Thursday, August 21, 2008

Media Coverage of Terri Schiavo

Neurology published a review of newspaper media coverage in the case of Terri Schiavo (subscription required), who had persistent vegetative state and died amid much public controversy over surrogate decision making in 2005. Dr. Eric Racine and his colleagues found 1,141 articles from the Washington Post, New York Times, and two papers from the Tampa-St. Petersburg area spanning 16 years (1990-2005). The focus of the study was to analyze the themes of the headlines, and the accuracy of medical terms and descriptions of Terri Schiavo's condition.

The study demonstrates a large mischaracterization of her neurologic condition that was not necessarily due to the refutation of the Schindler family and politicians. She was officially diagnosed as being in a persistent vegetative state, but journalists also used similar but inaccurate terms, such as 'brain destroyed', 'permanent vegetative state' and even 'brain death.' When looking at these alternate descriptions, it may not seem to be very different, but the difference between 'persistent' and 'permanent' is a pretty important distinction. Persistent describes the past and current situation and is part of a diagnosis. Permanent is really more future oriented and is best classified as prognostic information.

When describing the withdrawal of life support (artificial hydration and nutrition) is probably of most significance to the palliative medicine community. Some of the terms used include:

  • Murder - 9%
  • Painless, peaceful or comfortable death - 5%
  • Death by dehydration - 4%
  • Less then 2% for each of the following
  • Death sentence
  • Death with dignity
  • Euthanasia
  • Playing God
  • Elimination or extermination
  • Deprivation of food or water
  • Barbaric act
  • Medical terrorism (Yikes!)
  • Against God or religion
  • Physician-assisted suicide
The palliative medicine bioethics and neurology communities really missed a large opportunity to do some education about withdrawal of life support measures. Obvious barriers to this opportunity were large including national and local political pressures and the possibility that vocally taking a side could alienate a large portion of the population. The authors noted very few articles actually focused on expert opinions or research about persistent vegetative state or the withdrawal of artificial hydration or nutrition. This may be something to push to local and national media when we encounter similar controversies.

Fostering good relationships with the press is essential for the medical community to help avoid erroneous descriptions of complex medical situations. Communicating accurate medical information to the public and helping the public understand complex medical decision making situations is vital to the continued trust in the medical profession. Maybe it would be good for our professional meetings to have a talk about 'Medicine and the Media' or possibly even some mock interview sessions to make sure we are confident and adequately prepared in the future.

If you have any tips on working with the media or would like to tell the AAHPM, HPNA, or NHPCO to have a 'Medicine and the Media' talk or workgroup feel free to email them or comment below.

ResearchBlogging.orgRacine, E., Amaram, R., Seidler, M., Karczewska, M., Illes, J. (2008). Media coverage of the persistent vegetative state and end-of-life decision-making. Neurology DOI: 10.1212/

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