Terri Schiavo: Congress Agrees on Bill, Facts & History, The "Exit Protocol"

Update 20 Mar 6.00pm EST See below under latest.

I have included information in this post which I have not mentioned before regarding the background and history of Terri Schiavo's case, the medical facts regarding her disability, and the starvation process she is now enduring.

The Latest

Update: 20 March 03 The US Senate has passed the bill that would send Terri Schiavo's case to Federal court and have her feeding tube reinserted. The House will not consider the Bill until Monday after it was stalled and the House recessed. Reported here in Yahoo News. Meanwhile Terri Schiavo continues to suffer without food and water.

Congress Agrees on Bill

As reported here by Bloomberg:

"The U.S. Congress said it has agreed on legislation that could save the life of Terri Schiavo, a brain- damaged Florida woman whose feeding tube was removed yesterday. Lawmakers, who will meet tomorrow, said they have bipartisan legislation that would move the matter into the federal courts from state court in Florida, allowing for further legal challenges."

The Bill would guarantee Terri Schiavo a Federal Appeal and restore nutrition and hydration to Terri throughout the process.
Tom Delay and other Congress members have held a press conference which you can watch here at Jackson's Junction
President Bush has changed his schedule in order to be in Washington on Sunday to sign the legislation. See the report from NewsMax. This is very positive and Terri Schiavo's feeding tube may be reinserted soon.

The History and the Facts

The following information is taken from Dr. William M. Hammesfahr's Examination Report on Terri Schiavo, on 12 September 2002. Dr. Hammesfahr is a neurologist who specialises in the diagnosis and rehabilitative therapy of brain-injured patients. He wrote:

"Ms Schiavo was in her usual state of good health until 2/25/90, when her husband reported that he was awakened from sleep approximately 6 AM by her falling. He reports that she was unresponsive. Paramedics were called, and aggressive resuscitation was performed with 7 defibrillations en route. In the Emergency Room, a possible diagnosis of heart attack was briefly entertained, but then dismissed after blood chemistries and serial EKG's did not show evidence of a heart attack. Similarly, a pulmonary or lung cause of the disorder was ruled out in the Emergency Room after normal blood gases and Chest X-Rays were obtained. The possibility of toxic shock syndrome was also entertained. The diagnosis of the cause of her condition was unknown. Her admission laboratory studies showed low potassium level, markedly elevated glucose level, and a normal toxic screen without evidence of diet pills or amphetamines. The abnormal potassium level and sugar level were found on admission to the Emergency Room and were successfully corrected by the hospital staff over the next several days. The patient had a difficult hospital course with the development of poorly controlled seizures and prolonged coma state requiring, for a time, ventilator support. However, the staff noted improvement, and it was recommended by several physicians that she be discharged to an intensive rehabilitation center. She was eventually transferred to Mediplex in Bradenton for intensive rehabilitation. She was poorly responsive. However, after a brain stimulator was placed in 11/90, the staff started to report greater interactions of the patient with her environment, including intermittently apparently following commands, turning her head to voice, tracking visually, etc. This pattern continued even after discharge to a nursing home, although her course from that time on included multiple medical problems including recurrent urinary tract infections and hospitalizations, at times with severely low episodes of blood pressure due to a lack of treatment of urinary tract infections ordered by the husband and subsequent urinary sepsis requiring hospitalization. During 1998, she was evaluated by Dr. James Barnhill, neurologist, who testified that he examined her for ten minutes and determined that she had no chance for recovery, and was in a persistent vegetative state.

With stimulation Terri improved and was interactive. Dr. James Barnhill examined her for ten minutes and said she was in a persistent vegetative state. A persistent vegetative state means the patient only has sleep-wake cycles and cannot interact or respond to others. Clearly Dr. Barnhill is quite wrong after his ten minute examination. Dr. Hammesfahr's findings after examining Terri were:

"The patient is not in coma.
She is alert and responsive to her environment. She responds to specific people best. She tries to please others by doing activities for which she gets verbal praise. She responds negatively to poor tone of voice. She responds to music.
She differentiates sounds from voices.
She differentiates specific people's voices from others.
She differentiates music from stray sound.
She attempts to verbalize.
She has voluntary control over multiple extremities
She can swallow.
She is partially blind
She is probably aphasic and has a degree of receptive aphasia.
She can feel pain.

These were some of his observations:

On September 3, I spent from approximately 11AM until 4PM with Ms. Schiavo, returning the next day to also observe Dr. Maxfield and complete my portion of the exam (which duplicated that of Dr. Maxfield, so I observed without myself specifically repeating that part of the exam that same day). The exam was videotaped at my request. The exam started with the setting up of the video camera by the videographers, with Mr. Michael Schiavo present.

...Her mother then entered the room, coming toward her and speaking her name. The daughter immediately showed awareness of the presence of her mother, looking for her, then finding her visually when the mother was approximately 8 inches from her face. She then smiled and made sounds. Her father also entered the room with further apparent recognition by the daughter. The first part of this exam included observing her interactions with her mother and her father. Here she clearly was aware of them and attempted to interact with them: the sounds, facial expressions, and searching out and tracking them.
...I asked the mother to bring a tape of piano music. Two separate pieces were listened to. The first she appeared aware of the sound, but would not sing or interact significantly. The second she did interact making sounds with the music. She stopped making these sounds, when the music stopped.
...Alertness: The patient was alert throughout essentially the entire exam.
Responsiveness: The patient would immediately respond to sound, tone of voice and to touch and pain. With respect to responding to those around her, she had limited responsiveness to me personally until approximately 45 minutes into the exam. She started to look at me, against her traditional right gaze preference, about the same time that we started getting significant relaxation in her contracted left arm (the arm that had been contracted for several years.) She appeared to identify the sound of my voice, with the relaxation of the arm. From that point, she would generally look toward the sound of my voice when heard, attempt to find me visually, then track the sound of my voice in its movements, or track me if I was within approximately one foot of her eyes. Prior to that time, she did not track me, or try to locate me visually. When playing music, she had a clear preference to the specific sound track played, and would listen to piano music, but change levels of listening depending on the track played. Her attention to the music would not wander during the track she preferred. She would pick out her mother's voice or her father's voice separate from the music or other voices or sounds in the room, and re-fix her gaze to those people. She would tend not to blink when watching those people.

She ignored her husband's loud foot-tapping that went on for approximately five minutes at one point. She also ignored his voice and did not try to seek him out visually when he would at times interject comments during the exam or immediately afterwards.

It is evident that Terri Schiavo is responsive, and not only interacts with others and with her surroundings, but chooses who to interact with. She responds immediately to her parents, takes time to get to know the doctor, and ignores her husband who is being deliberately distracting. There are videos of Terri at The Terri Schindler-Schiavo Foundation. Click on multimedia on the left sidebar and then go to the right of the page to Videos of Terri.

The "Exit Protocol"

There have been reports in the mainstream media that death by starvation and dehydration is "painless" and that a patient dying this way experiences "euphoria". In particular the Associated Press have reported this. AP reports are reproduced in both online and print media throughout the world. Consequently the bias of one reporter reaches a global readership of millions. Death by starvation and dehydration is neither painless nor euphoric. It takes approximately two weeks. In this report from NewsMax in 2003 on Dr. Wesley J. Smith's comments on Terri's case and his book there is the following:

"Proponents of dehydration contend that deaths by dehydration are peaceful," Smith wrote. Noting that "the patients we are discussing are not terminally ill" and that those who are conscious can feel hunger and thirst, Smith quotes Dr. William Burke, a neurologist in St. Louis, who described the agonizing process. "A conscious person would feel it (dehydration) just as you and I would. They will go into seizures. Their skin cracks, their tongue cracks, their lips crack. They may have nosebleeds because of the drying of the mucous membranes, and heaving and vomiting might ensue because of the drying out of the stomach lining. They feel the pangs of hunger and thirst. Imagine going one day without a glass of water. Death by dehydration takes ten to fourteen days. It is an extremely agonizing death."

Fr. Rob Johansen has obtained the document outlining Terri's "exit protocol" prepared by the hospice at which she resides, by their own doctors and nurses. It was produced in anticipation of the first time Terri's feeding tube was removed, in 2001. You can read it all at Thrown Back. It says in part:

"1. d/c ["discontinue"] antacid. d/c Naproxen suspension.
2. d/c Vitamin liquid
3. Monitor symptoms of pain/discomfort. If noted, medicate with Naproxen rectal suppository 375 mg Q8* prn.
4. Signs of compromised skin integrity continue vigilant skin care, provide moistener to lips, consult wound-care specialist if needed.
5. Signs of dehydration(A) dry lips, mouth. Swab saliva substitute inside mouth prn.
6. Pulmonary (A) Inability to clear secretions - reposition and swab mouth, consider scopolamine patch behind ear every 3 days.
(B) dyspnea ["difficulty in breathing"] nebulize low dose 2-5 mg morphine sulfate Q4* prn.
7. Multifocal myoclonus or terminal agitation (sometimes caused by electrolyte imbalance). Consider diazepam rectal administration 5-10 mg. May repeat in 4 hours if not resolved then daily - twice daily as needed.
8. Grand Mal seizure, which is highly unlikely given current conditions and lack of contributing factors (meds). Recommend diazepam 15 mg rectally as indicated in seizure management orders.

Fr. Johansen has explanations of the medical terms at his site. In short - Terri will experience pain, cracked and bleeding skin, mouth ulcers, difficulty in breathing, muscle spasms causing writhing and agitation, and siezures. As well as this her body will start literally eating itself and she will lose weight and become skeletal - this is extremely painful.

How You Can Help

1. Check for ways to help here at the Terri Schindler-Schiavo Foundation. There is a list of US Senators and Representatives with contact details.
2. Please pray for Terri, who is now without food and water, for her family, and for the decision makers.
Thankyou to those who have left comments and emailed me. I appreciate it very much.