After 14 Years, Controversy Still Roils around Schiavo Case
Gross, Judy, National Catholic Reporter
Florida Supreme Court justices unanimously struck down the hastily passed, so-called "Terri's Law" Sept. 23, saying it unconstitutionally abridged the separation between the judicial and legislative powers. That action, however, has done little to end the debate about end-of-life care for patients unable to speak for themselves.
Terri Schiavo, 40, has been in a persistent vegetative state for the past 14 years after suffering a heart attack brought on by an eating disorder. The law was passed when Schiavo's Catholic parents, Robert and Mary Schindler, appealed to Catholic Gov. Jeb Bush to intervene in an earlier court's decision allowing the removal of a feeding tube. The tube was reinserted six days later.
Schiavo's husband, Michael, whom the courts have repeatedly given the legal right to decide if and when to discontinue feeding tube use, has sought its removal on the basis of a conversation in which Terri allegedly said she would not want to be kept alive in that condition. Terri's parents plan to introduce evidence to a lower court to fore-stall the removal.
If the case is accepted, the Schindlers will introduce a March 2004 papal statement that withholding hydration or nutrition constitutes passive euthanasia. Her husband responded that Terri was not a practicing Catholic; therefore the pope's position is irrelevant. Her parents insist she was practicing, and had attended Mass with them the day before her heart attack.
Three years in and out of courts have thrust Terri Schiavo and her family's private life into the spotlight. The Schindlers insist Terri could be rehabilitated with therapy. Her husband, who arranged experimental therapy soon after her brain was deprived of oxygen, is just as adamant it would be of no use.
The Schiavo case is an extreme example of what can happen when no advance directive, a document expressing a person's wishes regarding end-of-life care, is in place. As public as the Schiavo case is, the same scenario is played out in nursing homes and hospitals daily. An accident, stroke or other medical emergency can leave someone unable to make decisions. Often no living will exists, and the family can't agree whether to end life support.
Well, publicized cases of patients in a persistent vegetative state, such as Nancy Cruzan and Karen Quinlan, began the public debate in the 1970s. More often though, families are privately torn apart by an inability to answer to everyone's satisfaction: "How long is long enough?" Advanced medical technology has provided health professionals the ability to prolong life far beyond prior expectations and has given rise to ongoing arguments about the ethics of end-of-life decisions.
Bioethicist James J. Walter of St. Francis Medical Center in Lynwood, Calif., said he was surprised when Pope John Paul II and Florida bishops weighed in on the case. He said he fears a potential breach between hew Catholic theologians have interpreted the kind of extraordinary means of treatment Schiavo has received thus far, versus "care" as expressed in the papal statement. Currently Catholic health care systems operate on the principles laid out by Pope Pius XII in 1957, declaring that ending heroic life sustaining measures, when the burden is too great, is not considered euthanasia. "The new papal statement assumes intervention is always of benefit," said Walter, who works in an intensive care unit.
Fr. Michael Shaw, associate pastor of Tallahassee St. Thomas More Co-Cathedral, said, "There are few absolutes in these cases and what is best for the patient must be always be considered."
Jeffrey Spike teaches ethics to future family physicians at Florida State University's new medical school. He said a shift in consensus occurred in the 1980s, when the use of artificial hydration and nutrition "as part of saving the species" was rare. By 1990, medical practice and popular opinion shifted in favor of using all available means, including respirators and feeding tubes, to keep patients alive. …