Another Ring in the Terri Schiavo Circus

The US Congress is getting involved in this case:

http://www.cnn.com/2005/LAW/03/18/schiavo.brain-damaged/index.html

For those of you not following this, Terri Schiavo is a Florida woman who suffered a respitory collapse (likely as the result of a chemical imbalance brought on by an eating disorder) 15 years ago in 1990, at the age of 26. She suffered a loss of oxygen to the brain which caused severe brain damage including loss of nearly all of her cerebral cortex. Her brain stem was largely undamaged and she is not brain dead: she continues to breath and her hearts continues to beat, without outside intervention. However, she has no ability to walk, sit, speak, chew, swallow, relieve herself, clean herself or care for herself in anyway. She is in a “persistent vegegative state” and has been unchanged in that state for 15 years. She does occasionally make a noise or move her hands but has not been observed to communicate or perform any coordinated activity in 15 years. She is currently kept alive by means of a feeding tube inserted down into her stomach: without it she will starve to death.

In the early 90s, her husband Michael sued the hospital where she was treated and after a lengthy court case and trial eventually settled for around $300K for himself and another $800K for Terri’s medical expenses. Terri was in hospice care for most of the 90s, except for a period in the early 90s when Mr. Schiavo took her to CA for therapy in the hopes of improving her condition, unfortunately without success.

In 1998 after a brain scan showed that Terri’s cerebral cortex had atrophied and that a significant chunk of her brain area was a void filled with cerebro spinal fluid, Mr. Schiavo gave up hope and filed a petition to ask a Florida court to determine what her wishes would be. Mr. Schiavo and Terri’s adult friends all testified that her wishes would have not to be kept alive in these circumstances. Mr. Schiavo requested a ruling that Terri’s feeding tube be removed and she be allowed to die. Terri’s parents, the Schindlers, adamantly opposed this view and testified that Terri as a Catholic would have wanted to be kept alive at all costs. The matter went to a court trial under Florida law and the Judge applied the Florida law which had been drafted a few years previously in response to another big right to die controversy years earlier. This law included a presumption in favor of life and required a that finding in favor of removing the feeding tube be made with “clear and convincing evidence” which is a much higher standard under Florida law than the normal “preponderance of evidence” (which is just the usual 51% probability). After the trial the Judge found that the multiple statements of Terri’s husband and adult friends constituted sufficient evidence to order the removal of the feeding tube. Judge Greer felt that the testimony of Terri’s parents reflected her childhood views, and he ruled that as an adult Terri would not have wanted to be kept alive artificially. (Terri had left her home state of PA (IIRC?) and moved to Florida a few years earlier and although she had not cut off relations with her parents, she didn’t interact with them frequently, just at holidays and vacation visits).

The Schindlers appealed that ruling to the Florida appellate court, who reviewed the entire case and agreed with Judge Greer. The Schindlers again appealed, to the Florida Supreme Court, who stood by the appellate decision. The Schindlers then appealed again to the US Supremes who said this was not a federal matter and turned them down. At that point an order to remove the feeding tube issued and the tube was removed. The Schindlers filed a large batch of new motions and appeals, contending amongst other arguments, that new medical therapies were availalable that would allow Terri to recover. Since her condition was not hopeless, they argued, she would want to live.

Judge Greer granted the Schindlers a second trial and 5 medical experts were selected to evaluate Terri, 2 picked by Mr. Schiavo, 2 by the Schindlers and 1 by the court. The 2 doctors for Mr. Schiavo and the court appointed doctor all said that Terri’s condition was not going to change: she didn’t have a cerebral cortex and there is no way to regrow that kind or amount of brain tissue. The 2 doctors for the Schindlers both acknowledged the severe brain damage but both said the therapies they offer would help her, although they could not make any specific promises. One of the therapies offered was physical therapy and one was hyperbaric (immersion in high oxygen environment). Neither doctor was able to explain how those therapies would regrow Terri’s cerebral cortex.

After a lenghy trial, including testimony by the doctors, and many of the nurses and caregivers who had attended Terri for the 11 years since her accident, Judge Greer ruled that there was no medical hope. He did review the videotape that the Schindlers offered (thats the source of the images you often see which appear to show Terri reacting to her mother) but felt that it did not show actual response by Terri: just random motions that at times corresponded with her mothers attempts to elicit a reponse. (The video is 120 minutes and shows 82 attempts by Mrs. Schindler to elicit a response from Terri, and shows 16 movements or sounds by Terri - 2 of the movements or sounds corresponded in time to 2 of the 82 attempts, but the other 80 attempts elicited no response of any sort. Judge Greer ruled that the video showed merely random activity by Terri’s still functioning brainstem but no cognition or consciousness.)

Judge Greer again ruled in favor of removing the feeding tube. The Schindlers appealed again to the Florida appellate court who again reviewed the entire case (including the medical testimony and video) and again agreed with Judge Greer. The Schindlers again filed an appeal with the Florida Supremes which was again rejected. The Schindlers then again filed an appeal with the US Supremes which was, again, rejected.

A second order to remove the feeding tube issued. During the lengthy litigation the Schindlers had started to recieve legal assistance from various right to life groups, and also conservative political groups in Florida, including Operation Rescue. The struggle to keep Terri alive became a big phenomenom on talk radio and the blogosphere as she became a symbol of right to life and a focus of anti-euthanasia views. There was a great emotional outpouring by many who saw Terri as an innocent about to be executed. Also, Michael Schiavo began to be villainized for taking up with another woman - he was accused of many things including wife abuse, financial motives, etc (none of these were ever proved in any of the 3 trials that occurred in the case and Mr. Schiavo has never been convicted or indicted of any crime or wrongdoing. The appellate court opinions had made mention of the loving care and attention provided to Terri by both Mr. Schiavo and the Schindlers.)

As the feeding tube was removed a second time, the Schindlers and their political allies mounted a massive campaign to get the Florida legislature to intervene. After an intense but short political debate the Florida legislature passed a special law allowing Governor Jeb Bush to order a stay on the feeding tube - it was put back in and Terri remained alive. This special law was challenged as unconstitutional for several reasons and after hearings the law was thrown out on multiple grounds under the Florida Constitution. It was ruled as a violation of Terri’s due process, as a violation of separation of powers, as an invalid law of special application, and in general overreaching by the state legislature. The Schindlers appealed and lost in the appellate court, appealed and lost in the Florida Supreme Court and appealed and were denied by the US Supremes.

So now after another round of motions, appeals, new lawsuits, etc, a third order to remove the feeding tube has issued. It was scheduled to take effect today. All avenues within Florida have been fully exhausted. The Florida legislature again debated a new law which passed in the Florida House but failed in the Florida Senate.

But Congressional Republicans have now stepped in. The Senate has issued a subpeona commanding the appearance of Mr. Schiavo and Terri Schiavo before the Senate on the issue of right to live/right to die. The Schindlers believe this will stay the removal order and keep Terri alive.

I have tried to be as neutral as possible in my description. However, the facts of the case put me squarely in the right to die camp: I’m convinced that Ms. Schiavo has no higher brain functions and wouldn’t want to live unnaturally in those conditions, and that the attacks on Mr. Schiavo are baseless and grounded in emotion, religious believe, or political positions.

If you want a scrupulously neutral source, here is a Florida legal blog:

http://abstractappeal.com/

This is a legal blog run by an appellate lawyer who has followed the case and maintained a very neutral position (although like me he tends to think the law has been followed properly and the Schindlers are pushing beyond the bounds). He has a page with a full rundown of the history and links to the legal opinions:

http://abstractappeal.com/schiavo/infopage.html

There are a ton of “keep Terri alive” sites out on the web but in my view they all tend to be emotional, religious or political. I don’t consider them persuasive.

The reason I bring this up in P&R is that I think the most recent action by Congressional Republicans is a disaster. The Feds have no business in this case issuing subpeonas at this late date is just a blatant attempt to interfere in state business. Plus its a violation of separation of powers for the legislature to interfere with a court case. AND its a singling out of an individual for special treatment.

Also there is a sick and creepy element here. In the SF Gate article the Schindler’s attorney said

“The family is prayerfully excited about their daughter going before the United States Congress for the whole world to see how alive she is.”

Given the fact that Terri doesn’t have a cerebral cortex such a live appearance is likely to be a national disgrace. I think its deeply disrespectful to treat a person as badly injured as Terri is as a show pony.

Dan

I agree that this case is ridiculous, disgusting, and shameful in its treatment of Terry herself, but that’s nothing new, of couse. Just wanted to add that you’re dead on with all of the quoted points.

The thing I can’t figure out in this is what her parent’s deal is. Do they actually think she’s still alive in any meaningful sense in there?

But is the answer death by starvation and dehydration?

As a Florida resident, I can only say how sick of this story I am, and how disgusted I am with the wacko politicos interfering with a court case.

The Judge should also seriously consider sanctioning the parents for frivolous litigation at this stage…

BTW, according to the latest, the judge ordered the feeding tube removed immediately.

That’s not really a harsh sentence to a vegetable.

If the law requires non-intervention, then it has to be. Obviously it’d be saner and more humane to just give her a lethal dose of morphene, but morally we can’t do that. We treat horses better than we treat sick people. We also pay veterinarians and zookeepers a lot more than we pay nurses.

  • My wife just chimed in. She says dehydration and starvation are normal parts of the dying process - meaning, a dying or very sick person will refuse food and water because it’s actually more painful to be fed and hydrated while dying of natural causes. She’s a Geriatric Clinical Nurse Specialist, FYI.

Until such time as assisted euthanasia is allowed.

That’s not really a harsh sentence to a vegetable.[/quote]

It’s harsh saying so, but they are no longer feeding a human being, they are fighting to fertilize a vegetable. :x

It was scheduled to take effect today. All avenues within Florida have been fully exhausted.

I know I’ve heard this before regarding this case. Frankly, until Terri is passed on, I’m not at all convinced its over.

The judge basically told congress to fuck off. The tube has been removed.

http://www.sun-sentinel.com/news/local/southflorida/sfl-318schiavo,0,2720746.story?coll=sfla-home-headlines

``I have had no cogent reason why the (congressional) committee should intervene,’’ Circuit Judge George Greer told attorneys in a conference call, adding that last-minute action by Congress does not invalidate years of court ruling.

My girlfriend works in the nursing home industry down here in Florida. It is not uncommon to have a patient die by having a feeding tube removed or refusing to have one installed. In some cases a patient will reach a point where they are no longer able to eat. A doctor is then brought in to councel them, they are made aware that they either need to have the tube or they will starve to death. Its their choice.

Starvation supposidly isn’t a bad way to die. And it is the only option since euthanasia is not allowed. All the fuss in this case is centered around the fact that Schivo cannot make the decision herself. The starvation is irrelevant.

Somebody tell Death Row and animal shelters…

Somebody tell Death Row and animal shelters…[/quote]

And it is the only option since euthanasia is not allowed

Terri is not going to starve. Once the feeding tube is withdrawn, dehydration will set in much more quickly, which will lead to renal failure.

Although my experience is obviously limited, renal failure is supposedly one of the least painful ways to die. Some terminally ill patients refuse dialysis for this reason.

Morphine overdose would be even better, but that’s not an option.

Somebody tell Death Row and animal shelters…[/quote]

Everyone on death row is a vegetable? Who knew…

I’d like to hear what some of you parents think about this, as a liberal I think that the guardian (her husband) should make the deision, that’s what guardians are for.

However as a parent I think if my daughter were in this state I would do the same as Terri’s parents have done. I’d bring her home and care for her for the rest of my life, stories like this one make me think that would be the right thing to do.
http://www.suntimes.com/output/news/cst-nws-coma12.html

The interesting thing is that when one part of the brain is damaged other parts take over in time. People who were never supposed to walk or talk again are walking and talking. It’s tough to say that when a person has a relative willing and able to take care of them that they should be denied medical care.

The two cases are not the same.

Sarah Scantlin has been able to communicate by blinking her eyes, and is aware of her environment. She was unable to speak until recently, but her higher functions have remained intact. She is a case of severe brain damage.

Terri Schiavo has no awareness of her environment, or any other higher functions. The brain tissue necessary to support any cognitive activity has long been destroyed, and cannot grow back. She is in a permanent vegetative state.

Comparing Sarah to Terri is like telling someone whose legs were amputated, “There’s hope, my uncle had a stroke and was in a wheelchair at first, but he’s regained his function and now he can walk!”

Just a note, one of the common misconceptions is that Michael Schiavo, as her guardian, made the decision for Terri. That is not correct. Under Florida law a guardian cannot make that decision; only a court of law. And the Judge must not make the decision “for” the sick person: the Judge has to step into the shoes of the sick person and decide what the sick person would have wanted, had they been able to communicate. Since these cases involve patients who cannot communicate, and who did not leave a written directive, the wishes of the sick person are determined by the trial judge on the basis of testimony as to the statements and behavior of the sick person before their loss of ability to communicate.

Also under Florida law, in cases where there is no written directive, there is a presumption in favor of life: the side asserting the patient would want to die has to prove their case by “clear and convincing evidence” which is a higher standard than the normal standard of evidence. In this case the Judge held a trial and found there was sufficient evidence to believe Terri would not want to linger on in this state. It’s actually Terri’s right to decide her own fate that the Judge is legally enforcing, NOT Michael’s Schiavos rights as guardian.

There are many many misconceptions about this case, some of which are being intentionally spread by the Schindler side in an effort to gain sympathy (such as the frequent and unjustified villification of Michael Schiavo which you will see as a common theme if you look at the Terri’s Fight type websites).

This is a sad case, but Florida actually has a well designed law to handle this sort of thing, with reasonable checks and balances and what sounds like a fair procedure to me. IMO the Schindlers have gone way beyond the bounds of reasonable appeals, filing excessive, repetitive, duplicative, frivolous and outright legally worthless petitions, motions and pleadings. And the State of Florida has done a lot of harm too: inappropriate attempts at intervention by the Florida dept of child services, inappropriate intervention by the Governor and State legislature. And now the Republican Congress wants to stick its nose in too.

Hopefully the legal proceedings will move to their natural conclusion and this can be put behind us. But if the Republicans really make this into a political football I think it may end up as a major political disaster for them, and it will certainly disgracefully prolonged an already ugly and over-delayed case.

I remember an America where we were dumbfounded by stories of societies killing their babies, killing sick people, killing unborn babies, killing old people. That seems so long ago now. I’ve walked through the looking glass and I’m a stranger in a strange country. I am so homesick for the America I loved and love, but it’s all gone now and I can’t go home again.

Muttbunch, how is your comment related to the discussion we are having?

Do you not understand anything about the history or context of this case? The courts of the state of Florida have decided that Terri herself would not want to live on in the condition she is now in. You may disagree with that position but its been reached after multiple trials and multiple appeals, all of which have reached the same result.

The key misconception that people have about this case is that some outside force (Terri’s husband or the state or euthanasia proponents or whoever) wants to kill Terri. Under Florida law the individual has the right to make this decision for him/herself. Ideally the individual does that in a written directive before becoming ill. If the individual doesn’t leave written instructions then the court has to figure out what to do, with a presumption in favor of life that can be overcome by “clear and convincing” evidence.

Also, there is no outside intervention here “killing” Terri: Terri is incapable of sustaining her own life without assistance. She cannot chew, swallow or drink on her own. Her life has been artificially prolonged by the provision of a feeding tube, for 15 years. The current situation is not outside intervention to kill Terri but is instead the withdrawal of outside intervention which has been artificially sustaining her.

Look I understand the emotions here, but there are some very strong medical facts, and a lengthy legal process that is fully complete, that have to be dealt with.

On a political note, the reason I think this is of national import is that it illustrates the degree to which the religious right in this country can get swept up in religious fervor and emotional intensity and disregard or intentionally misconstrue very strong factual and legal realities. Obviously you can have reality-denying fanaticism of all stripes but the strongest type in this country right now is the Christian Right. And that is significant b/c they have a very strong influence on the party that controls all 3 branches of our federal government and a big chunk of state governments.

Emotion is very important. But it doesn’t change reality. And the reality is that Terri Schiavo’s memory, identity, and personality, that which made her mentally human, died 15 years ago when her cerebral cortex was destroyed, and other parts of her brain damaged, by oxygen loss. The rest is just sad aftermath.