Autopsy says Schiavo was beyond hope

LARGO, Fla. -- All along, Michael Schiavo said his brain-damaged wife's situation was hopeless -- that she had zero chance of emerging from her persistent vegetative state. On Wednesday, the autopsy backed him up.

Medical examiners determined that Terri Schiavo suffered irreversible brain damage and even blindness, and they found no evidence that she was strangled or otherwise abused before she collapsed.

But the answers about Schiavo's condition were not enough to quell the controversy between her husband and parents, who still do not believe the findings. They insist their daughter interacted with them, tried to speak and may have gotten better with therapy.

The autopsy results on the 41-year-old woman were made public more than two months after Schiavo died of dehydration on March 31 following the removal of her feeding tube 13 days earlier. The death ended an extraordinary right-to-die battle that engulfed the courts, Congress and the White House.

The autopsy showed that Schiavo's brain had shrunk to about half the normal size for a woman her age and that it bore signs of severe damage.

"This damage was irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons," said Pinellas-Pasco County Medical Examiner Dr. Jon Thogmartin, who led the autopsy team. He also said she was blind, because the "vision centers of her brain were dead."

Yet medical examiners could not say for certain what caused her sudden 1990 collapse, long thought to have been brought on by an eating disorder. Her parents insisted her condition was not hopeless and suggested that their daughter was the victim of violence by their son-in-law.

The autopsy cast doubt on both the abuse and eating disorder theory.

George Felos, attorney for Michael Schiavo, said the findings back up their contentions made "for years and years" that Terri Schiavo had no hope of recovery. He said Michael Schiavo plans to release autopsy photographs of her shrunken brain.

"Mr. Schiavo has received so much criticism throughout this case that I'm certain there's a part of him that was pleased to hear these results and the hard science behind them," Felos said.

Nevertheless, attorney David Gibbs III said Schiavo's parents, Bob and Mary Schindler, continue to believe she was not in a vegetative state and questioned the conclusion that she was blind.

The finding that she was blind counters a widely seen videotape released by her parents of Terri Schiavo in her hospice bed. The video showed Schiavo appearing to turn toward her mother's voice and smile. She moaned and laughed. Her head moved up and down and she seemed to follow the progress of a brightly colored Mickey Mouse balloon.

The parents said the video that showed she was aware of her surroundings, but doctors said her reactions were automatic responses and not evidence of consciousness.

In Washington, White House spokesman Scott McClellan said the autopsy did nothing to change President Bush's position that Schiavo's feeding tube should not have been disconnected. He had signed a bill, rushed through by Congress in March, in a last-ditch effort to restore her feeding tube.

Thogmartin also said Schiavo would not have been able to eat or drink if given food by mouth as the Schindlers wanted after the tube was removed. In fact, he said, she might easily have choked to death if such feedings had been tried.

"Removal of her feeding tube would have resulted in her death whether she was fed or hydrated by mouth or not," Thogmartin told reporters.

The autopsy included 274 external and internal body images and an exhaustive review of Terri Schiavo's medical records, police reports and social services agency records.

Thogmartin said that the autopsy produced no conclusion on what triggered the temporary heart stoppage that caused her collapse and brain damage. He said there was no evidence of drug use, though he cautioned that Schiavo was not tested in 1990 for every conceivable substance that could have been in her blood.

He said there was no proof she suffered from an eating disorder such as bulimia, which can disrupt the body chemistry with lethal effect. The main piece of evidence cited for an eating disorder -- the low levels of potassium in her blood in 1990 -- could have been caused by the emergency treatment she received at the time, Thogmartin said.

While she had lost more than 100 pounds since high school, Schiavo never confessed to an eating disorder, she did not take diet pills and no one had witnessed her purging food, the medical examiner said.

He also discounted the possibility that she had overdosed on caffeine from drinking large amounts of tea in an effort to keep her weight down.

The cause of death was ruled dehydration from removal of the feeding tube, but the underlying reason for her brain damage was officially listed as "undetermined."

In addition, the autopsy found no traces of morphine in her system at her death, although she had been given two doses in the days before she died. The Schindlers had contended that morphine might have been used to speed their daughter's death.

The Schindlers fought their son-in-law in court over their daughter's fate for nearly seven years, battling to the end with conservatives at their side. Michael Schiavo said his wife never would have wanted to be kept alive artificially in such a condition.

Courts repeatedly rejected extraordinary attempts at intervention by Florida lawmakers, Gov. Jeb Bush, Congress and the president on behalf of her parents.

Experts said that the autopsy demonstrates how difficult it is for people to recover from severe brain damage.

"People should understand that sometimes, for known or unknown reasons, individuals sustain massive brain injury that for which healing is not possible," said Dr. Karen Weidenheim, the chief of neuropathology at Montefiore Medical Center in New York. "Everything that could have been done was done for this lady for 15 years, and this case is very tragic."

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On the Net:

Pinellas-Pasco Medical Examiner's Office: http://www.co.pinellas.fl.us/forensics/