Judge to Rule Soon on Withdrawal of
Terri Schindler-Schiavo's Feeding Tube
By Jenny Nolan
NRLC Department of Medical Ethics
and Liz Townsend
Florida Judge George W. Greer will decide by the end of November whether the feeding tube of a severely brain-damaged woman should be withdrawn, a ruling that may end the long court battle between the husband and parents of Terri Schindler-Schiavo and decide Terri's fate.
Judge Greer is sifting through the conflicting testimony of five doctors who divided on Terri's diagnosis and prognosis during hearings early last month. A decision is expected November 22.
Michael Schiavo's attempts to remove his wife's feeding tube are strongly opposed by Terri's parents, Bob and Mary Schindler, who deny that their daughter is in a persistent vegetative state and believe that her condition could improve with treatment, the Tampa Tribune reported.
Terri sustained brain damage when she mysteriously collapsed in her home on February 25, 1990, and her brain was deprived of oxygen for several minutes. Now 38, Terri can breathe, swallow, and maintain a heartbeat and blood pressure on her own, according to WorldNetDaily. She currently lives at Hospice House Woodside in Pinellas Park.
Greer first authorized Schindler-Schiavo's death in February 2001. She was without food and fluids for 60 hours beginning April 24, according to the St. Petersburg Times. Her parents obtained a temporary injunction of the order and she was fed, but Judge Greer again ordered her feeding tube to be removed.
However, the Schindlers took the case to the 2nd District Court of Appeal. The three-judge panel ruled on October 17, 2001, that doctors should examine Schindler-Schiavo before a final decision is made.
Five physicians were chosen -- two by the Schindlers, two by Schiavo, and one by Judge Greer -- to examine Terri and report to the court. During the current hearing, which took place between October 11 and 22, the doctors gave their opinions of Terri's condition and the potential for improvement, according to the Tribune.
During closing arguments, the Schindlers' attorney insisted that Terri must be given the chance to live. "Have we raised sufficient issues, in the words of the 2nd [District Court of Appeal], that there might be some doubt that she should die?" said Pat Anderson in her closing arguments, according to WorldNetDaily. "Because if the court is not a hundred percent satisfied that the facts and the law permit it, she can't be made a sacrificial lamb on the stage of the right-to-die movement."
However, Schiavo's attorney George Felos argued that there is no hope for recovery and that her husband should be able to order the withdrawal of food and fluids. "Unfortunately Terri is in a persistent vegetative state," Felos said in court, according to the Associated Press (AP). "She's not going to get better."
The opinions voiced by the physicians disagreed diametrically. The doctors called by Schiavo and Greer who testified at the October hearing agreed that additional therapy could not be expected to yield any improvement for Terri.
Court-appointed neurologist Dr. Peter Bambakidas testified that he knew of no treatments that could successfully improve Terri's condition, according to the AP. Bambakidas added that when Terri yawns, swallows, and laughs, her actions are merely "spontaneous" and "random," not evidence of meaningful brain activity.
Dr. Ronald Cranford, a University of Minnesota neurologist who frequently testifies in court cases advising the withdrawal of food and fluids, said he believes unconscious people, such as those in persistent vegetative states, lack personhood and therefore constitutional rights, according to the AP.
During Cranford's examination of Schindler-Schiavo, which was shown on videotape during the hearing, Terri smiled, moaned, and turned toward her mother as Mary Schindler touched her daughter's face, the AP reported. Cranford dismissed these reactions as "a classic nonspecific response" of a patient in a persistent vegetative state. "A smile doesn't mean she's happy," he testified, according to the AP. "It means she was touched."
In contrast, both of the Schindler-appointed doctors found Terri to be responsive and stated that she could improve with therapy.
Clearwater, Florida, neurologist Dr. William Hammesfahr testified that Terri shows cognitive function, can respond to her parents and follow commands, the Times reported. When the videotape of Hammesfahr's examination showed Terri's eyes moving when she was given a command, he commented, "A person in a coma does not do that."
Hammesfahr said that a new procedure that increases blood flow and oxygen to the brain could help Terri. "You can get major improvements from patients who have been plateaued for a very long time," he told ABC Action News.
Dr. William Maxfield, a Tampa radiologist, agreed that Terri is not in a persistent vegetative state, noting her ability to follow commands and her responsiveness, according to the AP. After comparing Terri's 1996 CAT scan to her 2002 scan, Maxfield also testified that Terri's brain tissue appeared more localized and uniform.
"It tells me that the brain tissue on the [2002] study has a more normal appearance," Maxfield testified, adding that hyperbaric oxygen therapy, similar to Hammesfahr's recommendation, could lead to improvement, the AP reported.
Felos disputed Maxfield's findings, calling Terri's reactions involuntary reflexes. "Vegetative patients can respond to the environment; so can plants," he told Bay News 9. "If you put a plant near a window it will grow towards the light; it doesn't mean it's not a vegetable. It's the same with patients."
Schiavo insists he has his wife's best interests at heart, but the Schindlers believe he is after Terri's money.
In 1992 Schiavo won a $700,000 malpractice award on Terri's behalf, intended to pay for her lifelong treatment and care. But court documents show that Schiavo's legal fees have drained the fund to $140,000. Schiavo received a separate $300,000 for himself, according to the AP.
As long as Schiavo is married to Terri, he will inherit the remainder of her settlement when she dies.
In 1998, independent guardian Richard L. Pearse Jr. reported to Judge Greer that Schiavo would benefit financially if his wife died, the AP reported. Pearse noted that for the first four years after Terri's collapse, "Schiavo pursued every manner of treatment and rehabilitation conceivable," but when the litigation ended and the money was awarded, Schiavo had "a change of heart concerning further treatment."
Pearse's recommendation to Greer was that Terri's feeding tube remain, according to AP.
Schiavo claims he is trying to respect his wife's wishes by withdrawing the feeding tube. Recalling a conversation he had with her years ago, he told Bay News 9, "She just put the book down and said, 'I don't ever want to be a burden to anybody. Don't ever let me live like that.'"
However, in 2001 new evidence surfaced challenging Schiavo's version of Terri's wishes. A former girlfriend, Cyndi Brasher Shook, came forward and said that Schiavo told her that he and Terri never spoke about the issue, reported the Times.
Shook told the Times that when she asked Schiavo what his wife would have wanted, he replied, "How ... should I know? She was 25 years old and we did not talk about it."
Currently, Schiavo lives with his fiancee of several years and their newborn daughter.
Other conflicts have fueled the already contentious case. The Schindlers complain that Schiavo limits their visits with their daughter. They also say he has refused to allow doctors to examine her, refused her antibiotics and needed dental work, refused to replace a broken wheelchair so she could be taken outdoors, and refused the delivery of flowers from a friend to her room on her birthday, the AP reported.
"Her teeth are fine; she doesn't eat," Schiavo told the AP. "Why take her to a gynecologist? She was supposed to die months ago. I don't want her room filled with flowers from strangers and right-to-life activists. Even though she is vegetative she has a right to privacy." Schiavo told Bay News 9 that if Terri were his own daughter he would be doing the same thing.
While Terri's parents have continued to fight for their daughter's life, they fear that Judge Greer will decide once more that Terri be deprived of food and fluids. "He's going to rule against us again," Bob Schindler told WorldNetDaily. "I have no doubt in my mind about it."
http://www.nrlc.org/news/2002/NRL11/shiavo.html