mar 22 2005, 03:24 PM)</td></tr><tr><td id='QUOTE'>

Originally posted by -Maureen@Mar 22 2005, 02:39 PM

<!--QuoteBegin--TheProudDuck@Mar 22 2005, 01:03 PM

Think of it this way:  Before the invention of CPR and defibrillation, if a person didn't have a pulse, he was effectively dead.

It is still true today even with CPR. The main reason for using CPR is to see if you can bring someone back from the dead.

M.

Is that right? Can a person be pronounced dead just because she's code blue?

If so, call me a miracle worker with a .500 batting average.

Can I kill someone if I do CPR incorrectly?

No. Remember the person in cardiac arrest is already clinically dead. CPR can only help. Even if it's not done "letter perfect" it will probably provide some benefit to the victim.

http://depts.washington.edu/learncpr/askdo....html#I%20heard

M.

[Snow]

Originally posted by Strawberry Fields@Mar 22 2005, 08:22 AM

Terri has not had any real chance to be rehabilitated and Michael has seen to this. She deserves a chance in spite of his efforts to hide his mistakes. Wonder what I am talking about? Look at the number of times he has tried (and succeeded) in keeping her from getting better in this link http://www.terrisfight.net/ click on timeline.

Perhaps ABC is as trustworthy as the propoganda sites you list but they say she had therapy including experimental therapy for 4 years.

[StrawberryFields]

Originally posted by Snow+Mar 22 2005, 07:46 PM--></span><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Snow @ Mar 22 2005, 07:46 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin--Strawberry Fields@Mar 22 2005, 08:22 AM

Terri has not had any real chance to be rehabilitated and Michael has seen to this. She deserves a chance in spite of his efforts to hide his mistakes. Wonder what I am talking about? Look at the number of times he has tried (and succeeded) in keeping her from getting better in this link http://www.terrisfight.net/ click on timeline.

Perhaps ABC is as trustworthy as the propoganda sites you list but they say she had therapy including experimental therapy for 4 years.

Show me.

Why in the yell would you call these sites propoganda?

[Snow]

Originally posted by TheProudDuck@Mar 22 2005, 12:03 PM

Also, Snow -- I may be wrong (who knows, since everybody commenting on this case seems to have different facts), but everything I've seen states that Terri Schiavo has had a CAT scan, not an MRI. The CAT scan does seem to show a brain that looks a lot different from a normal brain, but if I could read a CAT scan properly, I'd be healing people instead of boring myself suing them.

I'm still thinking about your earlier comment suggesting that the fact that it is modern technology that is keeping Terri marginally alive, which would not have been possible a few decades ago, is relevant to the ethical questions presented by this case. Not that I derive my philosophy from comic books, but the Spiderman quote "With great power must come great responsibility" (that's the original Stan Lee line, not the movie version) comes to mind. Assuming that preserving life is a moral duty, if our ability to preserve life expands, so does the duty.

Last night ABC News said MRI, and that would have been years ago, in the mid 90s. The CT scans would have been more recent.

I agree that with power comes authority. I also note that so many these people jumping up and down trying to save Terri's life by feeding her via a tube and machine don't and won't lift a finger to help feed starving children and adults the world over who have in fact made their wishes (to eat) explicit. What duty do we, the U.S. civilation have to Terri that we don't have to every other life we could save?

[Jenda]

Originally posted by Snow@Mar 22 2005, 06:55 PM

I also note that so many these people jumping up and down trying to save Terri's life by feeding her via a tube and machine don't and won't lift a finger to help feed starving children and adults the world over who have in fact made their wishes (to eat) explicit. What duty do we, the U.S. civilation have to Terri that we don't have to every other life we could save?

That is a blatantly false accusation whose only purpose is to cast doubt on the persons taking the opposite POV.

It's one thing to be righteously indignant, it is another thing to try to strip away the integrity of another person just because you are losing the discussion.

[StrawberryFields]

Originally posted by Snow@Mar 22 2005, 07:55 PM

What duty do we, the U.S. civilation have to Terri that we don't have to every other life we could save?

Snow, I realize that this is your thread but I also have a great deal of passion for this topic.

Contrary to popular belief Terri human and she is disabled and should be protected not starved to death.

Here is another "propaganda" link

http://www.expertclick.com/NewsReleaseWire...eDetail&ID=8472

Blow is a portion of what you will read...only click on the link if you can stomach the details of starving to death

TERRORISTS & SERIAL KILLERS TREATED BETTER THAN TERRI SCHIAVO!

Starvation is not a pretty picture,¡¦M.D. explains.

(Los Angeles, California) Got compassion? Apparently not enough in the Florida courtroom of Judge Greer, who has sentenced Terri Schiavo to death, beginning this Friday, March 18, 2005. ¡¦Beginning¡¦is the key word here -- since taking away her feeding tube will not kill her instantly, explains Carole Lieberman, M.D.

It is not like disconnecting someone from a respirator or giving them a lethal injection ¡¦both of which kill quasi-painlessly. But death from starvation and dehydration is slow and painful!¡¦

[Guest TheProudDuck]

I agree that with power comes authority. I also note that so many these people jumping up and down trying to save Terri's life by feeding her via a tube and machine don't and won't lift a finger to help feed starving children and adults the world over who have in fact made their wishes (to eat) explicit. What duty do we, the U.S. civilation have to Terri that we don't have to every other life we could save?

I'm a little surprised at that argument. I'd be willing to bet that to the extent the do/don't starve-Terri divide reflects the general American political divide, the "don't" side beats the "do's" in charitable contributions by a fair sight.

The poor will always be with us. No matter how much America and Americans do to feed starving children and adults the world over -- which is one heck of a lot -- we could always do more. This fact that we're not doing everything often gets held up as a reason for not doing one particular thing: "How can you justify spending X on Y when people are [starving in Eritrea, being trafficked in Moldova, being eaten in the Solomon Islands, being massacred in Sudan, etc.]?" But that's ridiculous. By that logic, we couldn't possibly justify any number of life-preserving measures. For example, the new standards for (naturally-occurring) arsenic in drinking water will cost gajillions of dollars to comply with, and are statistically expected to save only a handful of lives. That money could have gone a long way towards feeding/healing/saving the starving/sick/massacred children of Gondwanaland, but boy was there some hoo-hah when the implementation of those new standards was delayed for a couple of weeks. Heck, for that matter, virtually the entire American medical system is unjustifiable: How can you justify spending eleventy thousand dollars extending the life of some cholesterol-jammed octagenerian by a few months or years, when that same amount could save the lives of literally hundreds of African children dying from contaminated water, malaria, etc.?

In answer to your question, the duty that American civilization has to Terri Schiavo that it doesn't have to the suffering masses around the world is this: For better or for worse, following her original collapse, we began medical treatment, and in so doing undertook certain affirmative duties to her. (Anglo-American law traditionally doesn't impose affirmative duties, but once such duties are voluntarily undertaken, a duty arises to discharge them properly.) By attaching a feeding tube in the first place, the situation was changed to be such that if Terri were to die, it would be because of an affirmative act -- the removal of the feeding tube. A civilized society should not take affirmative measures to cause a person's death without a compelling reason -- in this case, clear and convincing evidence that the person would refuse medical treatment, as is her right, were she capable of expressing such a refusal.

Finally, there's the fact that, for some reason I haven't quite figured out but still don't really question, we owe greater duties to those close to us. I would do more to help my children than to help a friend, more to help my friend than a stranger, and am more willing to pay taxes to support social services for my countrymen (which services may eventually be used by me or by those close to me) than to support people in other countries. It's good to be a generous citizen of the world, but it's also important not to be like that Dickens character who obsessed about suffering African natives but was oblivious to the sufferings going on in her own neighborhood.

[Snow]

Originally posted by Strawberry Fields+Mar 22 2005, 07:05 PM--></span><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Strawberry Fields @ Mar 22 2005, 07:05 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin--Snow@Mar 22 2005, 07:55 PM

What duty do we, the U.S. civilation have to Terri that we don't have to every other life we could save?

Snow, I realize that this is your thread but I also have a great deal of passion for this topic.

Contrary to popular belief Terri human and she is disabled and should be protected not starved to death.

That doesn't really address my point and it trivializes, and incorrectly so, those that support the idea that the govt should stay out of private health care decisions. No one thinks that Terri is not a human being.

[Snow]

Originally posted by TheProudDuck@Mar 22 2005, 08:21 PM

I agree that with power comes authority. I also note that so many these people jumping up and down trying to save Terri's life by feeding her via a tube and machine don't and won't lift a finger to help feed starving children and adults the world over who have in fact made their wishes (to eat) explicit. What duty do we, the U.S. civilation have to Terri that we don't have to every other life we could save?

I'm a little surprised at that argument. I'd be willing to bet that to the extent the do/don't starve-Terri divide reflects the general American political divide, the "don't" side beats the "do's" in charitable contributions by a fair sight.

The poor will always be with us...

No matter how much America and Americans do to feed starving children and adults the world over -- which is one heck of a lot -- we could always do more. This fact that we're not doing everything often gets held up as a reason for not doing one particular thing: "How can you justify spending X on Y when people are [starving in Eritrea, being trafficked in Moldova, being eaten in the Solomon Islands, being massacred in Sudan, etc.]?" But that's ridiculous. By that logic, we couldn't possibly justify any number of life-preserving measures. For example, the new standards for (naturally-occurring) arsenic in drinking water will cost gajillions of dollars to comply with, and are statistically expected to save only a handful of lives. That money could have gone a long way towards feeding/healing/saving the starving/sick/massacred children of Gondwanaland, but boy was there some hoo-hah when the implementation of those new standards was delayed for a couple of weeks. Heck, for that matter, virtually the entire American medical system is unjustifiable: How can you justify spending eleventy thousand dollars extending the life of some cholesterol-jammed octagenerian by a few months or years, when that same amount could save the lives of literally hundreds of African children dying from contaminated water, malaria, etc.?

In answer to your question, the duty that American civilization has to Terri Schiavo that it doesn't have to the suffering masses around the world is this: For better or for worse, following her original collapse, we began medical treatment, and in so doing undertook certain affirmative duties to her. (Anglo-American law traditionally doesn't impose affirmative duties, but once such duties are voluntarily undertaken, a duty arises to discharge them properly.)

Finally, there's the fact that, for some reason I haven't quite figured out but still don't really question, we owe greater duties to those close to us. I would do more to help my children than to help a friend, more to help my friend than a stranger, and am more willing to pay taxes to support social services for my countrymen (which services may eventually be used by me or by those close to me) than to support people in other countries. It's good to be a generous citizen of the world, but it's also important not to be like that Dickens character who obsessed about suffering African natives but was oblivious to the sufferings going on in her own neighborhood.

You're right. It is more of an observation and not a proper argument. I should have seperated it and said so.

By attaching a feeding tube in the first place, the situation was changed to be such that if Terri were to die, it would be because of an affirmative act -- the removal of the feeding tube.  A civilized society should not take affirmative measures to cause a person's death without a compelling reason -- in this case, clear and convincing evidence that the person would refuse medical treatment, as is her right, were she capable of expressing such a refusal.

It is only an affirmative act because you have so framed it. I doubt that they actually pulled the tube, that would leave a hole. When I have seen this done, they simply stopped the machine from continuing the feeding, thus by your framing, it wouldn't be an affirmative act, it would just be like not performing CPR or not giving a potentially life saving medication. But at any rate, that argument ignores that quite regulary we affirmatively stop treatment and allow people to die. The question is not whether it is an affirmative or passive act but rather in the absence of written and verified instructions can a surrogate make health care decisions. Of course the answer is yes, our system of medicine could not function were it not so. So the real question, can a surrogate decide to end treatment that would then result in death and of course the answer is yes, absolutely, it happens all the time. If Terri were on a ventilator or heart/lung machine, this story would have gotten no play. But remember, tubes on people in Terri's condition are pulled daily, seriously daily and no one says boo. So, then, isn't the real question - can a legal surrogate make life/death health care decision when other interested but non-surrogates, disagree and are willing to make a public show of it all.

... after all is said and done, I wouldn't want the govt to force their morals upon me or my family. The government has little or no moral authority.

[Guest TheProudDuck]

... after all is said and done, I wouldn't want the govt to force their morals upon me or my family. The government has little or no moral authority.

Agreed in principle, but I think the government is going to be involved either way, if only by (1) determining who the proxy for an incapacitated person will be, and (2) reviewing the proxy's decisions to ensure, as much as is possible, that they reflect the incapacitated person's likely wishes. After all, it's not as if the spouse of any incapacitated person can just walk into a hospital room the day after an incapacitating accident and pull the plug. The hoops that have to be jumped through to be recognized as a surrogate and to take major actions in that capacity are all incidents of a system designed to enforce public morality -- in this case, the values of life and personal autonomy.

In this case, I think the judge blew both calls. I tend not to buy late-in-the-game sudden late-in-the-game recollections of convenient facts, least of all when lawyers are involved. And if Terri's nurse wasn't lying when she testified Mr. Schiavo muttered "why won't the b**** just die", then his legal surrogacy should have ended right then and there.

[Snow]

Originally posted by TheProudDuck@Mar 23 2005, 12:17 AM

The hoops that have to be jumped through to be recognized as a surrogate and to take major actions in that capacity are all incidents of a system designed to enforce public morality -- in this case, the values of life and personal autonomy.

The reality is that tubes are pulled daily in nursing homes with an order of a doctor who says he has obtained "informed consent" from the proper party(s). The facility may ask if there are any other relatives who might protest but there are few hoops if the paient has a willing doctor and willing spouse or kids and the facility is willing.

[StrawberryFields]

Originally posted by Snow+Mar 22 2005, 10:26 PM--></span><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Snow @ Mar 22 2005, 10:26 PM)</td></tr><tr><td id='QUOTE'>

Originally posted by -Strawberry Fields@Mar 22 2005, 07:05 PM

<!--QuoteBegin--Snow@Mar 22 2005, 07:55 PM

What duty do we, the U.S. civilation have to Terri that we don't have to every other life we could save?

Snow, I realize that this is your thread but I also have a great deal of passion for this topic.

Contrary to popular belief Terri human and she is disabled and should be protected not starved to death.

That doesn't really address my point and it trivializes, and incorrectly so, those that support the idea that the govt should stay out of private health care decisions. No one thinks that Terri is not a human being.

Snow,

The government should do a lot of things they do not do, but they should protect those who can not protect themselves. The disabled and child are two parties who should be protected by the government.

Yes, I believe that the U.S. civilization should have a vested interest in what happens in Terri’s case because this case will set precedence for others to come. Any one of us could be in Terri's position with the blink of an eye because brain injury is REAL and it happens to people every day. It is the reality of how easily this can happen to us or one of our loved ones which keeps most people in denial that it exists.

Brain injury occurs more often then people realize.

Traumatic Brain Injury (TBI) and Acquired Brain Injury

Brain Injury: Introduction

According to the Brain Injury Association of America, more than 1.5 million Americans suffer brain injuries each year; of these, roughly 50,000 die and 80,000 are left permanently disabled. These disabilities are physical, cognitive, behavioral, and emotional. Those victims who survive brain injury and who are not left permanently disabled need, on average, five to 10 years of rehabilitation before they can lead normal lives.

Understanding Brain Injury

A normal brain sends messages via nerves to all parts of the body, signaling them to carry out their functions. These functions include everything from regulating breathing, heart rate, body temperature and metabolism to facilitating cognitive thought, vision, hearing, sense of smell, and the sensation of touch. Every section of the brain has its own tasks; if a section is injured, the entire system can be thrown off.

When a brain is injured, it cannot adequately carry out all functions as it did before. Nerves and neurons may not be able to deliver their messages, thereby affecting speech, bodily movement, thought processes, personality, and internal functions, such as blood pressure and bladder control. Such injury is called a brain injury.

There are two types of brain injury: traumatic brain injury (TBI) and acquired brain injury. Both can have devastating, permanent effects and can even cause death.

Traumatic Brain Injury (TBI)

Traumatic brain injury (TBI) is caused by an external force, usually in the form of a blow to the head. Car accidents, firearm accidents, brawls, slip and fall, and sports such as skiing are some of the most common causes of traumatic brain injury, as are incidents in which the brain is shaken violently inside or ricocheted off the skull (such in the case of Shaken Baby Syndrome and some high-speed car accidents). Diffuse Axonal injury, concussion, contusion, Coup-Contrecoup Injury, Second Impact Syndrome, and penetration injury also fall under traumatic brain injury. Sometimes, the outside force is so strong that it breaks the skull, which can dig into and subsequently injure the brain.

Symptoms of traumatic brain injury include:

• Dilated pupils

• Loss of consciousness/confusion

• Changes in vision (blurred vision, seeing double, intolerance of bright light)

• Dizziness or difficulty balancing

• Respiratory failure

• Coma

• Paralysis and trouble moving parts of the body

• Poor coordination

• Weakness/ lethargy

• Slowed pulse and breathing rate

• Vomiting

• Tinnitus

• Cognitive thought problems

• Loss of bowel or bladder control

• Unexplained emotional outbursts

Levels of Traumatic Brain Injury

There are several levels of traumatic brain injury, ranging from mild to severe.

Mild Brain Injury

Generally referred to as a concussion, a mild traumatic brain injury is characterized by either a brief loss of consciousness or a feeling of confusion. Tests or scans often appear normal; however, the victim’s personality, memory, physical abilities, or other functions may be affected.

Moderate Traumatic Brain Injury

A moderate traumatic brain injury is caused by loss of consciousness that lasts from a few minutes to a few hours. The accompanying confusion can last from days to weeks, while physical, cognitive, behavioral, and/or emotional impairment can last for months or become permanent.

Severe Traumatic Brain Injury

A severe traumatic brain injury involves a prolonged unconscious state or coma that lasts days, weeks, months, or even years. Typically, the longer an individual remains in a coma, the greater the amount of brain damage and the less promising the recovery. However, every traumatic brain injury is different, and every victim responds differently.

Measuring the Severity of a Traumatic Brain Injury

Generally, the Glasgow Coma Scale is used to gage the severity of a traumatic brain injury. The Scale measures eye opening ability, verbal response, motor response, and other areas and gives each a score. These scores are then totaled and evaluated – the lower the score, the more severe the brain injury.

The Glasgow Coma Scale is used as a preliminary evaluation tool to gauge the severity of a TBI. It measures post-trauma eye opening abilities, verbal responses and motor responses, assigning each area a score. The scores from each section are then added together for a total score - the lower the score, the worse the initial traumatic brain injury.

Acquired Brain Injury

Acquired brain injury is caused by a disruption in oxygen flow to the brain. Stroke, aneurysm, heart attack, tumors, infectious disease, airway obstruction, near-drowning, crushing injuries to the chest, toxic exposure , drug abuse, vascular disruption, infectious disease, meningitis, and more are typically culprits. Further, reckless behavior (such as drunk driving), medical malpractice, and medical negligence can also cause acquired brain injury. In addition, birth trauma can cause acquired brain injury. Such acquired brain injury can affect reasoning, cognitive thought, memory, physical ability, psychosocial behavior, and personality, among other traits and functions.

Symptoms of acquired brain injury include:

• Cognitive impairment (memory, thought, etc.)

• Vegetative state for extended periods of time

• Behavioral problems (acting out, depression, resistance, psychosis, etc.)

• Muscle coordination problems

Treating Brain Injury

First, realize that because every brain injury is different, every victim should undergo a personalized rehabilitative treatment plan. Such a plan might include physical rehabilitation, medication, community support programs, speech/cognitive thought rehabilitation, neuropsychological services, and other options. This care may be administered on either an inpatient or outpatient basis.

Most brain injury victims fare best when they have a team of caretakers and supporters, from doctors, nurses, and psychotherapists to family members, close friends, and even coworkers. Having a solid support network can lessen the emotional blows – including depression and mood swings, dealt by brain injury.

This could someday be someone who you love and care about... I pray that it never happens to one of our children who is "married" to a self serving spouse.

Has this case changed they way I feel about living wills? You bet it has! I will council those who have them not to place just one person (guardian) in charge of their care. I believe that in light of what I have seen, that it is just not a spouse who should have control, but the families who's influence isn't muddied like that of Michael Shiavo.