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Terri Schiavo
Who Has the Right to Die? [pic]

GM520 Legal, Political and Ethical Dimensions of Business

June 10, 2009
Terri Schiavo’s death has become a key element in the right-to-die argument she plays a key role in the case of who should decide what the value of life is? Terri Schiavo’s case was front page news for advocates of both the pro-life and right-to-die organizations, and each side believed they had the winning argument to support their position. The case became so big that both Congress and President Bush weighed in on the issue.
On February 25, 1990, at approximately 4:30 a.m. EST at the age of 26, Terri Schiavo collapsed in her home and suffered a heart attack which interrupted the flow of oxygen to her brain. Paramedics were called to the scene and administrated first aid until she arrived at Humana Northside Hospital. Physicians continued attempting to revive Terri until it was determined that she had been without oxygen for too long and was placed on a ventilator. This lack of oxygen caused a condition called hypoxic encephalopathy (a neurological injury caused by lack of oxygen to the brain). Many people wondered what caused a healthy 26 year old woman to have a heart attack and some thought that there was foul play involved, but her Husband Michael Schiavo claimed that his wife was battling bulimia and a chemical imbalance was the cause of the heart attack. Terri spent the next two and half months in a coma until she awoke to what is called a vegetative State (a state of wakefulness without detectable awareness. It is a diagnosis of some uncertainty in that it deals with a syndrome, not an etiology).[1] In this vegetative state she was able to breathe on her own and maintain some vital bodily functions. Terri had a gastric feeding tube inserted in her abdomen and remained in this vegetative state for the next fifteen years. Michael Schiavo brought his wife home in September of 1990 and during the next three years he spent all of his time trying to help Terri recover from her Permanent Vegetative State (PVS) (approximately 1 year of being in a Persistent Vegetative State)[2]. During this period he moved Terri from one rehabilitation center to another and spent several months in California where they attempted experimental procedures to help Terri recover. Michael also took Terri to familiar parks and other public places hoping that they would help ignite a spark in Terri brain dead body. In 1992, Michael Schiavo initiated a medical malpractice suit against Terri’s doctors, a general practitioner and a gynolocologist, claiming that she may have suffered from an eating disorder which they failed to detect. During the trial the Chief of Rehabilitation from Bayfront Medical Center and a second rehabilitation specialist both testified that Terri could expect a normal life span and would require extensive care throughout her life. Based on that and other evidence, the jury awarded Michael Schiavo $600,000 for loss of spousal consortium and over $1.5 million to Terri. Out of the $1.5 million, $780,000 was placed in trust to provide for Terri’s future healthcare and therapeutic needs.[3]
In early 1993 Michael Schiavo and Terri’s parents Robert and Mary Schindler started to disagree on Terri’s treatment options. The Schindlers wanted Michael to continue the therapy he had started the previous year but Michael did not see any point in continuing a process that was not working. This decision caused a rift between Michael and the Schindlers which lead to Michael limiting the Schindlers access to Terri, and their accusation that Michael was misusing the trust fund set up to care for Terri. The Schindlers were very upset with Michael’s decision to block their access to Terri and filed a court challenge to Michael’s rights as Terri’s guardian. This challenge failed and over the next few years there remained a conflict between the Schindlers and Michael Schiavo.
In 1997 Michael Schiavo made the decision that he wanted to end the bickering over Terri’s care and hired attorney George Felos who was an expert in the right-to-die field. George Felos filed a petition to stop supplying Terri with food and water and end her artificial life support. The Probate Court appointed Richard L. Pearse Jr. of Clearwater, Florida, as Terri's Guardian Ad Litem and instructed him to investigate the matter and report back with a recommendation. Pearse filed his report with the court on December 28, 1998 urging that the court deny the petition to remove Terri's food and water. [4] Michael Schiavo and his attorney fought the decision and had the Guardian ad Litem removed from the case, the court did not name a replacement for Pearse. By filing the petition in court Michael removed much of the decision making process from both himself and the Schindlers Terri’s fate was now in the hands of the courts.
In early 2000, Judge George W. Greer in Pinellas-Pasco’s Sixth Judicial Circuit was designated to hear another petition to withdraw life support by Michael Schiavo and his attorney George Felos. Judge Greer was convinced by Michael Schiavo’s testimony and the support of his brother and sister-in-law that his wife would not have wanted to be keep alive by artificial means. Judge Greer determined that Terri Schiavo would refuse any artificial life support and ordered the gastric feeding tube removed.
The Schindler appealed the February 11, 2000 order and the Second District Court of Appeals affirmed Greer’s ruling. The matter was appealed to the Florida Supreme Court, who declined to hear the case, and to the Supreme Court of the United States, who also declined to hear the case[5].
On April 21, 2001, the gastric feeding tube was removed from Terri Schiavo and after sixty hours the Schindlers and their attorneys were able to petition Judge Frank Quesada to order an injunction to reinsert the feeding tube. Judge Quesada’s decision was based on evidence from a past girl friend of Michael Schiavo that claimed he told her they had never discussed the topic of extended life support.
Late in 2001the Schindlers filed a motion before Judge George W. Greer that Terri’s neurological condition had improved since his previous decision in 2000. The Schindlers offer testimony and affidavits from various medical professionals to support their claim that Terri was not in a PVS. Judge Greer did not feel there was enough new evidence to warrant a new hearing and denied their motion. The Schindlers appeal his decision and the case was sent back to Judge Greer for a medical evidentiary hearing.
Judge Greer conducted the medical evidentiary trial in October of 2002. The trial consisted of the testimony of six physicians who the Schindlers claimed were biased because one was a noted right-to-die advocate and another was a business partner to Michael Schiavo’s attorney, George Felos. Judge Greer viewed Videotapes of Terri to determine if her reactions were that of a cognitive person or that of a person in a PVS. Florida’s statutes state that a persistent vegetative state is the total absence of awareness and ability to communicate. Judge Greer instead based his ruling on the consistency of Terri’s reactions. He found her to be in a persistent vegetative state and reaffirmed his earlier ruling that she would want to die.[6]
The Schindlers again appealed Judge Greer’s ruling but it was denied by the Second District Court of Appeals who order Judge Greer to set a date for the removal of Terri’s feeding tube.
October 15, 2003 was the date set by Judge Greer to remove Terri’s feeding tube. There was a large crowd of pro-life advocates and the Schindlers had collect close to 200,000 signatures on a petition to request Florida’s Governor Jeb Bush to invoke Florida’s Adult Protective Custody statutes. By this time Terri’s case had become a nationwide firestorm between the two sides and each had taken up the cause of trying to make there argument through Terri’s suffering.
Terri’s Law was passed during a special session of the Florida Legislature, and this law provided the Governor with the authority to overrule the court’s decision and reinstall Terri’s feeding tube. The law also had a provision for the Courts to appointment a Guardian ad Litem for Terri.
Pinellas County Chief Judge David Demers named Dr. Jay Wolfson, director of the Florida Health Information Center at the University of South Florida, as an independent Guardian ad Litem to represent Terri's interests in legal matters only. Judge Demers gave Dr. Wolfson 30 days to examine Terri's situation and recommend to Governor Jeb Bush whether or not she should continue being fed through a gastric feeding tube. Dr. Wolfson, who has a law degree, was not to replace Michael Schiavo as guardian on any other matters.[7]
At this point the American Civil Liberties Union joined Michael Schiavo and his attorney to file a brief requesting the Court review Terri’s law to see if it was unconstitutional. Their brief stated that the legislature and governor unconstitutional bypassed the court's ruling that Terri’s was in a PVS and that her feeding tube should be removed.
Bob and Mary Schindler pleaded with the courts to have Dr. Wolfson removed as Terri’s Guardian ad Litem because he could not be objective in the case. The Schindlers referenced an interview in which Dr. Wolfson stated that he disagreed with the way Terri's Law which was passed by the legislature and Governor.
Judge Baird of the 6th Circuit court ruled that ‘Terri’s Law’ was unconstitutional and the Florida Supreme Court agreed with Judge Baird's ruling that 'Terri's Law' was unconstitutional. In January of 2005, the Supreme Court of the United States again refuses to hear Terri’s case.
On February 25, 2005 the case was back where it started in Judge George W. Greer court room. He set a date of March 18, 2005 to remove Terri’s feeding tube and also added that Terri may not receive hydration or nutrition by mouth. At approximately 1.40pm ET. On March 18, 2005, Terri Schiavo’s gastric feeding tube is removed and the slow process of death from dehydration began again. In a last ditch effort to keep Terri alive, the Schindlers made a plea to Congress to intervene on Terri’s behalf. Congress responded by enacting Terri’s Law II, authorizing Terri's parents to seek a federal court review of whether Terri's federal rights have been protected.[8] The Schindlers filed a request for an emergency injunction in the U.S. District Court for the Middle Distinct in Tampa. US District Court Judge James Whittemore denies the Schindler’s request to have Terri's feeding tube reinserted.
For the final time the Supreme Court of the United States declines to hear Terri Schiavo case and it returned for the final time to Judge Greer’s court room.
Judge Greer issued an injunction denying Florida’s Department of Children & Families from stepping in as an advocate for Terri Schiavo.
On March 31, at 9:05 am EST. Terri Schiavo, the 41-year-old brain-damaged woman who became the centerpiece of a national right-to-die battle, died nearly two weeks after doctors removed the feeding tube that had sustained her for more than a decade. [9]
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The Terri Schiavo case was argued in many different courts for well over a decade and it raised a lot of attention in the right-to-die argument. This case also drove a wedge deeper between the people on either side of the issue. Many of the same old questions were brought back up again such as, who has the right to die? Who has the right to make the decision concerning the quality of life? What is the value of life? Do we devalue life when someone is depressed or has suffered a devastating injury, do we end their life because it seems like the honorable or reasonable thing to do. If someone is in a coma and can’t tell us what they want, who are we to decide if their life is no longer worth living? What may seem reasonable to one person may not seem reasonable to another.
Many people feel they want to die when they first come to the realization of their dire situation. Over time most can overcome the constant depression and hopeless, and regain the feelings of joy that everyday life can bring to them. They find out that they can handle much more than they think. That is just one reason why virtually all disability advocacy groups and others like the Institute on Disability Studies, the Scholl Institute for Bioethics, the California Medical Association, and Joni and Friends are so vehemently opposed to this idea of helping someone die, which may sound warm and fuzzy, but in the searing light of truth, is just plain murder.[10]

In the Netherlands euthanasia was made legal in 2001[11]; they have already begun to see changes reflected in the culture. The idea of right-to-die as changed to the idea of duty-to-die. People end up learning that it’s okay to end a life that’s inconvenient or difficult either for themselve or their loved ones.

The State of Oregon passed the Death with Dignity Act in 1997 during the first seven years of the act there were 208 official deaths attributed to the prescription of death.[12] This number of deaths could be far greater because there no way of knowing if any additional deaths went unreported. Of the patients who requested assisted suicide in 2003, up to 87% made that request because of fear of disability and 63% cited fear of being a burden on family, friends and caregivers as the reason for their assisted suicide.[13] Is this really or choice, or is it just the fear that you no longer have a choice. The only people who can receive the suicide prescription are those that can ask for it and take it themselves, but there is already a movement to amend the law to allow the suicide prescription to be administered by someone other than the patient. Here again we have to ask the question who decides what the value of life is?

The Idea of euthanasia has been around for a long time and is often associated with animals. We see euthanasia as a way to end the pain and suffering of our pets and it is seen as a compassionate method of ending their lives. The problem arises when we use this same concept on humans.

The different organizations that believe in and support euthanasia define euthanasia in the following ways:

• Euthanasia: the intentional killing by act or omission of a dependent human being for his or her alleged benefit. (The key word here is "intentional". If death is not intended, it is not an act of euthanasia) • Voluntary euthanasia: When the person who is killed has requested to be killed. • Non-voluntary: When the person who is killed made no request and gave no consent. • Involuntary euthanasia: When the person who is killed made an expressed wish to the contrary. • Assisted suicide: Someone provides an individual with the information, guidance, and means to take his or her own life with the intention that they will be used for this purpose. When it is a doctor who helps another person to kill themselves it is called "physician assisted suicide." • Euthanasia By Action: Intentionally causing a person's death by performing an action such as by giving a lethal injection. • Euthanasia By Omission: Intentionally causing death by not providing necessary and ordinary (usual and customary) care or food and water. [14]
In direct response to the Terri Schiavo case the National Right to Life Committee is urging all state legislatures to protect people suffering from lifelong disabilities or catastrophic injuries like Terri Schiavo from suffering the fate of any definition of euthanasia.

The National Right to Life Committee has developed a model Starvation and Dehydration of Persons with Disabilities Prevention Act.[15] The proposed Act is written to be constitutional under the governing precedents of the United States Supreme Court to prevent it from being overturned as it was in Florida. It would allow the for those that are incapable of making health care decisions on their own, or unable to express those wishes the ability to receive food and fluids so long as it is medically possible.

Many people think the Terri Schiavo case was an isolated incident but it happens on a daily basis in nursing homes and hospitals across America. People around the world who never asked to die are being starved to death because of family members and sometime court appointed third parties to make these death decisions with little or no scrutiny or accountability. The public news coverage and media hype created by the Terri Schiavo case has caused all of America to take notice and join a side in the right-to-die issue.

The National Right to Life Committee has taken on the mission of educating people about these inhuman practices and working to change the legal presumption of starvation and dehydration. Their fight is not against people who have made a conscious decision to refuse artificial life support or signed a Do Not Resuscitate order. They are only trying to protect those who can’t speak for themselves.

There are many arguments both for and against euthanasia, the pro-euthanasia advocates will tell you it provides relief from constant and unbearable pain, it is a way for a person to end their life on their own terms and, most important it is a case of personal freedom. The anti-euthanasia advocates will tell you it devalues human life, will become a method of reducing health care costs, and depending on the legal aspect can be changed from voluntary to non-voluntary very easily. Each side will tell you they are right but in the end it comes down to what you personally believe is right.

References
Eareckson Tada J., Estes S. (1992) When is it Right to Die Grand Rapids, MI Zondervan;

http://en.wikipedia.org/wiki/Persistent_vegetative_state 5/18/09

http://www.terrisfight.org/pages.php?page_id=31 5/18/09

http://www.weeklystandard.com/Content/Public/Articles/000/000/003/337laakp.asp
5/19/09

http://www.mnddc.org/news/inclusion-daily/2003/10/103103fladvschiavo.htm 6/3/09

http://findarticles.com/p/articles/mi_hb5554/is_200503/ai_n21850458/ 6/4/09

http://www.cnn.com/2005/LAW/03/31/schiavo/index.html 6/4/09

http://archives.cnn.com/2002/WORLD/europe/04/01/netherlands.euthanasia/ 6/4/09

http://www.oregon.gov/DHS/ph/pas/docs/year7.pdf 5/23/09

http://www.internationaltaskforce.org/orrpt7.htm 5/23/09

http://www.nrlc.org/euthanasia/modelstatelaw.html 6/5/09

http://www.euthanasia.com/definitions.html 6/5/09
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[1] http://en.wikipedia.org/wiki/Persistent_vegetative_state 5/18/09
[2] http://en.wikipedia.org/wiki/Persistent_vegetative_state 5/18/09

[3] http://www.terrisfight.org/pages.php?page_id=31 5/18/09
[4] http://www.weeklystandard.com/Content/Public/Articles/000/000/003/337laakp.asp 5/19/09
[5] http://www.terrisfight.org/pages.php?page_id=316/1/09
[6] http://www.terrisfight.org/pages.php?page_id=316/3/09
[7] http://www.mnddc.org/news/inclusion-daily/2003/10/103103fladvschiavo.htm 6/3/09
[8] http://findarticles.com/p/articles/mi_hb5554/is_200503/ai_n21850458/ 6/4/09
[9] http://www.cnn.com/2005/LAW/03/31/schiavo/index.html 6/4/09
[10] Eareckson Tada J., Estes S. (1992) When is it Right to Die Grand Rapids, MI Zondervan;
[11] http://archives.cnn.com/2002/WORLD/europe/04/01/netherlands.euthanasia/ 6/4/09
[12] http://www.oregon.gov/DHS/ph/pas/docs/year7.pdf 5/23/09
[13] http://www.internationaltaskforce.org/orrpt7.htm 5/23/09
[14] http://www.euthanasia.com/definitions.html 6/5/09
[15] http://www.nrlc.org/euthanasia/modelstatelaw.html 6/5/09