- The Washington Times - Thursday, March 31, 2005


An autopsy can’t establish a diagnosis of persistent vegetative state by itself the way it can show cancer, but it could provide evidence to support that diagnosis in the case of Terri Schiavo, specialists say.

George Felos, the attorney for the Florida patient’s husband and guardian, Michael Schiavo, said this week that the chief medical examiner for Pinellas County had agreed to perform an autopsy. Mr. Felos said Mr. Schiavo wants definitive proof showing the extent of the brain damage.

Doctors have said Mrs. Schiavo is in a persistent vegetative state, which means she is awake but not aware of herself or her surroundings. But a Florida neurologist asserted in a court affidavit last week that he thought it’s more likely she is in a “minimally conscious state.” Someone in that condition occasionally can follow a simple command or try to use an object, such as a comb, correctly.

The diagnosis of persistent vegetative state is chiefly based on behavior rather than a definitive biological test. But a close look at Mrs. Schiavo’s brain could shed light on whether the diagnosis was correct, specialists said.

“If there’s very extensive brain injury, it would be hard to accept another diagnosis as being conceivable,” said Dr. Roger Albin, a neurology professor and director of the brain bank at the University of Michigan Medical School.

Dr. Karen Weidenheim, chief of neuropathology at the Montefiore Medical Center in New York, said that although she can’t comment on the Schiavo case specifically, a brain autopsy can provide some support to such a diagnosis.

“An autopsy would show the extent of brain damage in a person,” she said. “There is information on the patterns of brain damage in persistent vegetative states, and the results in a given patient could be compared to that known data. And it could be stated whether it was consistent or not. But that’s all the farther one could go.”

Mrs. Schiavo’s family also has suggested that an autopsy might confirm their suspicion that her husband abused her before her collapse 15 years ago, an accusation he has denied repeatedly.

Autopsies can detect whether an adult’s bones had broken and healed, even many years ago, said Dr. Michael Baden, chief forensic pathologist for the New York State Police. They can’t by themselves reveal how long ago any breaks occurred, but X-rays from an earlier time could shed light on that, he noted.

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