HealthCommentary

Exploring Human Potential

The Terri Schiavo Case

Mike Magee

Theresa Marie Schindler was born in a Philadelphia suburb on December 3, 1963. She and her bother Richard and sister Suzanne attended local schools. Terri struggled with weight and had an eating disorder. By the time she attended Bucks County Community College, she had lost 100 pounds, and met fellow student Michael Schiavo in 1982. They were married two years later, and moved to Florida in 1986, in part to be closer to Terri’s parents. Her husband Michael was a restaurant manager and Terri worked for an insurance company.

Terri apparently continued to struggle with her eating disorder, a condition left undiscovered when she sought evaluation for infertility. On February 25, 1990, she collapsed in the lobby of their apartment in St. Petersburg, Florida. She was 26 years old. Her husband discovered her face down and unconscious, and called 911. She was resuscitated and intubated by paramedics.

On admission to the local hospital, Humana Northside, she was determined to have had a cardiac arrest brought on by a cardiac arrhythmia caused by hypokalemia with a blood potassium of 2.0 mEq’L (normal 3.5 – 5.0 mEq/L).

Her condition stabilized, but her mental status never improved. She had no “Living Will” or Advanced Directive. Michael received a court order on June 18, 1990 making him legal guardian and director of future medical decisions related to his wife. After thorough examinations and diagnostic studies directed by specialists, two physicians independently declared her in a “permanent vegetative state.” A gastric feeding tube was surgically placed to provide regular nutritional feedings.

During the initial year or two after Terri’s arrest, her parents and husband maintained cordial relationships. They initially supported intense rehabilitation. Nine months after the injury, Michael accompanied his wife to the University of California in San Francisco, for three months of experimental nerve stimulation treatments. She showed no improvement, and when they returned, Michael admitted her to a Rehabilitation Center in Bradenton, Florida, and subsequently to a Skilled Care facility.

In 1992, Michael Schiavo sued Terri’s gynecologist for missing a diagnosis of bulimia, claiming this error contributed to her cardiac arrest. He ultimately received  $2.0 million in damages to cover injuries and cost of permanent care. There was disagreement at that time between Terri’s husband and her parents over legal guardianship and access to the funds. The parents wanted him to sign over legal guardianship and encouraged him to “go on with his life.” They also suggested some distribution of the court award to assist in the care of their daughter. Michael refused.

When she developed a urinary tract infection in mid-1993, he signed a Do Not Resuscitate (DNR) order on her behalf.

By 1998, relations between Michael and his in-laws had further deteriorated. He refused their appeals to divorce their daughter and relinquish control. In May, 1998, Michael filed a petition to remove the feeding tube, providing some evidence that his wife would not have wanted to continue to live this way. The Court appointed a secondary legal guardian who agreed that Terri was in a “permanent vegetative state”, but that Michael, as inheritor of the remains of the legal settlement should his wife die, also had a conflict of interest. The legal advocate also noted that the parents were conflicted as well, and recommended not removing the tube.

The case went to Court and a decision to remove the tube was upheld in Florida Second District Court of Appeal in February 2000. After multiple legal maneuvers, the tube was finally removed on April 24, 2001. Terri was now 37 years old. The Schindler’s charged Michael Schiavo with perjury, and a judge ordered the tube reinserted 2 days later. The Schindler’s claimed new treatments were now available, which triggered more experts, more testing, and more court dates. Finally, on September 17, 2003, as Terri approached her 40th birthday, a frustrated presiding Judge George Greer declared the actions of the Schindler’s “an attempt to re-litigate the entire case”, and ordered the feeding tube to be removed for a second time, which it was on October 15, 2003.

By now, the case had entered the public reign, with the Schindler’s joined by their son, Bobby, engaging anti-abortion Operation Rescue/Right to Life extremist Randall Terry in their campaign. The Republican Party offered their support as well. Still none would have predicted that the Florida legislature in emergency session would grant then Gov. Jeb Bush (filled with Presidential aspirations), the authority to intervene in the case. Citing the new “Terri’s Law”, Bush assumed authority for Terri’s medical decisions and ordered the feeding tube reinserted for a third time which it was. In the meantime the ACLU lined up with Terri’s husband. On May 5, 2004, “Terri’s Law” was declared unconstitutional.

Before a permanent solution was reached, the United States Congress held hearings on the case, and then President George W. Bush brokered a compromise transferring the case to Federal Courts. The Federal Court agreed with prior State Court Appeals. Terri Schiavo’s feeding tube was removed a final time on March 24, 2005. She died at a Pinellas Park hospice on March 31,2005.

The Republican party suffered two political casualties by injecting itself into the case. The first was the career of Senator Mel Martinez (R-FL). He was damaged irreparably when his top aide, Brian Darling’s memo in the middle of the controversy went public. Commenting on the case, it read, “This is an important moral issue, and the pro-life base will be excited…This is a great political issue, because Senator Nelson of Florida has already refused to become a co-sponsor and this is a tough issue for Democrats.”

A second casualty was the future political career of doctor turned politician, Senator Bill Frist, who had Presidential aspirations but couldn’t resist weighing in as a physician. Breaking an unspoken code of ethics for the profession, without every seeing the patient, he challenged the decision to remove Terri’s feeding tube, proclaiming on broadcast television,  “I question it based on a review of the video footage which I spent an hour or so looking at last night in my office.”

Terri Schiavo’s father, Robert, died of heart failure on August 31, 2009.  His mother Mary, and her brother Bobby and sister Suzanne, went on to establish Terri Schiavo Life & Hope Network. Their guest of honor at their First Annual Fundraising Gala in 2013 was Sarah Palin who once again asserted that Advanced Directives and Living Wills were constructs designed to support “Death Panels.”

The case spanned 15 years, and was rejected by the Supreme Court for a hearing four times. Hijacked by political opportunists and Right-to-Life activists, it rode the poor health and disability of one unfortunate woman literally into her grave with devastating consequences for all concerned.

Show Buttons
Hide Buttons