The full autopsy report on Terri Schiavo was released today. Preliminary news reports on the press briefing held by the Pinellas County Coroner indicate that the results were much as had been expected by those who understood the facts of the case: Schiavo had suffered severe, irreversible brain damage, showed no signs of physical abuse, and was incapable of taking food or water by mouth.

The AP summarized the findings this way:

An autopsy on Terri Schiavo backed her husband’s contention that she was in a persistent vegetative state, finding that she had massive and irreversible brain damage and was blind, the medical examiner’s office said Wednesday. It also found no evidence that she was strangled or otherwise abused. . . .

Thogmartin also said she did not appear to have suffered a heart attack and there was no evidence that she was given harmful drugs or other substances prior to her death.

She died from dehydration, Thogmartin said.

He said she would not have been able to eat or drink if she had been given food by mouth as her parents’ requested.

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

He also said she was blind, because the “vision centers of her brain were dead.”

Her parents, Bob and Mary Schindler, had fought their son-in-law, Michael Schiavo, in court for seven years over her fate.

Thogmartin said that Schiavo’s brain was about half of its expected size when she died 13 days after her feeding tube was removed.

“The brain weighed 615 grams, roughly half of the expected weight of a human brain,” he said. “This damage was irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons.”

He said a review of hospital records of her 1990 showed she had a diminished potassium level in her blood. But he said that did not prove she had an eating disorder, because the emergency treatment she received at the time could have affected the potassium level.

The findings are significant in several respects regarding controversies over the case:

• The finding of pervasive and irreversible brain damage substantiates the diagnosis of persistent vegetative state (but does not prove it, because PVS is a clinical diagnosis - based upon the patient’s reactions - not an anatomical one; note that all doctors who consulted on Terri Schiavo before her feeding tube was removed - other than those working for the Schindler family, who in many cases did not examine her and in some cases had no relevant clinical expertise - agreed that she was in PVS).
• The finding of massive degeneration of brain tissue makes it obvious that the predictions of the Schindler family and one of their quack consultants that she could regain consciousness were unfounded.
• The finding that her vision centers were destroyed makes it obvious that claims that she was responding consciously to visual stimuli - as supposedly demonstrated on the infamous “balloon” video - were false. This fact illustrates not only the sadness and desperation of the Schindlers’ entirely understandable false hopes, but also the sheer incompetence and duplicity of their supposed “experts” who testified at length about her specific and conscious visual tracking abilities.
• The findings apparently do not prove that it was impossible that she made conscious speaking efforts - only that, in order to do so, she would have had to muster the necessary thought, will, and motor control while operating with about half of a severely damaged brain. The finding that she was blind does prove that some of her claimed vocalizations in response to visual stimuli could not have been possible.
• The finding that mouth feedings were impossible makes obvious how irresponsible and in fact potentially fatal were arguments in favor of mouth feedings in lieu of her PEG tuve - not to mention overt attempts to do so by trespassing activists.
• The question of her original ailment remains unsolved. The working presumption was that she suffered a heart attack secondary to electrolytic imbalance brought on by an eating disorder. I presume the statement that “she did not appear to have suffered a heart attack” means there was no evidence of her ever having had one, including at the time of her original collapse (some signs could still be evident at autopsy). That would be evidence against the heart-attack scenario, but not necessarily that whatever caused her to collapse (obviously something did) was caused by the eating disorder. There were no findings to indicate she did not suffer that condition.
• The complete lack of any evidence of recent or past physical abuse is consistent with the uniform findings of investigations of the many wild complaints made against Michael Schiave previously. Such accusations have appeared in the case since (but only since) the falling-out between Michael Schiavo and the Schindler family over money following the malpractice settlement that paid for Terri Schiavo’s ongoing care. Not one has ever been substantiated, or even supported with any evidence other than statements that were in many cases absurd on their face.

Unfounded charges, unscientific pronouncements, and wild accusations will no doubt continue to dog this case, but a few things are clear: every bit of physical scientific evidence that has been amassed - both during actual examinations of Terri Schiavo’s body before her feeding tube was withdrawn, and now at autopsy - has supported the finding that she was in PVS and had no conscious participation in the continuing biological life of her body; every accusation of mistreatment or abuse has been found to be entirely without factual support; every optimistic, and in many cases bizarre, prediction for Terri Schiavo’s possible recovery has been found to be unsupportable; every wild claim regarding her consciousness and conscious reactions has been found to be without support and in many cases actually physically impossible.

In short, the position of Michael Schiavo in this long sad mess, endorsed by every responsible commentator at the time, has been as fully vindicated as is scientifically possible - while the position of the Schindler family and Michael Schiavo’s many critics has found absolutely no support, as far as we can tell from the preliminary reports, and has in significant aspects been conclusively disproven.

One would hope this would give Michael Schiavo some peace, not to mention repair his public reputation and (reaching for the sky here) garner an apology from his unbelievably irresponsible critics. One might hope this would inspire some humility and a greater respect for science among the knee-jerk wing-nut crowd. One might hope also this would encourage a calmer and more responsible appreciation of end-of-life issues within the general public. And one might hope that the entire US Congress and the President of the United States would feel the shame and embarrassment they brought on themselves with their irresponsible and grossly ignorant blundering. One would not be likely to hold one’s breath, however.