In a comment on “Alas” last month, TZ and I had this exchange:
Amp: “What I haven’t seen is an explanation of how a woman who, according to cat scans, lacks the physical capability to have thought or emotion or feeling or experience, can be said to be having any sort of life.”?
TZ: “You’re making a statement on a highly complex clinical issue about which even experts in this matter disagree.”
It has not been established that “experts” do disagree. At her own (extremely good) blog, TZ writes:
Seventeen medical experts have reportedly filed affidavits questioning whether Terri Schindler-Schiavo is in a persistent vegetative state and supporting the need for additional neurological, neuropsychological, and other testing of her abilities, particularly with new technologies.
“17 experts” certainly sounds impressive. Yet, if you visit creationist websites, you can find many more than 17 “experts” claiming that Darwinistic evolution couldn’t have happened. That doesn’t mean that it’s true that experts disagree about Darwinistic evolution; it just means that sometimes unqualified people claim to be experts, or advocates misunderstand or misrepresent what experts say.
The quote TZ provides is from Dr. David Hopper. Dr. Hopper does not comment on Terri’s cat scans at all; this is rather like someone arguing gravity doesn’t exist but not commenting on the issue of how it is everything tends to stick to the ground. He doesn’t disagree with the most essential evidence in Terri’s case; he ignores the evidence altogether.
Although Hopper claims to have a doctorate “in neuroscience” on his website, in his under-oath affidavit his only claimed Ph.D. is in counseling psychology. According to the bibliography he provides, he’s never had any research published in specialized neuroscience journals. In fact, apart from some allegedly “in press” articles, he hasn’t published anything in over a decade – and the majority of his publications before that point appeared in Somnology, a journal edited by – what a coincidence! – Dr. David Hopper. (Somnology, by the way, is the study of sleep disorders.)
Dr. Hopper is the sort of faux-expert who makes a big deal of being listed in a bunch of “Who’s Who’s” directories – never mentioning that virtually anyone can be in “Who’s Who” if they write a check to the publisher. He collects certifications – however lame most of them are – like they were baseball cards (hilariously, he reproduces 20 or 30 mostly irrelevant wall-decoration certificates and degrees with his affidavit). For most of the past decade his main academic position has been high school science teacher. There’s nothing wrong with teaching in high school, but it’s not a position held by actual experts in brain science.
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How about the others? None of them apart from Dr. Hopper are ridiculous. However, regarding the specific issue discussed in my and TZ’s exchange, most of them are not experts. There are more speech pathologists and psychologists than there are neurologists. And the most qualified experts in this group, seem to take care not to state an opinion. For example, Dr. Kennedy – arguably the best-qualified neurology expert of the 17 – says that he’s willing to examine Terri with the most modern MRI technology. And that’s all he says.
I’ve read all 17 affidavits. I’m not a doctor, of course. But I know a lot about argumentation and debate. One of the most basic tenets of debate is that you have to address the opposing arguments. These affidavits simply don’t do that; like Dr. Hopper, rather than addressing the most crucial evidence and arguments in this case, they pretend that they don’t exist.
There are two issues here: Terri’s cerebral cortex, and the famous videos of Terri appearing to smile and react to her parents.
1. The Cerebral Cortex Argument.
The conclusion the court came to is that, based on medical testimony and Terri’s CAT scan, her cerebral cortex has basically turned to liquid. The cerebral cortex is the seat of all our higher brain functions. Without a cerebral cortex, it is impossible for a human being to experience thought, emotions, consciousness, pain, pleasure, or anything at all; nor, barring a miracle, is it possible for a patient lacking a cerebral cortex to recover.
There are only two logical responses to that argument, that I can think of.
A) An expert could argue that someone can experience consciousness without a cerebral cortex.
B) An expert could argue that Terri’s CAT scan was faulty, or was not read correctly.
Not one of the 17 experts clearly made either of the above arguments. Nor did they make some other argument I didn’t think of. In fact, none of them mentioned the term “cerebral cortex” at all. None of them even referred directly to Terri’s CAT scan.
Many of the 17 pointed out that there are more subtle tests than a CAT scan or MRI (several recommended an fMRI). However, it does not require a subtle test to detect that someone’s cerebral cortex is mostly liquid; nor do any of the experts suggest that a CAT scan is incapable of distinguishing between liquid and solid. (On the contrary, Dr. Uszler – an expert on medical scanning technology – states that “CAT scans are good for examining anatomy”).
None of the experts argued that any mental life is possible sans cerebral cortex. None of them argued that Terri’s CAT scan was inaccurate or misunderstood. Contrary to TZ’s claim, if these 17 affidavits are a fair sampling, experts don’t disagree about these matters.
However, two of the 17 – Dr Weidman and Dr. Uszler – addressed the cerebral cortex argument obliquely.
Dr. Uszler says that he hasn’t examined Terri, and has no opinion one way or the other about her case. He does say that “CAT scans are good for examining anatomy, but they do not tell you about brain function.”
That’s doubtless true in many cases, but in Terri’s case the CAT scan shows that her cerebral cortex anatomy has liquefied. It would be bizarre to claim that a CAT scan can accurately show that brain anatomy is essentially absent, but cannot support a claim that absent anatomy isn’t functioning. Nothing in Dr. Uszler’s comments addreses the specifics of Terri’s case, or argues that someone who lacks a cerebral cortex could possibly recover higher brain functions; nor does he argue that the CAT scan already done of Terri has been misunderstood or is faulty.
Dr. Weidman also addresses the question of the CAT scan, pointing out that his mother had cognitive functioning even after CAT scans showed “a significant decline in gray matter.” However, there’s a big difference between a “decline in gray matter” and a near-total liquidization. Unless Dr. Weidman’s mother’s CAT scan shows a cerebral cortex as destroyed as Terri’s – and he doesn’t claim it did – then the comparison simply doesn’t address the question of how someone without a cerebral cortex could possibly recover higher brain functions.
2. Those Famous Video Clips of Terri
So if none of the 17 experts address the cerebral cortex issue, what do they talk about? None of these experts have examined Terri, and only one claims to have looked at her medical records. What they discuss is the famous videos of Terri apparently tracking a balloon’s movement with her eyes, smiling at her mother, and so forth.
The court ruling addressed those videos. Although the out-of-context video snips featured on the terrisfight.org website, and on TV newscasts, seem to show Terri reacting to things around her, the full, uncut video shows Terri smiling and moving her eyes at random. In one instance, her eyes appear to track a balloon; that short sequence has been shown over and over. What they don’t show is the many failed attempts made to get Terri to follow the balloon. With clever editing, even random motions and reflexes – such as smiling and eye movements – can seem conscious. The intelligence and cognition on display isn’t Terri’s, but the film editor’s.
This is a well-known argument, brought up by past expert witnesses and relied on by Judge Greer in his decision. Yet not one of the 17 experts address this argument at all. Not one of the 17 experts reports having viewed the uncut films of Terri (and I doubt any of them did); in fact, several of them specify that they viewed the short clips available on the internet or seen on TV.
These 17 affidavits do not respond, in any way at all, to the court’s reasoning regarding the videos of Terri. Again, rather than addressing essential arguments, they simply pretend they don’t exist.
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Obviously, I am not a medical expert. But you don’t have to be a doctor to understand that you can’t refute an argument if you don’t address it. These 17 expert opinions do not address any of the arguments for why Terri experiences no cognition, feelings or thoughts at all; nor do they address the court’s reasoning regarding the videos. They do nothing but repeat long-discredited arguments; which is great if the goal is to be able to say “look, 17 doctors say blah blah blah,” but not useful if the goal is to meaningfully discuss Terri’s medical condition.
UPDATE: Majikthise has more criticism of the 17 affidavits.