Friday, March 18, 2005

Schiavo - Dr. Cranford Offers a Reply

My opinion, expressed in my original post
here, complete with an update referring to both Hugh Hewitt's and Captain Ed's posts on the NRO article, indicated an aversion to political/media involvement in this long-disputed case.

Following a review of the NRO article, I emailed Dr. Ronald Cranford, the expert for Terri's husband in the original trial, and asked his response to the NRO story allegations.

Here is his complete email response which he offered quite promptly, and which seems to answer the NRO charges.......

"----- Original Message -----
From: Ronald Cranford MD
To: Paul Duke Deland
Sent: Friday, March 18, 2005 12:37 AM
Subject: Re: Information Please

For your information and background on the facts of the Schiavo case, I've attached a background memo prepared by myself and a letter on the issue of a medical panel suggested by Art Caplan. I believe this material will address many of your questions, but here are a more comments.

An MRI was never recommended because, in this case and other patients in a permanent vegetative state, the CT scans were more than adequate to demonstrate the extremely severe atrophy of the cerebral hemispheres, and an MRI would add nothing of significance to what we see on the CT scans. Plus the MRI is contraindicated because of the intrathalamic stimulators implanted in Terri's brain. A PET scan was never done in this case because it was never needed. The classic clinical signs on examination, the CT scans, and the flat EEG's were more than adequate to diagnose PVS to the highest degree of medical certainty, along with the credible testimony of the three neurologists at the longest evidentiary hearing in American law, whose opinions were strongly affirmed by the trial court judge and three appeal court judges. Please see Judge Greer's opinions on the credibility of the experts testifying on behalf of the Schindler family.

In addition, the only PET scan center in the country I would trust right now for doing the PET scan for the determination of PVS is New York-Cornell Medical Center with Niko Schiff. There are other PET scan centers in the US (such as in Miami and Atlanta which I contacted in 2002 as to the feasibility of doing a PET scan at these centers), but the only one doing top quality work with the precision necessary for PVS is the one in New York.

I do not believe there are "a number of other prominent members of your field" who feel these other tests should be done, because these "other prominent members" are physicians with strong conservative credentials who obviously don't know the facts of the case, and some of these physicians have "credentials" similar to Dr. Maxfield and Dr. Hammesfahr (the "HBO and vasodilator experts"). Where were these physicians earlier in the case when they could have examined Terri and testified at trial on behalf of the Schindler family, instead of the two doctors whom Judge Greer found not very credible?

The calls for new tests on Terri are nothing more than one of several last minute desperation moves by the Schindlers and their supporters to delay the withdrawal of the feeding tube from Terri. There has never been a more extensively litigated case in the history of right to die cases in terms of the length of the entire litigation itself, and the extensive medical testimony during the elaborate evidentiary hearing of 2002, and the thorough review of this medical tesimony by the appeals court.

As for the National Review Online article, I stand by my record. The record is very clear that I did not testify that Robert Wendland was in a PVS, and the same applies for the case of Michael Martin in Michigan. Both these patients were clearly not PVS (see Broder AJ, Cranford RE. Mary, Mary, Quite Contrary, How Was I to Know? - Michael Martin, Absolute Prescience, and the Right to Die in Michigan. University of Detroit Mercy Law Review, 1995; 72:787-832. and Nelson LJ, Cranford RE. Michael Martin and Robert Wendland: Beyond the Vegetative State. Journal of Contemporary Health Law and Policy, 1999;15:427-453). In all the major right to die cases on a national level in which I have testified or been heavily involved with (including Brophy, Rosebush, Torres, Cruzan, Busalacchi, Ellison, Butcher, Martin, Wendland, and now Schiavo), my neurological diagnosis and the final opinions of the courts were identical (except for some legitimate differences of opinion on the degree of cognitive functions in Wendland). So my record stands for itself.

I feel that I am well-qualified as a national expert in this field of the neurological diagnosis of severely neurologically impaired patients, and the opinions I, and other qualified neurologists, expressed in Schiavo were strongly endorsed by the trial court and appeals court judges.

Thanks. Any further questions?

Dr. C"

While the email is a bit long, Dr. Cranford's reply includes two additional items which shed some light on the subject, but are quite lengthy.

I will be following, in my next post, with one of his additional extensive timeline, and summation of the entire case.

My opinion, following review of both the NRO story and Dr. Cranford's materials, remains the same. I believe the media circus, legislative intrusion into judicial areas, etc. is wrong. The conclusion of the case, albeit hard and against the grain for those among us who feel there might be a chance for some cognitive recovery by Terri, should be in accordance with more than ten years of complete legal exploration of the case; not by a media-driven, emotion-charged legislative intrusion! I am quite sure any legislative effort to compound laws based on one case will ultimately come back to bite us....with quite possibly disasterous long-term results.

As my original Schiavo post stated; I am sorry for all involved....however, it is time to let this go.

More to follow.....

Duke of DeLand

UPDATE: Here is link to the complete 17 page report by Dr. Cranford. It is a LONG read, but I also give you a short cut to the Summation, if you wish to cut it short.......

GO HERE for the report!

UPDATE 2: Thanks to Respectful of Otters for the link and traffic.