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The ‘right to live’– the essential right of every human being is sometimes threatened by issues that make us sit back and question the very concept of the value of life. The value of life doesn’t always refer to the ‘right to live’; it also refers to the right to choose between life and death. The conflict between the ‘right to live’ and the ‘right to die’ is even more glaring in the case of Terri Schiavo which generated a lot of public interest not only because of the nature of the case but also because of its implications on the end-of-life care (Hampson and Emanuel 972-975).
Till the 1940s, the main aim of medical care was to offer some relief from pain. But things have changed dramatically in the last fifty years. Medicine now has the power to prolong life. Subsequently, we are faced with a dilemma – shall we continue to live or choose to die? But what if one lacks the cognitive ability to decide for oneself? Who is going to decide in such a case in the best interest of the patient?
These were the concerns that led to the conflict between Terri’s husband, Mr. Michael Schiavo, and her parents, Robert and Mary Schindler, which assumed a magnitude hitherto unprecedented and involved the legislative, the executive and the judicial branches of the United States federal government as well as the State of Florida. It was on the fateful day of February 25, 1990, at approximately 4:30 am EST that Terri suffered a massive respiratory and cardiac arrest in her St. Petersburg apartment. She was taken to the Humana Northside Hospital where she was in a coma for two and a half months and later slipped into a persistent vegetative state (PVC) (Blendon 2580-2584).
In November 1998, Michael sought permission from the court to remove Terri’s feeding tube based on the statement his wife made earlier that she would not prefer to live on artificial sources of sustenance. Terri’s parents, however, objected to it, but their plea was overruled by an appeal court judge’s decision “that Terri Schiavo was in a permanent or persistent vegetative state and that, if she could make her own decision, she would chose to discontinue life-prolonging measures” (Annas 5).
Subsequently, Schiavo’s feeding tube was removed for the first time on April 26. 2001. However, it had to be reinserted two days later as a civil suit filed by Terri’s parents alleging Michael of perjury was still not settled. Moreover, the Terri case had already started drawing considerable media attention by then, and various politicians, pro-life activists and religious groups were already involved with the case. The Schindlers, then, challenged the original court decision claiming they have substantial evidence of a new form of treatment that they felt would help Terri regain her cognitive function (Fins 304-307).
On the basis of the results of the medical examination of Terri by the appointed physicians, the appeals court upheld the earlier decision and ordered the removal of the feeding tube for the second time. After the Supreme Court refused to review the decision made by the appeals court judge, the Schindlers, backed by various religious groups, appealed to the state legislature for legislation pronouncing the reinsertion of Schiavo’s feeding tube (Hampson and Emanuel 972-975).
What happened subsequently is history. The state legislature passed a new law, famous as “Terri’s law” entrusting the then governor of Florida, Mr.Jeb Bush, with the power to stop the withdrawal of artificial sources of sustenance from a patient in certain specific situations.Mr Bush intervened in the case and immediately ordered the insertion of the feeding tube. This law led to widespread repercussions from various sections of the society and the Supreme Court of Florida denounced the law as unconstitutional primarily because it gives the governor “unbridled discretion” to suppress “the rights of individuals, including the well-established privacy right to self-determination…”(Annas 7).
The case assumed greater significance during the final days in Terri Schiavo’s life in the year 2005. The legislature, the judiciary, the religious fundamentalists as well as pro-life activists were involved in a battle of sorts with Terri at the center of their movement for ethical rights. On February 23, 2005, Terri’s parents filed a petition seeking exemption from judgment for medical intervention. They wanted Terri to undergo a swallow test. However, their appeal was turned down by Judge Greer who ordered the removal of the feeding tube at “1:00 pm. On Friday, March 18, 2005” (Siegel 890).
The impact of the case on American society, at large could be well determined by the subsequent course of events that led to the formulation of the controversial law, known as the “Palm Sunday Compromise”. Anticipating Greer’s decision well in advance, the members of the Florida House and the Senate were considering ways of withholding the removal of artificial ways of sustenance. They met the day before Greer passed the decision, i.e. on March 17, 2005, to discuss this issue, the House passed the bill but the Senate failed to do so. On March 21, 2005, at an emergency meeting convened on a Sunday afternoon, Congress passed the bill with an aim to protect Terri from dying. President George W. Bush supported the bill wholeheartedly and he flew in from his holiday in Texas to sign it into law. According to the infamous law, the Palm Sunday Compromise, “the U.S District Court, for the Middle district of Florida, shall have jurisdiction” to intervene in “the alleged violation of any right of Theresa Marie Schiavo under the Constitution or laws of the United States relating to the withholding or withdrawal of food, fluids, or medical treatment necessary to sustain her life” (Annas 8).
A day later, the final appeal by Terri’s parents for a temporary restraining order for reinsertion of the feeding tube was rejected by the U.S District Court Judge James D. Whittermore, who rejected the plea on account of the parent’s incapability to prove any possibility of a substantial improvement in the particular case. Terri Schiavo breathed her last on March 31, 2005, at a Pinellas Park hospice (Fins 304-307).
Terri’s case is often considered to be a remarkable example of the end-of-life care cases in the 21st century although references can be made to two other popular end-of-life care cases – the 1976 New Jersey Supreme Court ruling in the case of Karen Quinlan and the 1990 U.S Supreme Court decision in the case of Nancy Cruzan. The case of Terri didn’t bring about any significant change in the laws involving such cases, nor did it attempt to provide any suitable alternative to such patients. However, it can be considered one of its kinds in the sense that its widespread publicity facilitated a greater interest among the general public on the end-of-life care measures and initiated the possibility of many people signing advance directives and even discussing the use of feeding tubes with their families (Hampson and Emanuel 972-975).
The importance of advanced directives in solving future legal hassles and the need for an extensive discussion of these issues with close friends and family have become more pronounced in the light of this case. Congress’s intervention in the Schiavo case was met with public disapproval. Interestingly, the California Medical Association adopted a resolution on the same day the Schiavo bill was passed by Congress. According to the resolution, the Medical Association disapproves of Congress’ interference in such medical cases (Siegel 889-890).
Terri is not just a woman reduced to a state where she is unable to decide the best possible course of action for herself; rather she reinforces the fact that decisions regarding end-of-life care for persons devoid of any cognitive function can never possibly be legal in nature. In such cases where there are no direct means of communication with the patient, decisions should always be taken in the best interest of the person concerned. Five years after Terri’s demise, its impact on end-of-life care measures can attain greater significance if it can facilitate further interest among the common people regarding this issue as well convince them of the benefits of signing advanced directives on a larger platform. This case has gone down in history and is regarded as a landmark legal approach on the issue.
Works Cited
Annas, George J. “Culture Of Life Politics: The Case Of Terri Schiavo.” BC.Edu. Lawstore, 2007. Web.
Blendon, Richard. “The American Public and the Terri Schiavo Case”. Arch Intern Med 165.3 (2005): 2580-2584.
Fins, James. “Late recovery from the minimally conscious state: Ethical and policy implications”. Neurology 68.6 (2007): 304-307.
Hampson, Leo.G., and Alice Emanuel. “The Prognosis For Changes In End-Of-Life Care After The Schiavo Case”. Health Aff (Millwood) 24.1 (2005): 972-975
Siegel, Michael. “Ethical Issues and the Allocation of Scarce Resources During a Public Health Emergency”. ANN INTERN MED 150.1 (2009): 889-890.
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