Autopsy supports claim that Schiavo was in a persistent vegetative sta
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《英国医生杂志》
The autopsy report on Terri Schiavo, the brain damaged woman at the centre of a "right to die" controversy in the United States, lends weight to the claim that she was in a persistent vegetative state and had irreversible brain damage.
The chief medical examiner for Florida抯 Pinellas and Pasco counties, Dr Jon Thogmartin, assisted by Dr Steven Nelson, medical examiner for three other counties, delivered their 39 page report on 15 June. Mrs Schiavo抯 death on 31 March ended a dispute that had involved the courts, Congress, and the White House (BMJ 2005;330:687, 26 Mar).
The most salient finding at the autopsy was that her brain weighed 615 g, about half the expected weight for a woman of her age. She had marked global anoxic ischaemic encephalopathy, resulting in massive cerebral atrophy. Severe hypoxic damage and neuronal loss in the occipital lobes indicated cortical blindness; the remaining brain showed severe hypoxic injury and neuronal loss and atrophy. There was no sign of traumatic injury.
The heart was normal, and no evidence of a heart attack was found. There was no evidence of trauma, and post mortem toxicology showed no trace of morphine. The cause of death was given as dehydration and not starvation.
"We found nothing contrary to persistent vegetative state," said Dr Nelson. Dr Thogmartin said, "This damage was irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons." He said that she was blind, because the vision centres of her brain were dead.
He could not say whether hypokalaemia had caused her cardiac arrest in 1990, and he pointed out that the low serum potassium concentration after her collapse (2 mmol/l) may have resulted from liquid transfusions during resuscitation attempts. He concluded, "It is the policy of this office that no case is ever closed and that all determinations are to be reconsidered upon receipt of credible new information."
Over the years Mrs Schiavo抯 parents, Bob and Mary Schindlers, have claimed that Michael Schiavo strangled and beat his wife the day she collapsed. Dr Thogmartin said medical evidence did not support the Schindlers?allegations.
The Schindlers led the fight to stop the withdrawal of artificial nutrition and hydration to their daughter, which Michael Schiavo favoured.
A White House spokesman, Scott McClellan, said that the autopsy findings did nothing to change President Bush抯 belief that Mrs Schiavo抯 feeding tube should not have been removed. He had signed a bill, rushed through by Congress last March, in an effort to have the feeding tube reinserted.(Florida Fred Charatan)
The chief medical examiner for Florida抯 Pinellas and Pasco counties, Dr Jon Thogmartin, assisted by Dr Steven Nelson, medical examiner for three other counties, delivered their 39 page report on 15 June. Mrs Schiavo抯 death on 31 March ended a dispute that had involved the courts, Congress, and the White House (BMJ 2005;330:687, 26 Mar).
The most salient finding at the autopsy was that her brain weighed 615 g, about half the expected weight for a woman of her age. She had marked global anoxic ischaemic encephalopathy, resulting in massive cerebral atrophy. Severe hypoxic damage and neuronal loss in the occipital lobes indicated cortical blindness; the remaining brain showed severe hypoxic injury and neuronal loss and atrophy. There was no sign of traumatic injury.
The heart was normal, and no evidence of a heart attack was found. There was no evidence of trauma, and post mortem toxicology showed no trace of morphine. The cause of death was given as dehydration and not starvation.
"We found nothing contrary to persistent vegetative state," said Dr Nelson. Dr Thogmartin said, "This damage was irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons." He said that she was blind, because the vision centres of her brain were dead.
He could not say whether hypokalaemia had caused her cardiac arrest in 1990, and he pointed out that the low serum potassium concentration after her collapse (2 mmol/l) may have resulted from liquid transfusions during resuscitation attempts. He concluded, "It is the policy of this office that no case is ever closed and that all determinations are to be reconsidered upon receipt of credible new information."
Over the years Mrs Schiavo抯 parents, Bob and Mary Schindlers, have claimed that Michael Schiavo strangled and beat his wife the day she collapsed. Dr Thogmartin said medical evidence did not support the Schindlers?allegations.
The Schindlers led the fight to stop the withdrawal of artificial nutrition and hydration to their daughter, which Michael Schiavo favoured.
A White House spokesman, Scott McClellan, said that the autopsy findings did nothing to change President Bush抯 belief that Mrs Schiavo抯 feeding tube should not have been removed. He had signed a bill, rushed through by Congress last March, in an effort to have the feeding tube reinserted.(Florida Fred Charatan)