Schiavo Case: Beyond Compassion, Beyond Ethics, Beyond Law
Here is today's story from AP News - from Tampa Bay Online: "WASHINGTON (AP) -- The Supreme Court refused on Monday [January 24, 2005] to step in and keep a severely brain-damaged woman hooked to a feeding tube, all but ending a long-running right-to-die battle pitting her husband against her parents.
It was the second time the Supreme Court dodged the politically charged case from Florida, where Republican Gov. Jeb Bush successfully lobbied the Legislature to pass a law to keep 41-year-old Terri Schiavo on life support.
The decision was criticized as 'judicial homicide' by Mrs. Schiavo's father, Robert Schindler, but applauded by her husband, Michael Schiavo, who contends his wife never wanted to be kept alive artificially."
I think this case has gone beyond consideration and compassion for the emotions of the family. It has gone beyond the legal decisions by the courts. It has gone beyond all ethical principles. The behavior of the family, after all the legal and ethical decisions were made to allow patient autonomy through the substituted judgment of a legal surrogate, the husband, appears to be solely in the family's own self-interest. And this behavior is wrong. Hopefully, with today's decision of the Supreme Court, the appropriate. ethical and legal conclusion of the case is soon to occur. ..Maurice.
posted by Maurice Bernstein, M.D. @ 4:11:00 PM
21 comments
21 Comments:
Hello, I saw this link from the blog of Kevin,MD. I'm just glad that the Supreme Court made a just decision. That life support already has become an extraordinary means to the patient. And I believe her suffering has ended. ;)
- Race (http://www.livejournal.com/~race2win)
My question is "How much money did the parents of Terry have to pay Tom Delay to take up this question in Congress?" As we know, he doesn't do anything without a pay-off.
I am stunned that Congress has chosen to meddle with this question. Is this the beginning of a world where legislators spend tax dollars (time) deciding whether a person lives or dies? How much worse can it get? Ms. Schiavo should be allowed to die, as were her wishes.
As an allied non-medical health professional with some extensive background in neurology, I am stunned and disgusted at the actions taken by Congress and the President. If, as Michael Schiavo contends, Terri's brain has "liquified" and turned into "cerebral spinal fluid," she deserves to exit life peacefully, and Michael deserves to get on with his life, to take care of his new children with his new partner. My heart goes out to Terri's parents, but folks, it's time to let go. In fact, I'm going to make certain my own parents never do to me what the Schindlers are doing to Terri.
It is my understanding that, after the original "event" left Terry Schiavo dehabilitated, she was responding to physical therapy and improving. Mr. Schiavo then directed the caregivers to terminate the therapy. Terry then began to deteriorate to the point where her second "event" damaged her brain further. In the mean time, Mr. Schiavo has shacked up with another woman and fathered two children. What does he care if Terry's parents want to take over her care? Could it be that he wants the rest of her medical malpractice settlement money? It certainly couldn't be that he wants to stay true to his marriage vows! What a scum. You want to side with him? A death row inmate has more court protections than does Terry Schiavo.
I have been a nurse for over 25 years and have cared for several patients in a persistent vegetative state such as Terri Schiavo. Micheal Schiavo's actions are fairly typical of a person who understands he has lost his spouse yet still cares for and loves them. In fact, I have not cared for a patient in this states who's spouse has either divorced but still maintained a caring relationship for their former spouse while remarrying, or who has done as Mr. Schiavo has - not divorced but has taken up with another partner while continuing to care for their husband or wife. It is unfair to call him "scum", and I do not see any reason to believe his actions are being done for financial reasons as Terri's condition has been essentially static for 15 years. If he was after money, why wait so long? As for Terri's parents, I can understand their perspective as well, and again, this situation is not that unique. Both parents believe Terri responds to them, can emote normally, and should be given another chance at therapy, even though the medical evidence seems to point to there being no chance for recovery. This is also a fairly common reaction to loving family members who have not yet acknowledged the need to begin to let go of their loved one. It appears to me Micheal Schiavo is way ahead of Terri's parents in this regard and has chosen to let go, while her parents are not yet ready to so. I have not personally viewed the medical records, of course, but have enough faith in the 11 judges that have to believe the medical testimony is clear that Terri is in a truly persistent vegetative state and that allowing her to die, if that would be her wish, would be appropriate. I agree with you, Maurice, that this case has certainly grown beyond the issues with the family members involved. But that is the problem. I believe the actions of the congress on Sunday night were wrong, and have been disappointed in most of the discussion surrounding this case since the feeding tube was removed. The congressmen and senators who wrote this bill and pushed for a special session to decide on Terri's fate were misguided and should not have intervened. This is still, at it's core, a situation where the family is trying its to decide what is in Terri's best interest. One side or the other is going to be disappointed, but it is not the job of the congress to take sides in such personal matters.
It strikes me as strange that some people choose to not believe numerous doctors diagnosis that Terri is in a vegetable state. One doctor, fine, lets get a second opinion, many doctors later, some court appointed, well that’s a different matter I think. Terri is a vegetable, we should all accept that and move on.
If a person accepts that she is a vegetable, i.e., without cognitive attributes, then Terri is no longer ‘with us’ and her appointed legal guardian has the right to make decisions for her regardless of what others may think. Our system is based on laws and once we start making exceptions to these laws when we don’t like the outcome there is a very bleak outlook awaiting this county.
As for the individual that said Terri was ‘scum’ – a bit harsh when describing a man who has chosen not to divorce his wife and has been in the picture for almost 15 years to ensure that her wishes are carried out. Terri married the guy so one should assure she choose a man with good character.
This is disgusting! If her husband really cared about her he wouldn't agree to starving her to death, that is barbaric. If the court wants to support euthenasia, then they should support merciful euthenasia! They are just avoiding taking any action on the subject because it is so contraversial, that's what they are doing by removing the feeding tube. Forcing her to die naturally is inhumane, we put our pets to sleep when we think it is their time, why not our beloved ones?
We even put those on death row to sleep!
I wish someone would stand up who can show how unethical this is, action through inaction is despicable way to avoid blame. She probibly should die if she wants to die, the goal is for her to die, but the way this goal is being achieved...
She is still a human being, and I think the ones making the decisions shouldn't only make them half way. If you're going to make a decision on a matter such as this you should make one you can be accountable for.
Euthenasia would certainly be the way to go. Unfortunately our laws do not support this today. Its very important during this case to stay within the law and not make exceptions to the rules based on emotions. I do wonder if Terri is even aware that she is being starved. If only lower brain functions are working, reflex actions, she may not even be aware of her plight. If that is the case, then, .... Perhaps the Terri we 'knew' back in the 80's died years ago and we are all fighting over the shell of the woman.
Who is acting in love in this case? Nurses tell you how abusive Michael Schiavo was to them. Terri was visibly upset whenever Michael visited her. His persistence in asking when she was going to die lacks compassion. Why stop rehab? Why not divorce her and allow her parents to care for her? Surely you can't allow someone to die based on hearsay? There are no documents indicating Terri's opinion. How can the parents' rights be totally denied and ignored? Why do we go with Michael's comments (that she would want to die) and not the parents' comments (she would not want to die)?
This is insanity. Terri has been responsive according to nurses communicating through slurred words. All she needs to remain alive is food and water. Alzheimer's patients and quadriplegics are in the same boat. They often can't feed themselves. Do we stop feeding them? What about Helen Keller? In the beginning of her life, nobody could communicate with her. But they didn't let her die by starvation. Joni Erickson Tada is a quadriplegic who has become an artist and author and impacted the lives of millions.
This lack of respect for life is sickening. Michael Schiavo is abusive and greedy and should have his custody revoked.
If America adopts a culture of death, it will be the end of her glory and the beginning of her demise. Life is sacred. Honor life.
There is no evidence besides Mr. Schiavo's statements that Terri would want her feeding tube removed.
There is sworn testimony from nurses caring for Terri that Terri was responding to rehabilitation when Mr. Schiavo ordered all therapy stopped.
There is sworn testimony from a nurse caring for Terri that Mr. Schiavo injected her with insulin (sp?) and this was reported to the police. My scepticism makes me hesitate on that one but, it has been reported.
There are statements from other caregivers that Mr. Schiavo made statements such as "When is this b@tch going to die" and "Has she died yet?"
There is enough evidence to, at a minimum, investigate Mr. Schiavo.
Terri has loving parents that are willing to care for her.
Mr. Schiavo has moved on with his life.
Mr. Schiavo's determination to see his wife die against her parents wishes does not make any sense unless you add the other potential motivating factors; the settlement money, the desire to marry his new shack-up honey, the desire to cover his tracks of mistreatment of his wife (I understand he will not allow an autopsy).
Why doesn't Mr. Schiavo simply turn over the care of Terri to her parents, divorce her, and move on.
Why do so many Americans side with death? Life is precious. It is not for us to determine a quality of life. I was about to throw in the gratuitous reference to Hitler but I am tired of seeing that myself.
I am amazed at how easily it has become for Americans to support death over life. Terri is mentally disabled, but many of you want her dead. Inconvenient babies are killed daily. Old people are starved to death daily. When will it stop. I feel the Hitler reference rising again...must...not...give...in!
The culture of death is in vogue.
Life is not about pleasure...when we are young and in good health, we have a good "quality of life"...when we are old, infirm, mentally ill, disabled we can't have a good "quality of life" so we think it better to be dead. Life is not about pleasure!
Sorry for the long post.
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Such a painful and difficult situation for Terri's parents and for her husband; my heart goes out to them all. I heard a newsman on MSNBC say that no one could be in the middle about this case, but I don't think that's so. I can see the Schindler's point of view--it's their daughter, for goodness' sake! In the same breath, I can easily empathize with Terri's husband's position: she made her wishes known to him; he has no reason to lie about this, pace someone's comment about his fiduciary motive.
I found it interesting to learn that the doctor who, without examining Terri, claimed she is not in a persistant vegetative state--whom Jeb Bush called "a renowned neurologist"--is widely known neither in the field of neurology or of bioethics. When asked about this doctor (Dr. William Cheshire), Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, replied, "Who?"
More, University of Minnesota Medical School neurologist and medical ethicist Dr. Ronald Cranford, who examined Terri for the Florida courts and determined she was hopelessly brain-damaged, said, "I have no idea who this Cheshire is... You'll not find any credible neurologist or neurosurgeon to get involved at this point and say she's not vegetative." Dr. Cranford went on to say that her CAT scan revealed that her brain has shrunk enormously, and her EEGs are flat--her brain exhibits no electrical activity.
Dr. Cheshire admits that during his brief observation of Terri she did not demonstrate any evidence of conscious awareness or the ability to speak.
When I see photographs of Terri now, I cannot help but wonder what she would think of this situation, of her current life, if she were as she once was. I would never want to be in her position, so changed and diminished by neurological damage as to no longer be recognizably myself.
I, too, have wondered about the manner of Terri's demise without food and water. It seems a cruel, cruel death.
It may seem cruel that Terri is being starved but you may also want to consider that in her vegetative state she may not even be aware of what is happening.
Michael is the legal guardian of Terri. He makes the decisions. It doesn't matter if the parents or any of us agree with his decision or not, it is his decision to make. He most likely spent the most time with Terri in the recent years before her heart attack so he knows her best. Maybe he tells the truth, maybe he does not, but only he knows and he get to make the choice. This is not about life and death, its about respecting an individual's right to choose the outcome of a problem. The court are right it is Michael's choice, period.
If Terri's parents were that concerned, devoted and determined that their daughter would recover and would get better, then why is she not home with them, 24/7 where they could care for her and insure that she receives all the therapy and rehabilitation she needs. If they are that positive she will recover, then they should have brought her home years ago, rather than leaving her in hospice, which has extremely stringent rules for admission and only take terminal cases. I am not doubting that their agony is real, but it rings a bit hollow to me because she is not in their physical care. And Michael's agony has to be just a real What remarks he may or may not have made can easily find their roots in the dreadful frustration that comes from watching somebody you loved disappear in a heartbeat and to have your hopes dashed of getting them back again in spite of the intervention of medical measures. But I find myself wondering if Terri's parents would have the same sentiments if they, instead of the angels of mercy at hospice, were responsible for her 24 hours a day, changing diapers, of turning a body unable to move itself to avoid bedsores, of sleeping two hours here one hour there, and a host of everything else that comes from being truly responsible for the care of an individual such as Terri. If they would not then recognized that there comes a time when it's time to go, that it is not the giving up of hope. As I have cared for my severely disabled son at home for the last 25 years, I have some experience in what I say and he is DNR/DNI/DNT because as deeply as I love him, I would not allow him to be put in a situation like Terri is in. He will go when it is his time to go as he has lived, with dignity and respect. This is not about her parents wants or her husband's wants, it's about the total loss of dignity for Terri. And that is what I grieve for the most. As hard as it may be for them to let her go, they need to restore her dignity to her, not make her death a media and congressional circus and honor her life, by giving her dignity and privacy when she needs it the most. Whatever their issues are with her husband, the worst thing they did was turn their daughter's life into this media and political fire fight. Give Terri back her dignity. Treat her like a person, not a pawn. Instead of petitioning courts and judges and politicians, sit with her, share the time, celebrate the life and give her dignity in death.
Since we all need food and water to exist, and since Terri Schiavo merely needs these and no other extraordinary care to exist beyond that which is given to quadriplegics, end stage Alzheimer’s patients, and others with severe neurological problems, and since her parents and the State of Florida (excluding Judge Greer and her husband) are willing to provide this subsistence then what is the harm in not executing her (OK,ok, in not forcing her to die with dignity by depriving her these basic necessities)? Because there is harm in executing her; she dies. And, it set a lousy precedent, it pushes us off on the slippery slope of what cognitive function/brain activity is enough to ward off termination? What about the cases where humans are so consumed by insanity that their brain, though functioning as well as possible under constant medical intervention (drugs and psychotherapy and physiotherapy – all denied to Terri) – all the time while they are being fed and watered, is not productive, their brains being even profoundly and actively anti productive. So should brain function alone be the final determinate of life or death, a lot more people, their families, and the courts need to gear up. It seems to be that demure Terri, requires less maintenance, support and care AND is not an active danger to other people in our society (such as profound psychopaths and sociopaths who also happen to exhibit violent behavior). Therefore, if her right to life is judged forfeit on the basis of hearsay evidence from a philandering husband, this demonstrates there may be little traction on this slippery slope for those who may actually be an evil/detriment or anyone so sickly as to be a greater burden on society than Terri.
Who decides these momentous decisions (here, just the estranged husband, as Terri's legal gardian whose opinion is naturally given great weight by the Flordia Courts), and are those decisions based on legal or ethical or moral judgments; and they will and do vary by the differing rules in different jurisdictions which seems to me to not be a fair result, but will (without a much decried Federal intervention) result in intresting forum shopping incidents in the future. Because the civil court action in Judge Greer’s court only required a preponderance of evidence to find in favor of Mr. Schiavo’s assertion that she stated verbally her wish to not be maintained by artificial means (did she have feeding tubes in mind or respirators, deliberators, pacemakers and IVs in mind?), this is a much lower burden of proof from that which ALL criminal convictions require before the state deprives one of liberty let alone life.
Pssss: Jeb Bush, get a friendly DA to charge her with a crime; she’ll instantly get heightened protection for her life, and they’ll never get a conviction based on the self serving hearsay testimony and a burden of proof that demands evidence to support a conviction to be beyond a reasonable doubt. So charge her with a capital crime; hey, maybe self homicide? Of course this may be an unfortunate precedent for anyone who ever said "I wish I were dead".
Finally one last thought; for those of you who want to see Terri live, lets try praying for a miraculous improvement; perhaps a complete recovery is too much to ask, but just imagine if we all pray for her and ask others to also do so. A million or two prayers will have an effect.
I live in Clearwater, FL and I know one of the Radiologists who first examined Schiavo years ago. He didn't want to get involved in the case, but he assures that there was no brain activity whatsoever. Terri Schiavo, he says, cannot feel pain or hunger and is in a completely vegetative state with no hope for recovery. He says it is an impossibility with the state she is in.
We hear of stories of people waking from comas years later, but this is not the case. Schaivo is brain dead and cannot recover.
If I were in her state, I wouldn't want to be exploited the way she is, with my photos and story all over the news.
Let her go, let her husband move on. He's been there for her all these years and hasn't divorced her. It's been too long and no one can heal from her death unless they finally accept it. The family is holding onto a false hope.
In addition, if the family is so religious, wouldn't they want their daughter to finally rest in peace and move onto a better place? I am not religious, but I feel that the unnatural prolonging of her life is in direct contrast to religious values. Had this situation happened over a century ago, we wouldn't have the capability of prolonging her life unnaturally and eventually, she would perish. Let nature takes it's course.
GOD BLESS YOU TERRI
If there was "No brain activity whatsoever" then we wouldn't see Terri following a balloon across her field of vision, smiling, making noises, responding in any way. No, I don't believe the "no brain activity" story for a minute. Bunch of bull!
Wow! I'm sorry, but I just have to comment on all of the anonymous posts!
I don't understand why people who are so passionate about an issue feel that they have to hide who they are.
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