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March 29, 2005

Autopsy Cannot Confirm a Clinical Diagnosis

Topics: Medical Issues

Although Michael Schiavo, through his attorney George Felos, has suggested that a planned autopsy of Terri Schiavo will confirm the extent of her brain injury, medical experts reject the use of a post mortem examination to confirm a prior clinical diagnosis. The following quotes from medical experts appeared in MedPageToday:

"Persistent vegetative state or minimally conscious state is a clinical diagnosis," says Michael De Georgia, MD, head of the neurology/neurosurgery intensive care unit at the Cleveland Clinic Foundation. "It cannot be confirmed by autopsy."

"The [pathologic examination of the] brain can't tell if there is a persistent vegetative state or not," says Harvard neuropathologist E. Tessa Hedley Whyte, MD. "The autopsy will show damage -- probably mostly scarring now -- and that damage will most likely correspond to some extent to what was seen on images."

[snip]

Michael Williams, MD, an associate professor at Johns Hopkins in Baltimore, puts it this way. "If you only had the brain to look at and you didn't know anything about the history of the patient, pathology alone cannot prove or disprove a diagnosis of persistent vegetative state."

It would appear that the planned autopsy has as its purpose an unachievable objective but is presently a useful PR tool for the Schiavo-Felos team.

However, there is userful information that could be gained from an autopsy. LifeNews, quoting Dr. Michael Baden, chief forensic pathologist for the New York State Police, reports that the autopsy could help investigators determine whether Terri suffered physical abuse prior to her 1990 collapse.

In a prior Fox News interview reported by WorldNetDaily, Dr. Baden ruled out potassium imbalance and a heart attack as factors in Terri's mysterious collapse and pointed to head trauma and bone injuries as a more likely cause.

Baden said he studied a bone scan made in March 1991 at a rehabilitation facility that describes her as having a head injury: "That's why she's there, that's why she's getting a bone scan."

"A head injury can cause, can lead to the vegetative state that Ms. Schiavo is in now," he continued, adding the scan showed evidence of other injuries, bone fractures.

It is duly noted that Michael Schiavo denies any actions leading to his wife's collapse and no law enforcement agency has every concluded that he was guilty of wrong doing. Consequently he should have no problem, should his wife pass away, agreeing to perform an appropriate investigation and/or postmortem examination to determine both the immediate cause of death AND the proximate cause of death, including the search for any injuries from the past consistent with a potential crime.

Posted by tim at March 29, 2005 9:53 PM


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Comments

Please make sure that Terri's family demands that a consultant expert forensic pathologist, like Dr. Michael Baden, participates in the autopsy, when and if it occurs!

Posted by: Robert W. Smith MD at March 30, 2005 9:29 PM