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The Lesson of Terri Schiavo

Copyright © 2005, 2008, 2009 by David E. Ross

Terri Schiavo

Born Theresa Marie Schindler 3 December 1963

Married Michael Schiavo 10 November 1984

Cerebrum destroyed, permanently ending the ability to think, emote,
communicate, desire, respond, or comprehend 25 February 1990

Died 31 March 2005

Background

Motives and Side Issues

Legal and Political Wrangling

Hope

Political Hypocrisy

The Lesson

The Autopsy

Some Final Thoughts

Background

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After 10 Years, Brain-Damaged Buffalo-Area Fireman Makes Astounding Recovery

Orchard Park, N.Y. — Ten years after a firefighter was left brain-damaged and mostly mute during a 1995 roof collapse, he did something that shocked his family and doctors: He perked up.

"I want to talk to my wife," Donald Herbert said out of the blue Saturday. Staff members of the nursing home where he has lived for more than seven years raced to get Linda Herbert on the telephone. It was the first of many conversations the 44-year-old patient had with his wife, four sons and other family and friends during a 14-hour stretch, said Herbert's uncle, Simon Manka.

"How long have I been away?" Herbert asked.

"We told him almost 10 years," the uncle said. "He thought it was only three months."

Herbert was fighting a house fire Dec. 29, 1995, when the roof collapsed, burying him under debris. After going without air for several minutes, Herbert was comatose for 2 1/2 months and has undergone therapy ever since.

Source: Associated Press, 3 May 2005


Donald Herbert was not diagnosed as being in a permanent vegetative state.

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In February 1990, Terri Schiavo suffered a heart attack that temporarily deprived her brain of oxygen. The damage to her brain left her in a vegetative state, sometimes called a "waking coma". Unable to even swallow — let alone feed herself — Terri received food and water through a tube inserted into her stomach.

Seeing no improvement in his wife's condition after ten years, her husband Michael obtained a court order to have Terri's feeding tube removed. With the support of some friends, Michael asserted that his wife expressed opposition to being kept alive artificially.

Bob and Mary Schindler, Terri's parents, had already been unsuccessful in having Michael Schiavo removed as Terri's guardian. They appealed the judge's order all the way to the Florida supreme court. This effort was also unsuccessful.

The Schindlers were more successful in lobbying the Florida legislature, which passed a bill taking control of the issue away from the courts and giving it to Governor Jeb Bush. Bush signed the bill into law in October 2003. In September 2004, the Florida supreme court declared "Terri's Law" an unconstitutional violation of the separation of powers between the executive, legislative, and judicial branches of government.

On 18 March 2005, Terri's feeding tube was again removed for the third time (the two previous removals in 2000 and 2003 reversed because of reversals of court orders).

Motives and Side Issues

Terri Schiavo may have been self-destructive. Her heart attack was the result of an eating disorder that led to a potassium imbalance. She may have indeed wished to die.

Michael Schiavo's motives might be questioned. After his wife's disability began, he acquired a new girlfriend with whom he is now living. Michael and his girlfriend now have two children.

Shortly after Terri Schiavo's heart attack, Michael Schiavo filed a malpractice lawsuit against her doctor, claiming that a simple blood test would have revealed the potassium deficiency. $750,000 was awarded to Terri in a trust for her ongoing medical care, and $300,000 was awarded to Michael for the loss of his wife's companionship.

While money might have been the original cause for the breakdown of relations between Michael and his in-laws, money was no longer a factor when Terri died.

None of those trying to keep Terri alive were really concerned about Terri's best interests. The Schindlers never reconciled themselves to the fact that the Terri they loved no longer existed; their motive was to preserve the fantasy that she might recover. The others — strangers who never knew Terri — were trying to advance their own religious "right to life" dogmas. (Anti-abortion terrorist Randall Terry became a leading supporter of the Schindlers.)

Even after Terri's death, the contention between Michael Schiavo and the Schindlers did not abate.

To aid the Schindlers in their costly legal battle to save Terri's life, well-wishers around the nation sent them contributions. According to the Los Angeles Times (1 April), the Schindlers rewarded those donors by selling their names and addresses to various political organizations.

Legal and Political Wrangling

Besides "Terri's Law", several political and legal actions attempted to interfere with Michael's quest to allow his wife to die.

Hope

The Schindlers' obsessive pursuit of court rulings and legislation resulted from a parent's fear that they might outlive their children. No family trauma is worse than a parent attending the funeral of a child. Thus, the Schindlers clung to the hope that somehow their daughter might recover.

In one of their last court actions — in Florida state court with Judge George Greer — the Schindlers claimed that Terri Schiavo said, "I want to live" just minutes before the feeding tube was removed. The parents say Schiavo said "AHHHHH [I]" and "WAAAAAAA [want]" when asked to repeat the phrase "I want to live."

Unfortunately, hope for the Schindlers reflects 15 years of denial. According to Dr. Walter Bradley — chairman of the Neurology Department of the Miller School of Medicine at the University of Miami — CT scans of Terri Schiavo's brain made in 1996 show that her cerebrum was dead and its space filled mostly with spinal fluid rather than nerve tissues. His analysis was confirmed by two other neurologists. Thus, Terri was incapable of thought, hearing, sight, voluntary movement, and emotions. (Contrary to her father's hopes, she could not possibly be alert.) Only her cerebellum and medulla — controlling her heartbeat, breathing, and digestion — still functioned.

According to other neurologists, the video of Terri Schiavo apparently responding to her family — shown repeatedly on TV — and any sounds she made were involuntary reflexes controlled by her cerebellum and medulla. They could not be alert responses involving thought, desire, or emotion. The reality was that the video was only a very short segment intended by the Schindlers to support their claims. The longer, complete video showed that Terri was actually non-responsive.

In the end, the Schindlers' hope was false. Recovery for Terri Schiavo was not possible. The daughter they loved ceased to exist in 1990. Their fight to keep Terri alive was based on fantasy.

Political Hypocrisy

What should have been a private family matter exploded into a very public, national, political issue. In the process, the true colors of our Republican President, Republican-controlled Congress, the Republican governor of Florida, and the Republican-dominated Florida legislature were revealed. The sharp conflict between Republican ideals and Republican practices must not be ignored.

Republican IdealRepublican Practice
The tradition of marriage must be protected.Every legislative move and every political pronouncement attacked the marital bonds between Michael and Terri Schiavo. One spouse knows far better than even parents the true wishes of the other spouse, but Congress and the Florida legislature both attempted to undermine this basic premise of marriage.
Activist judges must be stopped.S.686 demanded that the federal judiciary be very activist.
Capital punishment is appropriate."Our society, our laws, and our courts should have a presumption in favor of life."

President George Bush, 2 March 2005

The government is far too involved in controlling the personal lives of individuals.Both the federal government and the state of Florida intruded into what should have been a personal decision.
The federal government should stop usurping states' rights.S.686 abrogated 10 years of state court decisions, throwing open the possibility that no state court will ever again be able to settle any issue conclusively.

Sentator Frist

Special note must be taken of the actions of Senator Bill Frist of Tennessee, who might be a Republican candidate for President in 2008. Supporting S.686, Frist declared in a speech on the Senate floor that "speaking more as a physician than as a U.S. senator" there was "insufficient information to conclude that Terri Schiavo is in a persistent vegetative state." Frist made this diagnosis without actually examining the patient or her medical reports. He merely viewed the Schindlers' brief video segment, spoke to another doctor, and looked at the court records. Although Frist is indeed a doctor, his specialty is thoracic surgery, not neurology.

Since Senator Frist also helped pass S.686 with only three senators present instead of the Constitutionally required 51 senators, he committed both medical and legislative malpractice.

Would you want such an unprofessional doctor operating on you? Would you want him to be President?

The Lesson

For 15 years, things might have been quite different.

All the years wasted by Terri Schiavo's family, all the lives placed on hold, all the prolonged grief — all this could have been avoided if only Terri Schiavo had expressed in writing what she had already discussed with her husband, how she would want to be treated if she ever became incapacitated.

What happened to Terri Schiavo and her husband proves that there are far too many busybodies who do not know you but who would willingly interfere in personal life-and-death decisions affecting you. Many of them are motivated by religious beliefs that might be quite contrary to your own. Some will go to any extent to enforce their beliefs, including the involvement of the government.

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Some individuals rely on living wills or advance directives for health care. These clearly state their wishes and instructions for how they want to be treated, what they want to happen if they ever become incapacitated and unable to direct their own care. However, a durable power of attorney for health care also appoints a specific individual to enforce those wishes, to ensure those wishes are not ignored. For that reason, I prefer to rely on a durable power of attorney and not on a living will or advance directive.

The Schindlers tried to terminate Michael Schiavo's guardianship over his wife. My durable power of attorney provides for nominating a guardian and even successfor guardians, all of whom will follow my wishes. Before anyone can interfere, there is a line of four potential guardians who know what I really want.

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To prevent such interference, what everyone needs is a durable power of attorney for health care, clearly stating who has the legal right to make medical decisions for you when you can no longer make those decisions for yourself. Both my wife and I have executed such powers of attorney and had them notarized. Addressing some of the issues raised by Terri Schiavo's situation, mine states:

I direct that my health care providers and others involved in my care withhold or withdraw treatment to prolong my life if:

My agent is authorized to make all health care decisions for me, including decisions to provide, withhold, or withdraw artificial nutrition and all other forms of health care to keep me alive.

Treatment contrary to my wishes is not authorized. No payment for such treatment shall be made from my assets or estate.

Without exception, I direct that treatment for alleviation of pain or discomfort be provided at all times, even if it hastens my death.

No, you do not have to state such "pull the plug" wishes. You might instead want to be kept alive at all costs. What you must do, however, is express your individual wishes in writing and give someone legal authority to ensure that those wishes are fulfilled.

Many believe that living wills, advance directives, or durable powers of attorney are needed only by the elderly who are nearing the point where they might become incapacitated. However, Terri Schiavo was not yet 27 when she had her heart attack.

The lesson of Terri Schiavo is that none of us should create the turmoil for our own families that her family suffered.

Annette P. (a former coworker of mine) sent me an E-mail message with her own version of a living will. Beware! Annette has a strange but enjoyable sense of humor.

The Autopsy

On 15 June 2005, the Pinellas County Medical Examiner released his autopsy report on Terri Schiavo.

The most important finding of the autopsy was that no amount of therapy would have helped to regenerate Terri Schiavo's brain. The hope of her parents that proper treatment and therapy would help her to recover was a fantasy.

Before she died, Senator Bill Frist (TN, R) claimed that Terri made eye-contact with those around her. After the autopsy report was released, Representative Barney Frank (MA, D) noted that Senator Frist "was talking about making eye contact with a blind person". Frank also said the federal legislation in the Schiavo case was "a mix of ideology, religious zealotry, and political pandering — it was one of the worst legislative witches' brews that we have ever seen."

Some Final Thoughts

19 March 2005
Updated 9 January 2009


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