Autopsy suggests Schiavo cognizant

'It's possible Terri was aware of everything being done to her'

Challenging the assumptions of many analysts and news reports, an attorney who specializes in medical ethics cases points out the autopsy report of Terri Schiavo indicates the brain-injured woman might have been cognizant of her surroundings as her family insisted.

Jerri Lynn Ward of Austin, Texas, notes the report released Wednesday in the high-profile case states: "The frontal temporal and temporal poles and insular-cortex demonstrated relative preservation."

"What this tells us is that her cortex retained function and that her brain was more normal in the area that controls higher-level thinking," said Ward, who has weighed in on the case in her weblog and in an interview with "Joseph Farah's WorldNetDaily RadioActive" show.


The autopsy results on the 41-year-old brain-damaged woman were made public more than two months after her death ended a decade-long legal battle that brought in Florida Gov. Jeb Bush, Congress and President Bush.

Schiavo died March 31, nearly two weeks after the feeding tube that had kept her alive was removed under a court order obtained by her husband, Michael Schiavo. Her parents, Bob and Mary Schindler, said they were willing to care for their daughter, insisting she had a strong will to live.

Experts supporting Michael Schiavo -- contending Terri Schiavo's brain cortex essentially was missing and filled with fluid -- concluded she was in a persistent vegetative state. The Schindlers, arguing that their daughter recognized and responded to family members, produced neurologists who diagnosed her as "minimally conscious."

Pinellas-Pasco medical examiner Jon Thogmartin, speaking at a news conference Wednesday, said the damage to Terri Schiavo's brain was "irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons."

But Ward, pointing to the autopsy report, notes the brain's frontal lobe plays a part in impulse control, judgment, language, memory, motor function, problem solving, sexual behavior, socialization and spontaneity.

"It is very possible that she remained cognizant of sounds and other things without being able to communicate," Ward said. "It's possible Terri was aware of everything being done to her -- yet could do little to make people aware that she was there."

Ward pointed out that major damage to Schiavo's brain was shown to be toward the back -- the areas that affect motor skills.

So the question remains, says Ward, was Terri Schiavo still a thinking, aware human being?

In fact, neuropathologist Stephen Nelson, whose assessment is included in the report, conceded there is no way of determining through an autopsy whether a person was in a persistent vegetative state.

A national disability rights group that filed three amicus briefs in the case, Not Dead Yet, said the "real elephant in the living room," is whether or not we can really know how conscious anyone labeled PVS really is.

Several studies have revealed high misdiagnosis rates, the group noted, with conscious people being mistakenly regarded as totally and irrevocably unaware.

The autopsy report's documentation of significant brain atrophy and the assessement that the damage is "irreversible" is not the same as saying she had no cognitive ability, the group pointed out.

"It's always seemed to us that PVS isn't really a diagnosis; it's a value judgment masquerading as a diagnosis," said Stephen Drake, research analyst for Not Dead Yet. "When it comes to the hard science, no qualified pathologist went on the record saying she couldn't think or couldn't experience her own death through dehydration."

Diane Coleman, the group's president and founder, agreed.

"The core issues remain the same," she said. "Protection of the life and dignity of people under guardianship, and a high standard of proof in removing food and water from a person who can not express their own wishes. These are issues of great concern to the disability community -- evidenced by the 26 national disability groups that spoke out in favor of saving Terri Schiavo's life over the past few years."

Abuse not ruled out

Ward also challenges analysts who insist there was no abuse, pointing out the report does not rule out that possibility.

The autopsy report says, rather, that the medical examiner could not detect any evidence.

Ward said the evidence does not rule out that Terri Schiavo's condition could have been triggered by a blow to the solar plexis -- known as commotio cordis -- or by nontraumatic asphyxia, which could be produced by a pillow or hand to the face.

Either could have caused her to lose consciousness without leaving any evidence.

"This report does not rule out abuse," Ward said in an interview with Joseph Farah's WorldNetDaily Radioactive. "It certainly does not exonerate any of the people who were so eager to hasten her death."

Conversely, the report found no evidence to support the theory espoused by Michael Schiavo and his attorneys for 15 years, that the collapse in February 1990 was caused by an eating disorder.

That assertion was the basis of malpractice suits in 1992 that resulted in a settlements totaling more than $1 million.

The autopsy report said no one had ever witnessed Schiavo bingeing and purging, and family members said she had a big meal the evening prior to her collapse and was not in a position to covertly purge the meal.

Because of that, the report said, her potassium level was "an unreliable measure of her pre-arrest potassium. Thus the main piece of evidence supporting a diagnosis of Bulimia Nevosa is suspect or, at least, can be explained by her clinical condition at the time of the blood draw."

The Schindler family issued a statement on the autopsy report yesterday, saying it confirms that "Terri was not terminal, that Terri had no living will, that Terri had a strong heart and that Terri was brutally dehydrated to death."

The family statement also pointed out the report ruled out bulimia and heart attack as causes for Terri's condition.

The Schindlers' attorney, David Gibbs, questioned the finding of no abuse and said the report leaves many questions unanswered. He said the 70 minutes between her collapse and the time her husband called medics for help are "very, very troubling."

Thogmartin said Schiavo was tested thoroughly in the hours after her collapse for signs of abuse and trauma, and nothing was found. But he pointed out that his investigation was unable to determine what caused the collapse.

The Empire Journal, a Web publication that produced numerous investigations of the Schiavo case, noted Thogmartin indicated he based his autopsy findings on medical reports and records provided by Gary Fox, one of two medical malpractice attorneys for Michael Schiavo.

The medical examiner specifically stated that he could not have completed the autopsy without these reports. Thogmartin also said "a lot of records have been destroyed" and that the case would remain open because of the missing documents in the hope that someone might come forward with them.

Fox and attorney Gordon Woodworth had represented Michael Schiavo in bringing medical malpractice actions against a general practitioner and gynecologist who had been treating Terri Schiavo prior to her collapse.