Replies

general_re,

Given the climate of polarized opinions in this case agree with your prognosis for the likelihood of a solution. The tightening of guardianship laws would certainly be a welcome response from legislative quarters. My personal hope is that Florida lawmakers will look into Judge Greer's chronic mocking of the law and impeach him. As I stated before though, I see little hope for more than a symbolic censure at this time.

It may well be that we must settle for consensus on the immorality of this case. I have read reports that a TV movie about the Terri saga was negotiated with Michael Schiavo. It seems that the loving husband will earn some $2,000,000 from this. In view of the likelihood that it will portray him as a reluctant but principled hero, I think it appropriate to focus on his activities that show otherwise. I'll repost something I wrote in response to another poster's questions. To preserve privacy, I'll omit the poster's personal references.

You wrote: "Again, if the many people on FR who felt Greer made a mistake in interpreting Florida statutes never brought that issue to the very forefront, my logic tells me that maybe that wasn't an issue."

How many of the tens of thousands of post about Terri on FR have you had a chance to read? This issue WAS brought to the forefront repeatedly, not just by me but by many other posters. I wrote about it here as far back as 2003, and at that time there were already mega-threads on FR about Terri, many posts of which dealt with detailed analyses of the pertinent statutes.

"It has nothing to do with my expectations of how things should be. The law, in great part, sets my expectations of how these things should be."

What I meant was that your expectations seem to be that the law is being automatically followed by officials, or that it will be automatically questioned in the press when that does not happen. Laws are being broken all the time in government, and only a fraction of the instances receive attention.

"...states recognize living wills, and my wife and I have had ours for years, powers of attorney, living trust. I (we) believe that having control over end-of-life decisions should remain with us....not children, in-laws, et al."

Excellent. Same here. I found though that the standard forms lawyers use for drawing up a living will are insufficient and leave many ambiguities that could be exploited. It pays to read the text very closely and to amend it in those places, or to personally compose the entire Living Will. Many lawyers are reluctant to depart from the standard form, but the text of a Living Will is no less under a person's control than is the text of any bequeathement.

It is also important to not automatically sign all forms presented at admission to a hospital. Some of these are holding-harmless consents and will be insisted on, but there are others pertaining to end-of-life issues that could be used to supersede an existing Living Will.

"I viewed the Schiavo matter from that frame of mind. However, if Florida had foreclosed Michael from making that decision, I would have had no argument with that."

Neither would I. Had there been a Living Will it would, however, have been a Living Will attested during the late 1980s and would read quite differently from a current one. Nevertheless, I am in total support of honoring a person's wishes specified in a Living Will. I am not even opposed to bona fide testimony by relatives and friends about what the patient may have told them with regard to his or her wishes. I think that there are cases where such testimony should be accepted.

"Please answer this question for me, as it has nagged at me from early in the case: If Terri had signed a living will dictating that she didn't want to be kept alive under those conditions, would your efforts have been the same as they have been?"

Neither I nor most other people would have ever taken issue with this had that been the case. We need to remember though that life-end matters are still governed by law. Honoring someone's express wishes does not include skirting the law. When you say "would not want to be kept alive," that does not imply for instance that it would be OK to drive a bullet into the person's head or to administer a lethal drug. Until the statutes allow such things, they would take precedence over the mandate of a Living Will. Actions on a patient's behalf need to remain within the parameters of existing law.

You could, for example, not specify in your own Living Will that you want your wife to strangle you under certain circumstances. If she did, she would be prosecuted regardless of your written instructions. The State of Orgegon now has a provision for physician-assisted suicide involving the administration of lethal drugs. It still does not permit the administration of such a drug by anyone other than a physician. The invocation of a Living Will is conditioned on the attestation of medical futility, the patient's written consent and the execution of the Living Will within parameters of existing law.

If you have a rudimentary knowledge of how Terri's case developed, you will realize that it does not meet the standards of a Living Will. It also does not meet the standards of medical futility, simply because Michael Schiavo since 1982 forbade all therapies or tests. Had all the tests been performed and the therapeutic repertoire been exhausted, I would not even have a problem with the vagueness of Michael Schiavo's claim about his wife's expressed wishes. But, neither tests nor therapies were permitted, despite their falling under the mandate of retained rights specified by Florida statutes.

The opinion of PVS was rendered by a physician paid by George Felos, a physician making a living testifying in court for whatever party pays him. He did not administer MRI and PET scans, which are standard neurological instruments in the assessment of brain damage. Neither was a standard swallowing test performed to ascertain the actual necessity of a feeding tube.

Terri's room was stripped to bare white walls. Michael Schiavo forbade any decoration, pictures or other items that could have a stimulating effect. When well-wishers sent Terri birthday cards, Michael Schiavo expressly forbade their display in Terri's room. He forbade having Terri's picture being taken, thus ensuring that there would be no pictorial record of Terri's deterioration. The photos widely published in the press are five years old and were smuggled out of the hospice in defiance of a court order by Greer.

It is well known that sensory stimulation is a critical ingredient in brain rehabilitation. MS also forbade Terri being taken outdoors in a wheelchair, or even to have her be seated in a wheelchair indoors, something that is routinely done with neurologically impaired patients. He forbade standard joint mobilization, which also is routinely performed with bed-bound patients of cognitive impairment. Nurses were fired from facilities for lodging written complaints against this singling out of Terri for sub-standard treatment. They have voluntarily given affidavits attesting to Terri's being deprived of therapies and comforts available to all other patients with similar conditions.

You should realize that it is these things, along with dozens of other oddities or illegalities in this case, that attracted my and others' attention. It was not the absence of a Living Will. There are feeding tubes being removed daily all over the country. Do you see me protesting this? Do you see huge waves of public sentiment about any of these? You should ask yourself what makes Terri's case different from these others. Look for the differences and you'll see that it is not about a Living Will or its absence.

Before Michael Schiavo received the malpractice award money in 1982, Terri was being treated nicely. Like other patients in her condition, she sat in a wheelchair during the day. She was being fed by mouth. She was taken outside into the fresh air and sunshine. She had her hair done and was even taken on shopping trips to the mall. Photos from that time show a Terri that looked vital and beautiful. All that ended when the malpractice check was in the bank.

As a show to demonstrate his sincerity to the award jury ("I'll devote the rest of my life to Terri's recovery"), Michael Schiavo took Terri to California for an experimental therapy involving the implanting of electrodes. After bringing Terri back, he did not have the electrodes removed from her brain. In other words, they remained in her brain until her death as a constant source of irritation leading to the pooling of cerebrospinal fluid. Please don't assume that this was a mere oversight.

Shortly after receiving the malpractic money, Michael gave a "do not rescucitate" order to the nursing home. When she developed a urinary tract infection, he tried to forbid the administration of standard antibiotics. A urinary tract infection can quickly spread to the kidneys and be excruciatingly painful. Michael Schiavo was, of course, hoping that it would lead to fatal sepsis. He was stopped by medical personnel from carrying this out. This was in 1982, the year that he received the money, and shortly after he swore to devote the rest of his life to Terri's care.

Neither during the 1981/1982 malpractice trial, nor for another six years until the first hearing before Greer did Michael Schiavo remember his wife's having said anything about not wanting to be kept alive "by anything artificial." To the contrary, testimony by one of Michael Schiavo's girl friends and by one of his co-workers holds that he said Terri and he had never discussed such things.

He remembered Terri's alleged statement only after associating with George Felos and beginning to litigate Terri's feeding tube removal. That feeding tube, by the way, had not been there during the early days. It was inserted at the urging of Michael Schiavo, presumably so that he would later have something to remove.

When Judge Greer indicated that he needed corroborating witnesses for Terri's alleged mid-1980s statement, it took Michael Schiavo another two years to produce them. When he did, the witnesses that also claim to have heard Terri say it turned out to be Michael Schiavo's brother and his brother's wife.

By contrast, an opposite statement remembered by Terri's best friend was not allowed by Judge Greer. The rejection of that testimony was based on a misunderstanding by Greer, to which he later admitted. Despite the judge's acknowledgement of his own error, he continued disallowing the wrongly excluded testimony.

The first two brain scans upon Terri's initial admission after her mysterious collapse read normal. This is inconsistent with Michael Schiavo's later claim that Terri had been exposed to prolonged oxygen deficiency during her collapse. Nurses found an insulin syringe after one of Michael Schiavo's visits. A nurse's affidavit states that she had become suspicious and took Terri's blood sugar reading before and after Michael Schiavo's visits. The after readings indicated that Terri had been given high doses of insulin. It should be remembered that Michael Schiavo was at that time attending nursing school and would be familiar with the potentially deadly effects of insulin injections.

Nurses routinely place a washcloth into patients' hands when they suffer from neurological impairment that causes their fingers to curl. The idea is to prevent the fingernails from digging into the palms, causing painful lacerations that could lead to infections. Michael Schiavo forbade the placing of the washcloth. Why?

..., if there were just one thing wrong with Michael Schiavo's behavior during these many years, nobody would have ever bothered with the case. It is the amazing string of sordid details that makes this stand out as the fishy case that it is. Forget about the media hype that this is about the religious right's resistance to feeding tube removal. Look at the court transcripts yourself and then decide what it is about.

Ask yourself whether you expect your own spouse to engage in behavior like this in case of your incapacitation: Immmediately upon Terri's initial admission after her collapse, Michael Schiavo had Terri's two beloved cats put to sleep. Is that what a loving husband does while his wife is in the hospital? Remember, this was long before there was any medical controversy over Terri's relative chances of recovery. At that time the presumption had to be in favor of eventual recovery, since it was not even known yet what Terri's condition was. What was Michael Schiavo planning to tell his wife? "Oh, honey, I was so upset about what happened to you, I killed your two cats."

The inconsolable husband then took Terri's wedding and engagement rings (shouldn't they have been on her fingers?) and had them melted down and turned into jewelry for himself. "Oh, honey, I was out of my mind with sorrow and melted your rings down. But luckily I still have the gold. Here, we'll go and have them make you new wedding and engagement rings." You can read about these and other strange things in the actual court transcripts.

Do you find such incidents consistent with the behavior of a caring spouse? Remember, what I am citing here took place very early in the story, at a time when Michael Schiavo was trying to convince a jury to award malpractice money based on a life expectancy of at least 50 years for Terri. You are obviously troubled by some aspects of this case, so why not take the time to read real records? If you just rely on the media's glib soundbites to inform you about what happened, you'll be out of luck. The media almost exclusively took its information from press briefings given by George Felos.

I hope that these notes can be of use to you.

Warm regards,
TS