Relevance of Patient Diagnosis to Analysis of Terri Schiavo Case

IN RESPONSE:

Dr. Cochrane suggested that the distinction between persistent vegetative state and minimally conscious state in the Schiavo case was “irrelevant.” At least as a matter of legal importance, we do feel that the diagnosis of persistent vegetative state is critically important to the case.

The operative Florida statute (1) specifically classifies persistent vegetative state as 1 of only 3 conditions in which artificial life-prolonging procedures can be withdrawn. Florida law defines persistent vegetative state as “a permanent and irreversible condition of unconsciousness in which there is: (a) The absence of voluntary action or cognitive behavior of any kind. (b) An inability to communicate or interact purposefully with the environment” (2).

A diagnosis of minimally conscious state would not be explicitly covered under the Florida law that governed Mrs. Schiavo's fate. Consequently, the fact that the court concluded on 2 separate occasions (the 2000 trial and the 2002 hearing) that Mrs. Schiavo was in a persistent vegetative state is, from the perspective of the law, a fact of critical importance to all relevant decision makers.

In addition, the medical certainty of the diagnosis of persistent vegetative state is much greater than that of minimally conscious state, which has not been as well defined or as well documented in terms of poor prognosis. Families can much more easily accept a diagnosis with a wealth of medical documentation than one with less certain implications.