Wednesday, March 30, 2005

understanding PVS and raising questions

From RangelMD.com comes an accessible write-up on persistent vegetative state (PVS). This is the type of medical information which I have been looking for. And the infomation contained here is quite interesting, especially the point about the state of Terri Schiavo's brain by analyzing her CAT scan:
"The University of Miami web site has a link that it identifies as Mrs. Schiavo’s CAT scan of the head.To the medically trained person this scan appears grossly abnormal and sickening. The blue areas are remaining brain tissue but most of the scan shows black areas which are essentially fluid (cerebrospinal fluid). The normal body reaction to irreversibly damaged tissue is to replace it with fluid and this is clearly what has happened after Mrs. Schiavo suffered severe anoxic damage to her cerebral cortex . Most of what remains of her brain is essentially a fluid filled sac surrounded by a thin shell of brain tissue rather then the solid structure we normally associate with a brain. The deeper parts of her brain including the hypothalamus and brain stem (not shown in the scan) remain intact and these continue to function to cause wakefulness and regulate other automatic body functions. These deeper areas are more resistant to anoxic damage and so were for the most part uninjured from her cardiac arrest."

If this and the findings of Schiavo's doctors raise questions about the appropriateness of providing continued medical care such as artificial nutrition and hydration (ANH) to someone in her condition, then that's to be expected. Is ANH in the case of Schiavo as presented by RandelMD.com still "proportionate" care? Does it constitute a burden to the patient and her family (considering the stress which I presume her family seems to be currently in, due in part from all the media attention, I would say this is a "burden")? Are we keeping Schiavo from a greater and more desired good which is letting her pass from this world and onto the next?

The Church's position is not a vitalist one (for an explanation, see previous post). Yet the Church calls ANH obligatory care. In light of the state of Schiavo's brain, would a restoration of ANH be considered humane?

Read RangelMD.com here.

Powered by Blogger