Jump to content

Terri Schiavo case

From Wikipedia, the free encyclopedia

This is an old revision of this page, as edited by 24.34.94.87 (talk) at 07:48, 21 March 2005 (→‎Guardianship: Cleaned up first paragraph to make more NPOV -- RFC.). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Template:CONTROVERSIAL TOPIC - please read the talk page discussion before making substantial changes

File:Terri schiavo and mom.jpg
Terri Schiavo and her mother.

Theresa Marie Schiavo (neé Schindler; born December 3, 1963), commonly known as Terri Schiavo, is a severely brain-damaged American woman from the state of Florida, whose husband's efforts to remove her feeding tube have prompted a fierce debate over bioethics, euthanasia, guardianship, federalism, and civil rights. On March 18, 2005, her feeding tube was removed for the third time.

Michael Schiavo is Ms. Schiavo's husband and legal guardian. He contends that he is carrying out his wife's wishes to not be kept alive in that state. Ms. Schiavo's parents, Bob and Mary Schindler, and her siblings, dispute Mr. Schiavo's position, saying that Ms. Schiavo is "responsive" and in no discomfort, and that she would not wish to die. They also claim that Ms. Schiavo was a victim of domestic violence both before and after her injury, though they have no evidence to support this. They seek to revoke Mr. Schiavo's legal guardianship of his wife, arguing, among other things, that his living with another woman since 1995, with whom he has two children, makes him legally estranged from her.

The courts that have heard this case have all sided with Mr. Schiavo, but her family has vigorously appealed the courts' decisions and sought to prevent her death. The Roman Catholic Church, U.S. President George W. Bush, Florida Governor Jeb Bush, and many Republicans in the Florida Legislature and U.S. Congress have sided with Ms. Schiavo's family. Other organizations and people, such as the American Civil Liberties Union and some Democratic legislators, have sided with Mr. Schiavo.


Cause

On the morning of February 25, 1990, at approximately 5:30 AM, Ms. Schiavo collapsed in her home, resulting in irreversible brain damage from a lack of oxygen. According to her discharge summary from Humana hospital [1], Ms. Schiavo suffered cardiac arrest and anoxic brain damage, accompanied by hypokalemia (an abnormally low blood level of potassium), seizures, respiratory failure, and an injured knee. The cause of her cardiac arrest was undetermined, but her low potassium was suspected.

At a malpractice trial (1992), a jury concluded that Schiavo suffered from bulimia, which caused her chemical imbalance and cardiac arrest. Florida's Second District court upheld the finding that Schiavo suffered a cardiac arrest as a result of a potassium imbalance.

Mr. Schiavo first sought permission to remove his wife's feeding tube in November 1998. Her feeding tube was removed first on April 26, 2001, but was reinstated two days later on an appeal by her parents.

Since Mr. Schiavo's petitioning the court to remove his wife's feeding tube, questions about the cause of Schiavo's collapse have been raised by Schiavo's family, and by Dr. Hammesfahr, a neurologist they hired to examine her in 2002. A bone scan [2] done one year after her injury showed (according to the radiologist who evaluated it) that she had also suffered previous traumatic injuries to multiple ribs (on both sides), to both sacroiliac joints, to both knees, to both ankles, to several thoracic vertebrae, and to her right thigh, plus a minor compression fracture of the L1 vertebra. Ms. Schiavo's family did not know of the existance of this scan until November, 2002. Forensic pathologist Dr. Michael Baden, has suggested that physical trauma, specifically a head injury, might have caused Ms. Schiavo's condition,[3] though in a later interview[4] he agreed the bulimia/hypopotassemia explanation was possible.

After the family discovered a bone scan report that may have suggested abuse-related injuries, they petitioned Judge Greer for a full evidentiary hearing to evaluate the new evidence. On November 22, 2002 Judge Greer denied the motion, stating that the issue of trauma 12 years earlier was irrelevant to the current case[5].

Schiavo's family and the doctor they selected to represent them, Dr. Hammesfahr, have suggested that she was battered, presumably by her husband. [6] According to testimony from her brother and one of her co-workers, the couple was having marital problems at the time of her injury, and Ms. Schiavo had told them that she was considering divorce.

The Florida Department of Children and Families (DCF) has begun an investigation of the abuse allegations. Previous investigations have found Mr. Schiavo innocent. ([7] PDF Report) Moreover, the doctors who were the defendants in the 1992 malpractice lawsuit made no attempt to introduce any evidence suggesting that Ms. Schiavo was battered as part of an affirmative defense to mitigate their responsibility for her cardiac arrest.


Schiavo's condition

Ms. Schiavo's condition and prognosis are matters of dispute. The Schiavos' personal physicians, and many other doctors unconnected to either party, have since 1991 contended that she is in a persistent vegetative state. Patients in a persistent vegetative state (PVS) have severe brain damage and are in a state of "wakefulness without awareness." In many cases, including that of Schiavo's, a coma progressed to the vegetative state. Patients in a persistent vegetative state are usually considered to be unconscious and unaware. They may experience sleep-wake cycles, or be in a state of chronic wakefulness. They may exhibit some behaviors that can be construed as arising from partial consciousness, such as grinding their teeth, swallowing, smiling, shedding tears, grunting, moaning, or screaming without any apparent external stimulus. They are unresponsive to external stimuli, except, possibly, painful stimuli.

Ms. Schiavo's parents claim that their daughter does not meet that definition. The only facts which appear not to be in dispute are that she is not in a coma, she is severely brain damaged, and she is partially blind. Since her collapse, she has been fed through gastric feeding tubes, which is the life support mechanism around which the case revolves. Her parents and others argue that this single tube does not meet the definition of life support in a traditional sense, which usually includes circulatory and respiratory system support. Whether she could, instead, be spoon-fed is disputed.

Much of Schiavo's cerebral cortex has been completely destroyed, replaced by spinal fluid; Dr. Ron Cranford, a neurologist at the University of Minnesota assessed Schiavo's brain function in 2001 as part of a court-ordered assessment. He was quoted in Florida Today as saying "[Schiavo]has no electrical activity in her cerebral cortex on an EEG (electroencephalogram), and a CT (computerized tomography) scan showed massive atrophy in that region." [8] [9]

Her family, and medical experts who support their position, claim that she smiles, laughs, cries, moves, and makes child-like attempts at speech. Sometimes she has been reported to say "Mom" or "Dad" or "yeah" when her parents ask her a question. When they kiss her, they claim she looks at them and sometimes "puckers up" her lips. They cite the testimony and affidavits of 33 physicians and therapists (including 15 neurologists), who, after reviewing video segments provided by her parents, believe that Ms. Schiavo should receive further tests and/or would likely respond to therapy. However, only two of these physicians had access to her full medical history and examined her in person. Some of these physicians have claimed that there is a "strong likelihood that Ms. Schiavo is in a 'minimally conscious state.'" There were six video segments provided by Schiavo's parents, totaling four minutes and twenty seconds in length (edited down from four and a half hours of videotaped interaction), and it is possible that the video selected for these segments represents moments where Ms. Schiavo's behavior coincidentally seemed to be appropriate to what was going on around her.

Mr. Schiavo, and the doctors he has chosen to care for and evaluate her, such as Dr. Ronald Cranford, contend that she is indeed in a persistent vegetative state, that her occasional apparent responses are actually reflex or random behavior common to PVS patients, and that therapy would be fruitless. Accordingly, Mr. Schiavo halted all therapy for her in late 1992. [10]

In 2002, a trial was held to determine whether or not any new therapy treatments would help Ms. Schiavo restore any cognitive function. A new computed axial tomography scan (CAT scan) was done, as was an electroencephalography (EEG).

Five doctors were selected: two doctors were selected by Schiavo's parents, two by Schiavo's husband, and one by the court. These five doctors examined the records, scans, videos, and Ms. Schiavo herself. The physicians were divided in their conclusions. The two doctors selected by Schiavo's parents supported their conclusion; the two doctors selected by Schiavo's husband and the doctor appointed by the court supported Mr. Schiavo's position. Greer ruled with the latter that Ms. Schiavo was in a PVS and was beyond hope of significant improvement. [11]

The Second District Court of Appeals reviewed all the evidence and upheld the trial court's decision, saying had they heard the case themselves they would have ruled the same as Greer. Some physicians, such as Dr. Peter Morin and Dr. Thomas Zabiega, both neurologists, say that no such diagnosis can reliably be made without more sophisticated tests such as an MRI or PET scan.[12] Judge Greer reviewed a six-hour tape of Schiavo and concluded that her vegetative condition was factual and not subject to legal dispute (see link 5, above).

Ms. Schiavo could be evaluted with a PET scan in her current condition. However, an MRI cannot be done without first removing experimental electrodes which were implanted within her brain in 1992. The doctor who implanted them instructed Mr. Schiavo to have them removed, but that has not been done.[13]

Guardianship

At present, Mr. Schiavo is Ms. Schiavo's legal guardian, although her family is seeking his removal as guardian. One of the reasons why the family is seeking removal of guardianship is so that they can assume responsibility for Ms. Schiavo's care. To date, Mr. Schiavo has successfully fought those efforts in court.

In a September 27, 1999 deposition, he told why he refused to turn over guardianship to Ms. Schiavo's parents. He said it was, "because they put me through pretty much hell the last few years [with] the litigations they put me through [and] their attitude towards me because of the litigations. There is no other reason." After consultation with his attorney, he later added that "another reason would be that her parents wouldn't carry out her wishes."[14]

In an appearance on ABC's Nightline on March 15, 2005, he cited Ms. Schiavo's parents' expressed willingness to keep her alive by any means necessary, including quadruple amputation, as a key reason for denying transfer of guardianship to the Schindlers.[15] [16]

Since his wife's injury, Mr. Schiavo has moved in with another woman, and fathered two children with her. Some contend that this is a conflict of interest, and should disqualify him from guardianship.

Controversy

The fundamental differences on both sides of the issue are focused mainly upon the disputed medical evidence presented by each side. Even though the courts have consistently ruled that, as her husband and legal guardian, Mr. Schiavo has the legal right to decide her medical treatment, her family members have nonetheless used every legal measure available to them to prevent her death.

Raising the issue of a possible conflict of interest is the fact that Mr. Schiavo stands to inherit the remainder of Ms. Schiavo's malpractice settlement upon her death. Mr. Schiavo has publicly responded to this charge by claiming that, of the original $1,050,000 awarded in the malpractice suit, less than $50,000 is left, the rest having been spent under a judge's supervision on medical care for Ms. Schiavo and the ongoing legal battle. He has also stated that, if he does receive this money, he will donate it to charity.

Ms. Schiavo's family has been battling her husband over her fate since 1993. Although she never wrote a living will expressing a wish to refuse nutrition or medical treatment if disabled, Mr. Schiavo claims that he recalls conversations they had had which make him sure she would not want to continue living in such a state, and two of his relatives have supported that claim.[17]

However, her family disputes his recollections, claiming that Ms. Schiavo is a devout Roman Catholic who would not wish to violate the Church's teachings on euthanasia by intentionally starving or dehydrating herself to death, and that she apparently never expressed such a desire to anyone in her own family or circle of friends. It was only after the courts awarded more than $1 million in legal settlements (mostly to cover the cost of her long term care and rehabilitation) that Mr. Schiavo first publicly recalled conversations in which his wife had expressed a wish to die rather than live in the condition in which she now finds herself.[18] Her family also cites an affidavit by a woman with whom he had a relationship prior to those legal settlements, indicating that Mr. Schiavo told her repeatedly that he did not know what Ms. Schiavo's wishes would be for her care[19], and the testimony of a close college friend, Diane Christine Meyer, who says that Schiavo told her in 1982 that Karen Ann Quinlan shouldn't have been removed from life support.

Ms. Schiavo's father, Robert Schindler, has stated that Florida Judge George W. Greer, who has pronounced the most recent decisions in the case, and who also appointed himself Ms. Schiavo's guardian ad litem (which Ms. Schiavo's family says was illegal), has never called her into the courtroom or visited her to observe her condition first-hand. Schindler feels that if his daughter dies in accordance with the court order, that it will be an instance of "judicial homicide".

Mr. Schiavo says that Ms. Schiavo would not have wanted to live "as a vegetable", and that he is fighting for her "right to die". As the legal guardian of Ms. Schiavo, he has placed strict limits on the time her family is allowed to visit her, and he has refused to allow her to undergo any sort of therapy; instead, he had Ms. Schiavo placed in hospice, though she is not terminally ill.

Politically this has roughly divided along traditional political lines. Publications such as the National Review, Weekly Standard, and Wall Street Journal have vocally supported the Schindlers' position to keep the feeding tube in place. The New York Times has supported the rights of Michael Schiavo to determine what is best for Ms. Schiavo. Peggy Noonan has predicted that the Republicans will face fallout from their own base if they fail in keeping Schiavo alive, mainly because the controversy is much more important to social conservatives. [20]

Republicans House Representative Tom DeLay of Texas and Senator Bill Frist of Tennessee have spoken in favor of keeping Ms. Schiavo alive, as has President George W. Bush. Democratic Senators Tom Harkin and Kent Conrad has also supported federal intervention in the Schiavo case. Democratic House Representative Henry A. Waxman has been very vocal in protesting Federal legislative efforts to intervene.

As the drama of the events have unfolded, the media storm regarding the controversy has increased. Conservative radio hosts, such as Michael Medved, Rush Limbaugh, and many others have been increasingly commenting on these matters, as have religious commentators such as Rabbi Daniel Lapin, The 700 Club, and other more conservative religious groups. Pro-life celebrities, such as Mel Gibson and Patricia Heaton have been also speaking out on it. [21] Liberal commentators such as Harvard law professor Laurence Tribe have been promoting the cause of non-intervention into the decisions of Mr. Schiavo regarding his wife.

In 2004, Mr. Schiavo won a court case to have his wife's feeding tube removed, which would have resulted in her death by dehydration. Lack of water intake causes electrolyte imbalance which causes a heart attack (Myocardial infarction) which results in cardiac arrest producing death. Six days later, the Florida Legislature, in emergency session, passed "Terri's law", giving Florida Governor Jeb Bush the authority to intervene in the case. Governor Bush immediately ordered the feeding tube reinserted.

During the six days that Schiavo's feeding tube was removed, her husband prohibited any attempt to feed her orally, and refused to allow a priest to place a small part of a sacramental wafer on her tongue[22] during Holy Communion.

On May 19, 2004, Florida Judge W. Douglas Baird overturned the law saying that it "summarily deprived Florida citizens of their right to privacy."

Governor Bush appealed the ruling to the Florida Supreme Court and on September 23, 2004 they reached a unanimous decision [23], ruling that the legislature and executive branches of government unconstitutionally intervened in a judicial matter. The appellants immediately appealed to the United States Supreme Court.

On January 24, 2005, the U.S. Supreme Court refused to hear the case.

The U.S. Congress convened the weekend beginning March 18, 2005, in an effort to pass Senate Resolution 686, requiring the federal judicial system to deliberate Schiavo's case. President George W. Bush returned from vacation at his Prairie Chapel Ranch in Crawford, Texas to Washington, D.C. to be on hand to sign the bill which occured in the early morning of March 21, 2005.

Recent developments

On February 25, 2005, Judge Greer ruled that Mr. Schiavo may order the feeding tube removed on March 18. The Florida Department of Children and Families is also attempting to intervene by investigating allegations of abuse by Mr. Schiavo. This could have resulted in a 60-day delay before the feeding tube was removed, but the request for the delay was denied on March 10. Similarly, their request to be permitted to attempt to spoon-feed Ms. Schiavo if the feeding tube is removed was denied on March 8.

Members of the Florida Legislature were considering a bill that would make removing food and water from patients in a persistent vegetative state illegal without a living will. [24] Although this bill was passed by the Florida House 78-37, the Florida Senate hours later defeated a different measure 21-16. [25]

Congress is also considering a bill to prevent Schiavo's death, called "The Incapacitated Person's Legal Protection Act" (H.R.1151, S.539). The primary sponsor of the House bill, H.R. 1151, is Florida Rep. Dave Weldon, a physician. Dr. Weldon says that medical evidence "prove[s] Terri is not in a vegatative state."[26]

On March 11, media tycoon Robert Herring offered US$1 million to Ms. Schiavo's husband if he agrees to sign all rights to her parents. The offer expired on March 14, 2005, four days before her feeding tube was removed. Robert Herring is a supporter of embryonic stem cell research, who believes her condition could be curable in the future. Mr. Schiavo's attorney, George J. Felos, stated that his client found the offer "offensive" and that he had already rejected other monetary offers, including one of US$10 million, to sign over his rights to his wife. [27]

Ms. Schiavo's feeding tube was removed at 1:45 p.m. EST on March 18[28]. Earlier in the day, U.S. Senate majority leader Bill Frist (R-TN) announced that she will be called to testify before the Senate's Health, Education and Labor Committee at a March 28, 2005 hearing. Frist, a practicing doctor, serves on the committee. Republican congressmen Dennis Hastert, Tom DeLay, and Tom Davis opened a congressional inquiry of the House Government Reform Committee, to take place in Clearwater on March 25, and issued subpoenas for Ms. Schiavo, Mr. Schiavo, and several hospice workers. According to the lawmakers, harming Ms. Schiavo or preventing her from appearing at the hearings would be a violation of federal law. [29] Judge Greer responded by defying the congressional subpoenas, and letting the order stand which gave Mr. Schiavo permission to remove his wife's feeding tube. The judge said he saw no reason to change his earlier permission allowing Schiavo's husband to remove her feeding tube. Greer ordered that the tube be removed immediately, per Mr. Schiavo's request.

On March 19, 2005, congressional leaders announced that they were drafting a bill which would order the reinsertion of Schiavo's feeding tube and allow a federal court to review the case. "We should investigate every avenue before we take the life of a living human being," said House Majority Leader Tom DeLay, R-Texas. "That's the very least we can do for her." [30]

Deliberation continued during an unusual Sunday House of Representatives session on March 20, 2005. When it came to a vote, the motion was passed 203-58, with 174 Representatives not present on the floor at the time of the vote. The vote took place at 12:41 a.m. on Monday March 21, 2005.

In the very early hours of March 21, it was announced that a compromise was passed. Congress approved emergency legislation to let Terri Schiavo's parents ask a federal judge to prolong their daughter's life, capping days of emotional debate over who should decide life and death. President Bush waited at the White House to sign the measure permitting a federal review of the case, which could trigger the reinsertion of feeding tubes needed to keep the brain-damaged Florida woman alive. The House passed the bill on a 203-58 vote after calling lawmakers back for an emergency Sunday session for debate that stretched past midnight. The Senate approved the bill Sunday by voice vote. About a half hour after it passed The House, President Bush signed the bill at 1:11am March 21.

Retrieved from "https://en.wikipedia.org/w/index.php?title=Terri_Schiavo_case&oldid=11352579"