If That Ever Happens to Me: Making Life and Death Decisions after Terri Schiavo

By Lois Shepherd | Go to book overview

1
DISORDERS OF CONSCIOUSNESS
AND THE PERMANENT VEGETATIVE
STATE

Theresa Marie Schiavo was twenty-six years old when she suffered a cardiac arrest for reasons still unknown. Terri grew up in the suburbs of Philadelphia, Pennsylvania, the oldest of three children. She married her first boyfriend, Michael Schiavo, whom she met in college, and they moved to Florida in 1986. Her family followed them there. Terri worked as a clerk for an insurance company while Michael worked in restaurant management. One early morning in February 1990, Michael awoke, found Terri collapsed in the hallway of their apartment, and called 911. Twelve minutes later, at 5:52, paramedics begin resuscitation efforts and, after several attempts at defibrillation, restored her heartbeat. By this time, her brain had sustained severe injury due to lack of oxygen. She was taken to a local hospital. She never again regained consciousness.


Defining the Permanent Vegetative State

Initially, Terri entered a coma. During this time, she would have looked like she was asleep. A coma resembles sleep because the patient's eyes are closed, but the patient is unresponsive and cannot be roused. A coma is typically a temporary condition; patients who initially enter a coma will either die without ever recovering consciousness, will recover either complete or partial consciousness, or will enter a vegetative state. This, after about a month, was how Terri's coma ended—in a vegetative state.

Drs. Bryan Jennett and Fred Plum adopted the term “persistent vegetative state” in 1972 to describe patients who had, after trauma to the brain, entered a condition of unconsciousness that is marked by periods of apparent wakefulness,1 where a cycle of “eyes-open, 'wakeful' appearance alternates with an eyes-closed 'sleep' state.”2

-15-

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If That Ever Happens to Me: Making Life and Death Decisions after Terri Schiavo
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • Acknowledgments ix
  • Introduction 1
  • 1: Disorders of Consciousness and the Permanent Vegetative State 15
  • 2: Legal and Political Wrangling Over Terri's Life 35
  • 3: In Context— Law and Ethics 57
  • 4: Terri's Wishes 77
  • 5: The Limits of Evidence 96
  • 6: The Implications of Surrogacy 112
  • 7: Qualities of Life 128
  • 8: Feeding 143
  • 9: The Preservation of Life 162
  • 10: Respect and Care an Alternative Framework 173
  • Appendix - The National Right to Life Committee's Model Starvation and Dehydration of Persons with Disabilities Prevention Act 189
  • Notes 193
  • Bibliography 201
  • Index 215
  • Studies in Social Medicine 223
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