Hacker News Reader

Comment by wahern | Hacker News Reader

Because it was repeatedly and conclusively shown at that point that her brain had atrophied to half its size. She was gone. The reason the situation almost devolved into an armed stand-off between the courts and the executive branch is because every judge (Florida and Federal) who looked at the case--that is, those officials presented with all the evidence from both sides--quickly understood the reality; whereas the politicians hundreds and thousands of miles away who hadn't the first clue about the facts had other objectives in mind.

The subsequent autopsy confirmed what was already known. But there was never any accountability because by then the media had moved on.

Terry Schiavo is not the case to point to when questioning the science and treatment of PVS.

View on HN

It was a fight between scientists and non-scientists. The scientists saw the scans of her head that showed a void where there should have been brain. The non-scientists looked at a handful of home movies where here random movements and facial expressions occasionally lined up to make her look aware. Such debate between scientific evaluation and layperson "gut feelings" predate so many of today's debates re climate.

It was also a generational fight. Her husband, the normal go-to for medical decisions was on one side, and her parents on the other. The parents wanted control over their daughter. They could not accept the widespread default that, for most all medical/legal matters, spouses trump parents. And this was Florida. So the "rights" of the older generation were given greater play in the courts than would have happened in other states.

>"The scientists saw the scans of her head that showed a void where there should have been brain."

People with "no" (very small) brains due to hydrocephalus have been discovered who are successful mathematics students and public servants. So, not sure the scientists are right here. As long as the brain is shrinking slow enough it may not be a huge deal in terms of mental ability.

http://mentalfloss.com/article/70204/man-without-brain

https://www.theguardian.com/education/2003/oct/02/research.h...

Nope. She had a medical problem related to medication. Her brain went from normal to tiny in the course of perhaps 24 hours. This was not just a small brain, this was a normal brain in which huge areas died away due to lack of oxygen.

I don't know the details but that does sound like the medical issue killed her.

She suffered cardiac arrest from low serum potassium levels (hypokalemia) and she suffered massive brain damage as a result of the lack of oxygen to the brain. It was definitely a sudden, abnormal, and catastrophic change in brain size.

Years ago I ran across those extreme bilateral hydrocephalus cases you linked. As a neuroscientist, naturally they piqued my interest. I was skeptical then, and even moreso now. To my knowledge, in the years since those 2-3 cases popped-up, there has never been any follow-up on those original patients, and no similar bilateral cases have been found in the modern-era of brain imaging.

I will happily stand corrected if someone can provide any evidence from the last 10 years where any case like this has been documented and independently confirmed. Until then, I will continue to consider the brain important.

could you elaborate? Do you think they really didn't have the condition described? If they did then while more evidence would be helpful in establishing likelihood, it would not make a difference in establishing possibility.

I think it's possible that Lorber is misreading and misrepresenting the CT scan, and the actual state of the cortex is very different than what we are being shown.

These cases are extremely interesting, and any high-impact journal would immediately accept a quantitative MRI report or the simplest fMRI study on such a patient (if it were from a reputable source).

This would make the cover of Nature or Science mags, and would capture the attention of the entire neuroscience community. Yet as interesting as they are, none of these existing case studies conform to the standards of modern neuroscience reporting.

What happens when life support is discontinued for someone who has a normal sized brain? Are steps taken to make the end quick, or do they also starve? If the latter, then I'm not sure that it being provably not potentially horrible for Schiavo has any relevance to the underlying ethical question.

Also, brains are overrated [1]. :-)

[1] https://www.iflscience.com/brain/man-tiny-brain-lived-normal...

Quick Googling suggests that it's widely understood that starvation isn't, per se, painful. Presumably what might be painful is prolonged malnutrition.

As someone who has fasted for a week, I can attest that much of the physical discomfort disappears rather quickly. Though, I can't speak directly to near-death starvation, nor to dehydration.

I agree that it's ridiculous that doctors (in the U.S., at least) rarely have a way to quickly and legally dispatch people (or the shells of people). It happens informally, though. Being such a high-profile case, advocates for Terry Schiavo's parents all but ensured the doctors would follow the book--starvation.

>As someone who has fasted for a week, I can attest that much of the physical discomfort disappears rather quickly. Though, I can't speak directly to near-death starvation, nor to dehydration.

There are quite alot of reports from prisoners on hunger strikes, some of whom died. The ones I read about agreed with you. The discomfort disappears after the first week of so, after that you just get weaker and weaker to the point were you are no longer able to eat normal food.

Dehydration is much more problematic with slipping into a delirium and going into spasm. Sadly there are also examples of prisoners experiencing this, as some countries have had the concept of "dry cells". They were first used as punishment and later to break hunger strikers. Baader of the German Baader-Meinhof group for example retained kidney damage from his stay in such a cell during a hunger strike.

So, torture cells.

She'd be fine with half a brain:

https://www.cbc.ca/radio/asithappens/as-it-happens-thursday-...

False equivalence. This is like showing a story about an arm amputee living a normal life, and using that to claim that someone who had just had their arm blown off would "be fine".

Reply on news.ycombinator.com