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Schiavo autopsy results misrepresented

After Terri Schiavo’s autopsy report was released, Republican leaders such as Senator Bill Frist, M.D., took the view that it was “time to move on.”

“You can understand why they would like to avoid the subject,” writes Chicago Tribune columnist Steve Chapman. “After all the ringing assertions made by Republican politicians and evangelical leaders about Terri’s condition, it must have been mortifying to hear the unvarnished scientific truth.”

The real enemies of “Terri Schiavo’s purported supporters,” Chapman said, were not a villainous husband and callous judges, but “medical science and individual freedom.”

The autopsy supposedly proved that Mrs. Schiavo was in a persistent vegetative state with irreversible brain damage, that she could not eat or drink by mouth, and that there was no evidence of spousal abuse.

Salient findings from the official autopsy report, accessible at www.earnedmedia.org/autopsy0615.htm, are as follows:

1. “Neuropathologic examination alone of the decedent’s brain—or any brain, for that matter—cannot prove or disprove a diagnosis of persistent vegetative state.”
2. The changes in the cortex were most severe in the occipital lobes, “with relative preservation of the frontal and temporal lobes.”
3. Oral feedings, based on autopsy findings and past medical records, were “potentially harmful or, at least, extremely dangerous to Mrs. Schiavo’s health and welfare” because of the risk of aspiration. [Better to dehydrate and starve the patient and cause certain death than to risk an aspiration pneumonia?]
4. The only evidence for an eating disorder was the initial low serum potassium, which could have resulted from the fluid load and epinephrine administered during her resuscitation.
5. The autopsy showed no signs of remote trauma to neck structures, but with 15 years delay, “even bony anomalies would have likely resolved.” External signs of trauma should have been apparent on her hospital admission just after her collapse. “Subtle trauma related to commotio cordis or nontraumatic asphyxia is also possible,” as are “drugs/toxins not typically detected by hospital toxicologic screening.”

Although Steve Chapman and many others are satisfied that all questions have been answered, vindicating Michael Schiavo, the courts, and those who opposed intervening to block the court-ordered death process, Medical Examiner Jon Thogmartin 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. In addition to fading memories, the 15-year survival of Mrs. Schiavo after her collapse resulted in the creation of a voluminous number of documents many of which were lost or discarded over the years. Receipt of additional information that clarifies outstanding issues may or shall cause an amendment of her cause and manner of death.”

Additional information:

AAPS Terri Schiavo Archive

Schiavo autopsy report released; Governor calls for further review - 6/18/05

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