The Terri Schiavo case was a series of court and legislative actions in the
United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
from 1998 to 2005, regarding the care of Theresa Marie Schiavo (née Schindler) (; December 3, 1963 – March 31, 2005), a woman in an irreversible
persistent vegetative state
A persistent vegetative state (PVS) or post-coma unresponsiveness (PCU) is a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. After four weeks in a vegetative stat ...
. Schiavo's husband and legal guardian argued that Schiavo would not have wanted prolonged artificial life support without the prospect of recovery, and in 1998 elected to remove her
feeding tube
Eating (also known as consuming) is the ingestion of food, typically to provide a heterotrophic organism with energy and to allow for growth. Animals and other heterotrophs must eat in order to survive — carnivores eat other animals, her ...
. Schiavo's parents disputed her husband's assertions and challenged Schiavo's medical diagnosis, arguing in favor of continuing artificial nutrition and hydration.
The highly publicized and prolonged series of legal challenges presented by her parents, which ultimately involved state and federal politicians up to the level of
President
President most commonly refers to:
*President (corporate title)
*President (education), a leader of a college or university
*President (government title)
President may also refer to:
Automobiles
* Nissan President, a 1966–2010 Japanese ful ...
George W. Bush
George Walker Bush (born July 6, 1946) is an American politician who served as the 43rd president of the United States from 2001 to 2009. A member of the Republican Party, Bush family, and son of the 41st president George H. W. Bush, he ...
, caused a seven-year (1998 to 2005) delay before Schiavo's feeding tube was ultimately removed.
On February 25, 1990, at age 26, Schiavo went into
cardiac arrest
Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possib ...
at her home in
St. Petersburg, Florida
St. Petersburg is a city in Pinellas County, Florida, United States. As of the 2020 census, the population was 258,308, making it the fifth-most populous city in Florida and the second-largest city in the Tampa Bay Area, after Tampa. It is the ...
. She was successfully resuscitated, but had massive
brain damage
Neurotrauma, brain damage or brain injury (BI) is the destruction or degeneration of brain cells. Brain injuries occur due to a wide range of internal and external factors. In general, brain damage refers to significant, undiscriminating t ...
due to
lack of oxygen to her brain and was left
coma
A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. Coma patients exhi ...
tose. After two and a half months without improvement, her diagnosis was changed to that of a persistent vegetative state. For the next two years, doctors attempted occupational therapy, speech therapy, physical therapy and other experimental therapy, hoping to return her to a state of awareness, without success. In 1998, Schiavo's husband Michael Schiavo petitioned the
Sixth Circuit Court of Florida to remove her feeding tube pursuant to Florida law. He was opposed by Terri's parents, Robert and Mary Schindler. The court determined that Schiavo would not have wished to continue life-prolonging measures, and on April 24, 2001, her feeding tube was removed for the first time, only to be reinserted several days later. On February 25, 2005, a Pinellas County judge again ordered the removal of Terri Schiavo's feeding tube. Several appeals and federal government intervention followed, which included Bush returning to Washington, D.C., to sign legislation moving the case to the federal courts. After appeals through the federal court system that upheld the original decision to remove the feeding tube, staff at the
Pinellas Park
Pinellas Park is a city located in central Pinellas County, Florida, United States. The population was 53,093 at the 2020 census. Originally home to northern transplants and vacationers, the hundred year old city has grown into the fourth largest ...
hospice facility disconnected the feeding tube on March 18, 2005, and Schiavo died on March 31, 2005.
The Schiavo case involved 14 appeals and numerous
legal motions, petitions, and hearings in the Florida courts; five suits in
federal district court
The United States district courts are the trial courts of the U.S. federal judiciary. There is one district court for each federal judicial district, which each cover one U.S. state or, in some cases, a portion of a state. Each district cou ...
;
extensive political intervention at the levels of the Florida state legislature, Governor
Jeb Bush
John Ellis "Jeb" Bush (born February 11, 1953) is an American politician and businessman who served as the 43rd governor of Florida from 1999 to 2007. Bush, who grew up in Houston, was the second son of former President George H. W. Bush a ...
, the U.S. Congress, and President George W. Bush; and four denials of ''
certiorari
In law, ''certiorari'' is a court process to seek judicial review of a decision of a lower court or government agency. ''Certiorari'' comes from the name of an English prerogative writ, issued by a superior court to direct that the record of ...
'' from the
Supreme Court of the United States
The Supreme Court of the United States (SCOTUS) is the highest court in the federal judiciary of the United States. It has ultimate appellate jurisdiction over all U.S. federal court cases, and over state court cases that involve a point o ...
. The case also spurred highly visible activism from the
United States anti-abortion movement
The United States anti-abortion movement (also called the pro-life movement or right-to-life movement) contains elements opposing induced abortion on both moral and religious grounds and supports its legal prohibition or restriction. Advocates ...
, the
right-to-die movement
The right to die is a concept based on the opinion that human beings are entitled to end their life or undergo voluntary euthanasia. Possession of this right is often understood that a person with a terminal illness, incurable pain, or without ...
, and
disability rights
The disability rights movement is a global social movement that seeks to secure equal opportunities and equal rights for all people with disabilities.
It is made up of organizations of disability activists, also known as disability advocat ...
groups.
Since Schiavo's death, both her husband and her family have written books on their sides of the case, and both have also been involved in activism over related issues.
Background
Early life
Terri Schiavo was born Theresa Marie Schindler to Mary (born 1941) and Robert Schindler (1937–2009) on December 3, 1963, in
Lower Moreland Township, Montgomery County, Pennsylvania
Lower Moreland Township is a township in Montgomery County, Pennsylvania, United States. The population was 12,982 at the 2010 census.
History
The Bryn Athyn-Lower Moreland Bridge and Fetter's Mill are listed on the National Register of Historic ...
, a suburb of
Philadelphia
Philadelphia, often called Philly, is the largest city in the Commonwealth of Pennsylvania, the sixth-largest city in the U.S., the second-largest city in both the Northeast megalopolis and Mid-Atlantic regions after New York City. Sinc ...
. She attended
Bucks County Community College
Bucks County Community College (Bucks) is a public community college in Bucks County, Pennsylvania. Founded in 1964, Bucks has three campuses and online courses: a main campus in Newtown, an "Upper Bucks" campus in the town of Perkasie, and a " ...
, where she met Michael Schiavo in 1982. The two began dating and were married on November 10, 1984. They moved to
Florida
Florida is a state located in the Southeastern region of the United States. Florida is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Bahamas and Atlantic Ocean, and to ...
in 1986, following Terri's parents. Michael worked as a restaurant manager, while Terri took up a
bookkeeping
Bookkeeping is the recording of financial transactions, and is part of the process of accounting in business and other organizations. It involves preparing source documents for all transactions, operations, and other events of a business. Tr ...
job with an insurance company.
Initial medical crisis: 1990
In the early morning of February 25, 1990, Terri Schiavo collapsed in a hallway of her
St. Petersburg, Florida
St. Petersburg is a city in Pinellas County, Florida, United States. As of the 2020 census, the population was 258,308, making it the fifth-most populous city in Florida and the second-largest city in the Tampa Bay Area, after Tampa. It is the ...
, apartment. Firefighters and
paramedics
A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research.
Not all ambulance personnel are p ...
, arriving in response to her husband Michael's
9-1-1
, usually written 911, is an emergency telephone number for the United States, Canada, Mexico, Panama, Palau, Argentina, Philippines, Jordan, as well as the North American Numbering Plan (NANP), one of eight N11 codes. Like other emergency nu ...
call, found her face-down and unconscious. She was not breathing and had no
pulse
In medicine, a pulse represents the tactile arterial palpation of the cardiac cycle (heartbeat) by trained fingertips. The pulse may be palpated in any place that allows an artery to be compressed near the surface of the body, such as at the nec ...
. They attempted to resuscitate her and she was transported to the Humana Northside Hospital. Paramedics had her
intubated and
ventilated.
Initial medical assessments
The cause of Terri Schiavo's collapse was determined to be
cardiac arrest
Cardiac arrest is when the heart suddenly and unexpectedly stops beating. It is a medical emergency that, without immediate medical intervention, will result in sudden cardiac death within minutes. Cardiopulmonary resuscitation (CPR) and possib ...
.
Her medical chart contained a note that "she apparently has been trying to keep her weight down with dieting by herself, drinking liquids most of the time during the day and drinking about 10–15 glasses of
iced tea
Iced tea (or ice tea) is a form of cold tea. Though it is usually served in a glass with ice, it can refer to any tea that has been chilled or cooled. It may be sweetened with sugar or syrup. Iced tea is also a popular packaged drink that can be ...
."
Upon admission to the hospital, she was noted as suffering from
hypokalemia
Hypokalemia is a low level of potassium (K+) in the blood serum. Mild low potassium does not typically cause symptoms. Symptoms may include feeling tired, leg cramps, weakness, and constipation. Low potassium also increases the risk of an abno ...
(low potassium levels): her serum
potassium
Potassium is the chemical element with the symbol K (from Neo-Latin ''kalium'') and atomic number19. Potassium is a silvery-white metal that is soft enough to be cut with a knife with little force. Potassium metal reacts rapidly with atmosphe ...
level was an abnormally low 2.0
mEq
An equivalent (symbol: officially equiv; unofficially but often Eq) is the amount of a substance that reacts with (or is ''equivalent'' to) an arbitrary amount (typically one mole) of another substance in a given chemical reaction. It is an arc ...
/
L (the normal range for adults is 3.5–5.0 mEq/L). Her
sodium
Sodium is a chemical element with the symbol Na (from Latin ''natrium'') and atomic number 11. It is a soft, silvery-white, highly reactive metal. Sodium is an alkali metal, being in group 1 of the periodic table. Its only stable iso ...
and
calcium
Calcium is a chemical element with the symbol Ca and atomic number 20. As an alkaline earth metal, calcium is a reactive metal that forms a dark oxide-nitride layer when exposed to air. Its physical and chemical properties are most similar to ...
levels were normal.
Electrolyte imbalance
Electrolyte imbalance, or water-electrolyte imbalance, is an abnormality in the concentration of electrolytes in the body. Electrolytes play a vital role in maintaining homeostasis in the body. They help to regulate heart and neurological function, ...
is often caused by
drinking excessive fluids, and a serious consequence of hypokalemia can be heart rhythm abnormalities, including
sudden arrhythmia death syndrome.
[Meyer J, et al]
"Sudden Arrhythmia death Syndrome: Importance of the Long QT Syndrome"
''Am Fam Physician''. 2003 Aug 1;68(3):483–488. Retrieved July 26, 2011. Schiavo was eventually switched from being fed by a
nasogastric feeding tube to a
percutaneous endoscopic gastrostomy
Percutaneous endoscopic gastrostomy (PEG) is an endoscopic medical procedure in which a tube (PEG tube) is passed into a patient's stomach through the abdominal wall, most commonly to provide a means of feeding when oral intake is not adequate (fo ...
(PEG) feeding tube.
Dr. Garcia J. DeSousa,
board-certified
Board certification is the process by which a physician or other professional demonstrates a mastery of advanced knowledge and skills through written, practical, or simulator-based testing.
Certification bodies
There are more than 25 boards that ...
neurologist
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal c ...
in St. Petersburg, Florida, who previously treated Terri Schiavo, cared for her during her initial admission to Humana Northside; both he and Victor Gambone, an internist and Schiavo family physician, independently made the diagnosis of persistent vegetative state (PVS) within approximately one year after her sudden cardiac arrest.
Relationship between Terri's husband and parents
From 1990 to 1993, Michael Schiavo and the Schindlers (Terri Schiavo's parents) enjoyed an amicable relationship, with the Schindlers allowing Michael to live rent-free in their condominium for several months.
Rehabilitation efforts: 1990–1993
In November 1990, Michael Schiavo took Terri to the
University of California, San Francisco
The University of California, San Francisco (UCSF) is a public land-grant research university in San Francisco, California. It is part of the University of California system and is dedicated entirely to health science and life science. It cond ...
, for experimental nerve stimulation with a
thalamic stimulator
A thalamic stimulator is a medical device that can suppress tremors, such as those caused by Parkinson's disease or essential tremor. It was approved for use by the Food and Drug Administration (FDA) on August 4, 1997. Installation is invasive, s ...
. The treatment took several months and was unsuccessful. He returned to Florida with her in January 1991 and admitted her as an inpatient to the Mediplex Rehabilitation Center in
Bradenton, Florida
Bradenton ( ) is a city in and the county seat of Manatee County, Florida, Manatee County, Florida, United States. As of the 2020 United States Census, 2020 census, the city's population is 55,698.
History
Late 18th and early 19th centuries ...
. On July 19, 1991, Terri Schiavo was transferred to the Sabal Palms Skilled Care Facility, where she received neurological testing and regular
speech
Speech is a human vocal communication using language. Each language uses Phonetics, phonetic combinations of vowel and consonant sounds that form the sound of its words (that is, all English words sound different from all French words, even if ...
and
occupational therapy
Occupational therapy (OT) is a global healthcare profession. It involves the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or ''occupations'', of individuals, groups, or communities. The field of ...
until 1994.
[ In mid-1993, Michael Schiavo requested a ]do not resuscitate
A do-not-resuscitate order (DNR), also known as Do Not Attempt Resuscitation (DNAR), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), no code or allow natural death, is a medical order, written or oral depending on country, indicating tha ...
order for her after she contracted a urinary tract infection
A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidney ...
.
Legal cases 1992–2005
Malpractice
In 1992, Michael filed a malpractice
In the law of torts, malpractice, also known as professional negligence, is an "instance of negligence or incompetence on the part of a professional".Malpractice definition,
Professionals who may become the subject of malpractice actions inc ...
suit against Terri's gynecologist
Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined area ...
on the basis that he failed to diagnose bulimia
Bulimia nervosa, also known as simply bulimia, is an eating disorder characterized by binge eating followed by purging or fasting, and excessive concern with body shape and weight. The aim of this activity is to expel the body of calories eate ...
as the cause of her infertility. Terri had gone to the doctor because she had stopped menstruating
The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs a ...
but the doctor had failed to take her medical history into account which might have revealed an eating disorder. During the case, one of Terri's friends testified that she knew Schiavo was bulimic. In November 1992, Michael won the case and was awarded $6.8 million by the jury, later reduced to $2 million as Terri was found partly at fault for her condition. After attorneys' fees and other expenses, Michael received $300,000 and $750,000 was put in a trust fund for Terri's medical care. According to Michael, in early 2003 the Schindlers demanded that he share the malpractice money with them.
Petition to remove feeding tube
On June 18, 1990, the court appointed Michael Schiavo as Terri Schiavo's legal guardian; this appointment was not disputed by the Schindlers at the time. In May 1998, Michael Schiavo filed a petition to remove Terri Schiavo's feeding tube, which her parents opposed. Richard Pearse was appointed by the court as a second guardian ''ad litem'' (GAL), and on December 29, 1998, reported "Dr. Jeffrey Karp's opinion of the ward
Ward may refer to:
Division or unit
* Hospital ward, a hospital division, floor, or room set aside for a particular class or group of patients, for example the psychiatric ward
* Prison ward, a division of a penal institution such as a pris ...
's condition and prognosis is substantially shared among those physicians who have recently been involved in her treatment." Pearse concluded from Karp's and Vincent Gambone's diagnosis of ''Persistent Vegetative State'' that Schiavo was legally in a persistent vegetative state as defined by Florida Statutes, Title XLIV, Chapter 765, §101(12). This includes the "absence of voluntary action" and an "inability to communicate or interact purposefully".
Pearse found that there was no possibility of improvement but that Michael Schiavo's decisions might have been influenced by the potential to inherit what remained of Terri Schiavo's estate as long as he remained married to her. Due to a lack of a living will
''Living Will'' is an American comedy film starring Ryan Dunn, Gerard Haitz and April Scott.
Cast
*Ryan Dunn - Belcher
*Gerard Haitz - Will
*April Scott - Krista
Production
In 2011, the domestic distribution rights to the film were purchased ...
and questions regarding Michael's credibility, Pearse recommended denying his petition to remove her feeding tube. Pearse reported that the issue of conflict of interest applied to the Schindlers as well since, had Michael divorced Terri as they wanted him to, they would have inherited the remainder of Terri Schiavo's estate upon her death.
Schiavo end-of-life wishes
Given the lack of a living will
''Living Will'' is an American comedy film starring Ryan Dunn, Gerard Haitz and April Scott.
Cast
*Ryan Dunn - Belcher
*Gerard Haitz - Will
*April Scott - Krista
Production
In 2011, the domestic distribution rights to the film were purchased ...
, a trial was held before Pinellas County Judge George Greer
George W. Greer (born 1942) is a retired Florida circuit judge who served in Florida's Sixth Circuit Court ( Pinellas- Pasco counties), family law division, in Clearwater, Florida. He received national attention in 2005 when he presided over t ...
during the week of January 24, 2000, to determine what Terri Schiavo's wishes would have been regarding life-prolonging procedures. Michael Schiavo was represented by attorney George Felos, who had won a landmark right-to-die case before the Florida Supreme Court
The Supreme Court of Florida is the highest court in the U.S. state of Florida. It consists of seven members: the chief justice and six justices. Six members are chosen from six districts around the state to foster geographic diversity, and one ...
in 1990.
The trial included testimony from eighteen witnesses regarding her medical condition and her end-of-life wishes. Michael Schiavo claimed that his wife would not want to be kept on a machine where her chance for recovery was minuscule. According to Abstract Appeal Trial Order, her parents "claimed that Terri was a devout Roman Catholic
Roman or Romans most often refers to:
*Rome, the capital city of Italy
*Ancient Rome, Roman civilization from 8th century BC to 5th century AD
*Roman people, the people of ancient Rome
*'' Epistle to the Romans'', shortened to ''Romans'', a lette ...
who would not wish to violate the Church's teachings on euthanasia
Euthanasia (from el, εὐθανασία 'good death': εὖ, ''eu'' 'well, good' + θάνατος, ''thanatos'' 'death') is the practice of intentionally ending life to eliminate pain and suffering.
Different countries have different eut ...
by refusing nutrition and hydration." Judge Greer issued his order granting the petition for authorization to discontinue artificial life support for Terri Schiavo in February 2000. In this decision, the court found that Terri Schiavo was in a persistent vegetative state and that she had made reliable oral declarations that she would have wanted the feeding tube removed. This decision was upheld by the Florida Second District Court of Appeal
The Florida Second District Court of Appeal is headquartered in Lakeland, Florida and has a branch on the campus of Stetson University College of Law in Tampa. There are fourteen counties in the Second District, which includes a population of ove ...
(2nd DCA) and came to be known by the court as ''Schiavo I'' in its later rulings.
Oral feeding and the second guardianship challenge
In March 2000, the Schindlers filed a motion to permit assisted feeding of Terri, which is not considered a life-prolonging procedure under Florida law. Since clinical records indicated that Terri Schiavo was not responsive to swallowing
Swallowing, sometimes called deglutition in scientific contexts, is the process in the human or animal body that allows for a substance to pass from the mouth, to the pharynx, and into the esophagus, while shutting the epiglottis. Swallowing i ...
tests and required a feeding tube, Judge Greer ruled that she was not capable of orally ingesting sufficient nutrition and hydration to sustain life, and denied the request. The Medical Examiner in his postmortem report was more definitive and reaffirmed that Schiavo could not have swallowed.
In 2000, the Schindlers again challenged Michael Schiavo's guardianship. The Schindlers suggested that he was wasting the assets within the guardianship account by transferring Terri Schiavo to a Pinellas Park, Florida
Pinellas Park is a city located in central Pinellas County, Florida, United States. The population was 53,093 at the 2020 census. Originally home to northern transplants and vacationers, the hundred year old city has grown into the fourth largest ...
, hospice
Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by ...
"after it was clear that she was not 'terminal' within Medicare guidelines" for hospices. By this time, while still legally married to Terri Schiavo, Michael Schiavo was in a relationship with Jodi Centonze, and had fathered their first child. He said he chose not to divorce his wife and relinquish guardianship because he wanted to ensure her final wishes (not to be kept alive in a PVS) were carried out. The court denied the motion to remove the guardian, allowing that the evidence was not sufficient and in some instances, not relevant. It set April 24, 2001, as the date on which the tube was to be removed.
''Schiavo II''
In April 2001, the Schindlers filed a motion for relief from judgment citing new evidence of Terri Schiavo's wishes. Judge Greer denied the motion as untimely under Rule 1.540(b)(5) of the Florida Rules of Civil Procedure. The Second District Court of Appeal upheld Greer's decision but remanded the issue in order to give the Schindlers an opportunity to file a new motion. On April 24, 2001, Terri's feeding tube was removed for the first time. The Schindlers filed a civil suit against Michael Schiavo alleging perjury
Perjury (also known as foreswearing) is the intentional act of swearing a false oath or falsifying an affirmation to tell the truth, whether spoken or in writing, concerning matters material to an official proceeding."Perjury The act or an inst ...
, which was assigned to another court. The judge, Frank Quesada, issued an injunction against the removal of feeding tube until this was settled. The feeding tube was reinserted on April 26, 2001. On appeal by Michael Schiavo, the Second District Court of Appeal reversed Judge Quesada's order. In the same time frame, Michael Schiavo filed a motion to enforce the mandate of the guardianship court (that the feeding tube be removed). The Second District Court of Appeal denied the motion. These three decisions, all published in a single order by Florida's Second District Court of Appeal, came to be known by the court as ''Schiavo II'' in its later rulings.
''Schiavo III and IV'': PVS diagnosis challenge
On August 10, 2001, on remand from the Florida Second District Court of Appeal
The Florida Second District Court of Appeal is headquartered in Lakeland, Florida and has a branch on the campus of Stetson University College of Law in Tampa. There are fourteen counties in the Second District, which includes a population of ove ...
, Judge Greer heard a motion from the Schindlers claiming that new medical treatment could restore sufficient cognitive ability such that Terri Schiavo herself would be able to decide to continue life-prolonging measures. The court also heard motions from the Schindlers to remove the guardian (Michael Schiavo) and to require Judge Greer to recuse
Judicial disqualification, also referred to as recusal, is the act of abstaining from participation in an official action such as a legal proceeding due to a conflict of interest of the presiding court official or administrative officer. Applica ...
himself. Judge Greer denied the motions and the Schindlers appealed to the Second District Court of Appeals. On October 17, 2001, the Court of Appeal affirmed the denials of the motions to remove and recuse. The Court of Appeals acknowledged that their opinion misled the trial court, and they remanded the question of Terri Schiavo's wishes back to the trial court and required an evidentiary hearing to be held. The court specified that five board certified neurologists were to testify. The Schindlers were allowed to choose two doctors to present findings at an evidentiary hearing while Schiavo could introduce two rebuttal experts. Finally, the trial court itself would appoint a new independent physician to examine and evaluate Terri Schiavo's condition. (These decisions, all published in a single order by the Florida Second District Court of Appeal, came to be known by the court as ''Schiavo III'' in its later rulings.) In October 2002, on remand by the Second District Court of Appeal, an evidentiary hearing was held in Judge Greer's court to determine whether new therapy treatments could help Terri Schiavo restore any cognitive function. In preparation for the trial, a new computed axial tomography scan (CAT scan) was performed, which showed severe cerebral atrophy
Cerebral atrophy is a common feature of many of the diseases that affect the brain. Atrophy of any tissue means a decrement in the size of the cell, which can be due to progressive loss of cytoplasmic proteins. In brain tissue, atrophy describes ...
. An EEG
Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The biosignals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in the neocortex ...
showed no measurable brain activity. The five physicians chosen were William Maxfield, a radiologist
Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiatio ...
, and four neurologists
Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
: William Hammesfahr, Ronald Cranford, Melvin Greer and Peter Bambakidis.
The five doctors examined Terri Schiavo's medical records, brain scans, the videos, and Terri herself. Cranford, Greer, and Bambakidis testified that Terri Schiavo was in a persistent vegetative state (PVS). Drs. Maxfield and Hammesfahr testified that she was in a minimally conscious state
A minimally conscious state (MCS) is a disorder of consciousness distinct from persistent vegetative state and locked-in syndrome. Unlike persistent vegetative state, patients with MCS have partial preservation of conscious awareness. MCS is a rel ...
. As part of the court-ordered medical exam, six hours of video of Terri Schiavo were taped and filed at the Pinellas County courthouse. The tape included Terri Schiavo with her mother and neurologist William Hammesfahr. The entire tape was viewed by Judge Greer, who wrote, Terri "clearly does not consistently respond to her mother". From that six hours of video, the Schindlers and their supporters produced six video clips intended to support their case, totaling less than six minutes, and released those clips to public websites. Judge Greer ruled that Terri Schiavo was in a PVS, and was beyond hope of significant improvement. The trial court order was particularly critical of Hammesfahr's testimony, which claimed positive results in similar cases by use of vasodilation
Vasodilation is the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. The process is the opposite of vasoconstriction, ...
therapy, the success of which is unsupported in the medical literature. This ruling was later affirmed by Florida's Second District Court of Appeal, which stated that "this court has closely examined all of the evidence in the record", and "we have ... carefully observed the video tapes in their entirety." The court concluded that "if we were called upon to review the guardianship court's decision '' de novo'', we would still affirm it." This decision by the Second District Court of Appeals came to be known as ''Schiavo IV'' in later rulings.
Around the start of 2003, the Schindlers began to create more publicity by lobbying for their case to keep their daughter alive. On September 11, 2003, the Schindlers petitioned the court to forestall removal of the feeding tube in order to provide for "eight weeks' therapy". Accompanying the petition were four affidavits from members of the Schindler family and one from Dr. Alexander T. Gimon. At the hearing, the Schindlers' counsel read into the record additional affidavits from three speech professionals and two nurses. In particular, nurse Carla Sauer Iyer asserted that she was able to feed Terri Schiavo orally but that Michael characterized any such interaction as "therapy" and ordered her not to do so. Iyer claimed in her affidavit that her initial training in 1996 consisted solely of the instruction, "Do what Michael Schiavo tells you or you're terminated," and that standing orders were not to contact the Schindler family, but that she "would call them anyway".
On September 17, 2003, Judge George Greer
George W. Greer (born 1942) is a retired Florida circuit judge who served in Florida's Sixth Circuit Court ( Pinellas- Pasco counties), family law division, in Clearwater, Florida. He received national attention in 2005 when he presided over t ...
denied the petition, and wrote that "the Petition is an attempt by Mr. and Mrs. Schindler to re-litigate the entire case. It is not even a veiled or disguised attempt. The exhibits relied upon by them, clearly demonstrate this to be true." Regarding (Nurse) Iyer's statements, Greer wrote that they were "incredible to say the least" and that "Ms. Iyer details what amounts to a 15-month cover-up from April 1995 through July 1996, which include the staff of Palm Garden of Largo Convalescent Center, the Guardian of the Person, the guardian ''ad litem'', the medical professionals, the police and, believe it or not, Mr. and Mrs. Schindler ... It is impossible to believe that Mr. and Mrs. Schindler would not have subpoenaed Ms. Iyer for the January 2000 evidentiary hearing had Iyer contacted them in 1996 as her affidavit alleges."
Terri's Law and other government delays
On October 15, 2003, Schiavo's feeding tube was removed. Within a week, when the Schindlers' final appeal was exhausted, State Rep. Frank Attkisson
Frank C. Attkisson (November 2, 1955 – April 6, 2017) was a Florida politician. He served in the Florida House of Representatives from 2000 to 2008 and as the mayor of Kissimmee, Florida from 1996 to 2000. Attkisson was a former County Commi ...
and the Florida Legislature
The Florida Legislature is the legislature of the U.S. State of Florida. It is organized as a bicameral body composed of an upper chamber, the Senate, and a lower chamber, the House of Representatives. Article III, Section 1 of the Florida Cons ...
passed "Terri's Law" in an emergency session giving Governor Jeb Bush
John Ellis "Jeb" Bush (born February 11, 1953) is an American politician and businessman who served as the 43rd governor of Florida from 1999 to 2007. Bush, who grew up in Houston, was the second son of former President George H. W. Bush a ...
the authority to intervene in the case. Governor Bush immediately ordered the feeding tube reinserted. Governor Bush sent the Florida Department of Law Enforcement
The Florida Department of Law Enforcement (FDLE) is a state-wide investigative law enforcement agency within the state of Florida. The department formally coordinates eight boards, councils, and commissions. FDLE's duties, responsibilities and ...
(FDLE) to remove Schiavo from the hospice. She was taken to Morton Plant Rehabilitation Hospital in Clearwater, where her feeding tube was surgically reinserted. She was then returned to the hospice. Part of the legislation required the appointment of a guardian ''ad litem'' (GAL), Jay Wolfson, to "deduce and represent the best wishes and best interests" of Schiavo, and report them to Governor Bush. Wolfson's report did not change Michael's role as her legal guardian and did not otherwise obstruct him legally.
Michael Schiavo opposed the Governor's intervention in Schiavo's case, and was represented, in part, by the American Civil Liberties Union
The American Civil Liberties Union (ACLU) is a nonprofit organization founded in 1920 "to defend and preserve the individual rights and liberties guaranteed to every person in this country by the Constitution and laws of the United States". T ...
(ACLU). At the same time, Robert and Mary Schindler, her parents, attempted to intervene and participate in the "Terri's Law" case but were denied by Judge W. Douglas Baird, a Circuit Judge in the Florida Sixth Circuit. They appealed, and, on February 13, 2004, the Florida Second District Court of Appeal
The Florida Second District Court of Appeal is headquartered in Lakeland, Florida and has a branch on the campus of Stetson University College of Law in Tampa. There are fourteen counties in the Second District, which includes a population of ove ...
(Second District Court of Appeals) ordered Baird to hold further hearings on the issue. On March 17, 2004, Baird denied the Schindlers the right to intervene a second time. The Schindlers, represented by the American Center for Law and Justice
The American Center for Law & Justice (ACLJ) is a politically conservative, Christian-based legal organization in the United States. It is headquartered in Washington, D.C., and associated with Regent University School of Law in Virginia Beach, V ...
(ACLJ), appealed the right to participate in the "Terri's Law" case, with the court scheduling an oral argument
Oral arguments are spoken presentations to a judge or appellate court by a lawyer (or parties when representing themselves) of the legal reasons why they should prevail. Oral argument at the appellate level accompanies written briefs, which also a ...
date for June 14. The Schindlers' other attorney, Pat Anderson, was concurrently challenging Michael Schiavo's right to be her guardian, and, on June 16, 2004, she made a petition for writ of ''quo warranto
In law, especially English and American common law, ''quo warranto'' (Medieval Latin for "by what warrant?") is a prerogative writ requiring the person to whom it is directed to show what authority they have for exercising some right, power, or ...
''.
On May 5, 2004, Baird found "Terri's Law" unconstitutional
Constitutionality is said to be the condition of acting in accordance with an applicable constitution; "Webster On Line" the status of a law, a procedure, or an act's accordance with the laws or set forth in the applicable constitution. When l ...
, and struck it down. Bush appealed this order to the Second District Court of Appeals, but on May 12, 2004, the court issued an "Order Relinquishing Case for Entry of Final Judgment and Order to Show Cause Why this Proceeding Should Not be Certified to the Supreme Court As Requiring Immediate Resolution". The Second District Court of Appeals, in sending it directly to the Florida Supreme Court, invoked "pass through" jurisdiction.
The Florida Supreme Court then overturned the law as unconstitutional.
Final feeding tube removal and federal involvement
Early 2005 motions
On February 23, 2005, the Schindlers filed a motion for relief from judgment pending medical evaluations. The Schindlers wanted Schiavo to be tested with an fMRI
Functional magnetic resonance imaging or functional MRI (fMRI) measures brain activity by detecting changes associated with blood flow. This technique relies on the fact that cerebral blood flow and neuronal activation are coupled. When an area o ...
and given a swallowing therapy called VitalStim. The motion was accompanied by thirty-three affidavits from doctors in several specialties, speech-language pathologists and therapists, and a few neuropsychologists, all urging that new tests be undertaken. Patricia Fields Anderson, the Schindler family attorney, still held out hope "that Terri might be able to take nourishment orally, despite past findings that she is incapable". Judge Greer formally denied the motion and ordered the "removal of nutrition and hydration from the ward" and set the time and date for the removal of the feeding tube as "1:00 p.m. on Friday, March 18, 2005".
On February 28, 2005, the Schindlers filed a motion, asking for permission to attempt to provide Schiavo with "Food and Water by Natural Means". This second motion asked for permission to "attempt to feed" Schiavo by mouth. Judge Greer denied the second motion on March 8, saying "it has become clear that the second motion is part and parcel of the previous motion on medical evaluations. The same declarations are being used for both motions and the motion appears to be an alternative pleading to the previous motion. Both are asking for an experimental procedure." The following day, Greer denied the first motion as well, citing that an affiant doctor for Michael cautioned that fMRI was an experimental procedure that should be conducted in an academic setting, because Schiavo had already undergone swallowing tests and failed, and because VitalStim had only been performed on patients who were not in a PVS. Greer noted that "most of the doctor affidavits submitted are based on their understanding of Schiavo's condition from news reports or video clips they have seen. Many are obviously not aware of the medical exams undertaken for the 2002 trial."
Following Greer's order on March 18, 2005, to remove the feeding tube, Republicans in the United States Congress
The United States Congress is the legislature of the federal government of the United States. It is bicameral, composed of a lower body, the House of Representatives, and an upper body, the Senate. It meets in the U.S. Capitol in Washing ...
subpoena
A subpoena (; also subpœna, supenna or subpena) or witness summons is a writ issued by a government agency, most often a court, to compel testimony by a witness or production of evidence under a penalty for failure. There are two common types of ...
ed both Michael and Terri Schiavo to testify at a congressional hearing. Greer told congressional attorneys, "I have had no cogent reason why the (congressional) committee should intervene." He also stated that last-minute action by Congress does not invalidate years of court rulings.
Palm Sunday Compromise
President George W. Bush
George Walker Bush (born July 6, 1946) is an American politician who served as the 43rd president of the United States from 2001 to 2009. A member of the Republican Party, Bush family, and son of the 41st president George H. W. Bush, he ...
and Congressional Republicans anticipated Greer's adverse ruling well before it was delivered and worked on a daily basis to find an alternative means of overturning the legal process by utilizing the authority of the United States Congress
The United States Congress is the legislature of the federal government of the United States. It is bicameral, composed of a lower body, the House of Representatives, and an upper body, the Senate. It meets in the U.S. Capitol in Washing ...
. On March 20, 2005, the Senate, by unanimous consent
In parliamentary procedure, unanimous consent, also known as general consent, or in the case of the parliaments under the Westminster system, leave of the house (or leave of the senate), is a situation in which no member present objects to a prop ...
, passed their version of a relief bill; since the vote was taken by voice vote, there was no official tally of those voting in favor and those opposed. Soon after Senate approval, the House of Representatives passed an identical version of the bill S.686, which came to be called the "Palm Sunday Compromise
The Palm Sunday Compromise, formally known as the ''Act for the relief of the parents of Theresa Marie Schiavo'' (), is an Act of Congress passed on March 21, 2005, to allow the case of Terri Schiavo to be moved into a federal court. The name ...
" and transferred jurisdiction of the Schiavo case to the federal courts. The bill passed the House on March 21, 2005, at 12:41 a.m. ( UTC−5). Bush flew to Washington, D.C.
)
, image_skyline =
, image_caption = Clockwise from top left: the Washington Monument and Lincoln Memorial on the National Mall, United States Capitol, Logan Circle, Jefferson Memorial, White House, Adams Morgan, ...
from his vacation in Texas
Texas (, ; Spanish language, Spanish: ''Texas'', ''Tejas'') is a state in the South Central United States, South Central region of the United States. At 268,596 square miles (695,662 km2), and with more than 29.1 million residents in 2 ...
in order to sign the bill into law at 1:11 a.m.
While the bill had been proposed by Republican Senators Rick Santorum
Richard John Santorum ( ; born May 10, 1958) is an American politician, attorney, and political commentator. A member of the Republican Party, he served as a United States Senator from Pennsylvania from 1995 to 2007 and was the Senate's thir ...
and Mel Martínez
Melquíades Rafael Ruiz Martínez (born October 23, 1946) is a Cuban-American lobbyist and former politician who served as a United States Senator from Florida from 2005 to 2009 and as general chairman of the Republican Party from November 200 ...
, it also had the support of Democratic Senator Tom Harkin
Thomas Richard Harkin (born November 19, 1939) is an American lawyer, author, and politician who served as a United States senator from Iowa from 1985 to 2015. A member of the Democratic Party, he previously was the U.S. representative for Iowa' ...
due to disability rights
The disability rights movement is a global social movement that seeks to secure equal opportunities and equal rights for all people with disabilities.
It is made up of organizations of disability activists, also known as disability advocat ...
concerns in the Schiavo case. Harkin had worked with disability rights groups for years and co-authored the 1990 Americans with Disabilities Act
The Americans with Disabilities Act of 1990 or ADA () is a civil rights law that prohibits discrimination based on disability. It affords similar protections against discrimination to Americans with disabilities as the Civil Rights Act of 1964 ...
. American disability rights groups traditionally tend to ally themselves with Democrats and the political left; however, in the Schiavo case, they joined pro-life organizations in opposing the removal of her feeding tube and supporting the Palm Sunday Compromise. According to Marilyn Golden, Harkin's support was necessary for passage of the bill, as any voice opposition by Democrats would have delayed it.
As in the state courts, all of the Schindlers' federal petitions and appeals were denied, and the U.S. Supreme Court declined to grant ''certiorari
In law, ''certiorari'' is a court process to seek judicial review of a decision of a lower court or government agency. ''Certiorari'' comes from the name of an English prerogative writ, issued by a superior court to direct that the record of ...
'', effectively ending the Schindlers' judicial options. At the same time, the so-called Schiavo memo surfaced, causing a political firestorm. The memo was written by Brian Darling
Brian Darling (born 1965) is the president and founder of the firm Liberty Government Affairs. He was Senior Communications Director and Counsel for Senator Rand Paul (R-KY) and a former senior fellow in government studies at The Heritage Foundat ...
, the legal counsel to Florida Republican senator Mel Martinez. It suggested the Schiavo case offered "a great political issue" that would appeal to the party's base (core supporters) and could be used against Senator Bill Nelson
Clarence William Nelson II (born September 29, 1942) is an American politician and attorney serving as the administrator of the National Aeronautics and Space Administration (NASA). Nelson previously served as a United States Senator from Flor ...
, a Democrat
Democrat, Democrats, or Democratic may refer to:
Politics
*A proponent of democracy, or democratic government; a form of government involving rule by the people.
*A member of a Democratic Party:
**Democratic Party (United States) (D)
**Democratic ...
from Florida
Florida is a state located in the Southeastern region of the United States. Florida is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Bahamas and Atlantic Ocean, and to ...
, because he had refused to co-sponsor the bill. Nelson easily won re-election in 2006.
Republican majority leader and physician Bill Frist
William Harrison Frist (born February 22, 1952) is an American physician, businessman, and politician who served as a United States Senator from Tennessee from 1995 to 2007. A member of the Republican Party, he also served as Senate Majority Lea ...
opposed the removal of her feeding tube and in a speech delivered on the Senate floor, challenged the diagnosis of Schiavo's physicians of Schiavo being in a persistent vegetative state (PVS): "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." After her death, the autopsy showed signs of long-term and irreversible damage to her brain consistent with PVS. Frist defended his actions after the autopsy.
Final local motions, death, autopsy, and burial
On March 24, 2005, Judge Greer denied a petition for intervention by the Florida Department of Children and Families
The Florida Department of Children and Families (DCF) is a state agency of Florida. Its headquarters are at 2415 North Monroe St., Ste. 400 in Tallahassee, Florida. The department provides social services to children, adults, refugees, domesti ...
(DCF) and signed an order forbidding the department from "taking possession of Theresa Marie Schiavo or removing her" from the hospice and directed "each and every and singular sheriff of the state of Florida" to enforce his order. The order was appealed to the Second District Court of Appeals the following day, which resulted in an automatic stay under state law. While the stay was in effect, Florida Department of Law Enforcement personnel prepared to take custody of Terri Schiavo and transfer her to a local hospital for reinsertion of the feeding tube. Once Greer was made aware of the stay, he ordered it lifted and all parties stood down. Governor Bush decided to obey the court order despite enormous pressure from the political right. If Bush (or the Florida Legislature) had ignored Greer's order by attempting to remove her from the hospice, a confrontation between the Pinellas Park Police Department and the FDLE agents could have ensued. In jest, one official said local police discussed "whether we had enough officers to hold off the National Guard."
Terri Schiavo died at a Pinellas Park
Pinellas Park is a city located in central Pinellas County, Florida, United States. The population was 53,093 at the 2020 census. Originally home to northern transplants and vacationers, the hundred year old city has grown into the fourth largest ...
hospice
Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by ...
on March 31, 2005.
Autopsy
Schiavo's body was taken to the Office of the District 6 Medical Examiner for Pinellas and Pasco counties, based in Largo, Florida. The autopsy
An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any di ...
was conducted on April 1, 2005, and revealed extensive brain damage. The manner of death was certified as "undetermined." The autopsy was led by Chief Medical Examiner Jon R. Thogmartin. In addition to consultation with a neuropathologist (Stephen J. Nelson), Thogmartin also arranged for specialized cardiac and genetic examinations to be made. The official autopsy report was released on June 15, 2005. In addition to studying Terri Schiavo's remains, Thogmartin scoured court, medical and other records and interviewed her family members, doctors and other relevant parties. Examination of Schiavo's nervous system by neuropathologist Stephen J. Nelson, revealed extensive injury. The brain
A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a v ...
itself weighed only , only half the weight expected for a female of her age, height, and weight, due to the loss of a massive number of neurons. Microscopic examination revealed extensive damage to nearly all brain regions
The human brain anatomical regions are ordered following standard neuroanatomy hierarchies. Functional, connective, and developmental regions are listed in parentheses where appropriate.
Hindbrain (rhombencephalon)
Myelencephalon
* M ...
, including the cerebral cortex
The cerebral cortex, also known as the cerebral mantle, is the outer layer of neural tissue of the cerebrum of the brain in humans and other mammals. The cerebral cortex mostly consists of the six-layered neocortex, with just 10% consisting of ...
, the thalamus
The thalamus (from Greek θάλαμος, "chamber") is a large mass of gray matter located in the dorsal part of the diencephalon (a division of the forebrain). Nerve fibers project out of the thalamus to the cerebral cortex in all directions, ...
, the basal ganglia
The basal ganglia (BG), or basal nuclei, are a group of subcortical nuclei, of varied origin, in the brains of vertebrates. In humans, and some primates, there are some differences, mainly in the division of the globus pallidus into an extern ...
, the hippocampus
The hippocampus (via Latin from Greek , 'seahorse') is a major component of the brain of humans and other vertebrates. Humans and other mammals have two hippocampi, one in each side of the brain. The hippocampus is part of the limbic system, a ...
, the cerebellum
The cerebellum (Latin for "little brain") is a major feature of the hindbrain of all vertebrates. Although usually smaller than the cerebrum, in some animals such as the mormyrid fishes it may be as large as or even larger. In humans, the cerebel ...
, and the midbrain
The midbrain or mesencephalon is the forward-most portion of the brainstem and is associated with vision, hearing, motor control, sleep and wakefulness, arousal (alertness), and temperature regulation. The name comes from the Greek ''mesos'', " ...
. The neuropathologic changes in her brain were precisely of the type seen in patients who enter a PVS following cardiac arrest. Throughout the cerebral cortex, the large pyramidal neurons
A neuron, neurone, or nerve cell is an electrically excitable cell that communicates with other cells via specialized connections called synapses. The neuron is the main component of nervous tissue in all animals except sponges and placozoa. N ...
that comprise some 70% of cortical cells – critical to the functioning of the cortex – were completely lost. The pattern of damage to the cortex, with injury tending to worsen from the front of the cortex to the back, was also typical. There was marked damage to important relay circuits deep in the brain (the thalamus) – another common pathologic finding in cases of PVS. The damage was, in the words of Thogmartin, "irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons."
The cardiac pathologist who studied Schiavo's heart found it and the coronary vessels Coronary () may, as shorthand in English, be used to mean:
* Coronary circulation, the system of arteries and veins in mammals
** Coronary artery disease
** Coronary occlusion
** A myocardial infarction, a heart attack
As adjective
* Referring t ...
to be healthy, which excludes the possibility that her initial collapse was the result of myocardial infarction
A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may ...
, although there was a localized area of healed inflammation (opening the possibility of myocarditis
Myocarditis, also known as inflammatory cardiomyopathy, is an acquired cardiomyopathy due to inflammation of the heart muscle. Symptoms can include shortness of breath, chest pain, decreased ability to exercise, and an irregular heartbeat. The ...
). Thogmartin found that "there was no proof that Terri Schiavo ever had an eating disorder such as bulimia." Regarding the possibility of strangulation or domestic violence as a cause of Schiavo's initial collapse, the report states: "No trauma was noted on any of the numerous physical exams or radiographs performed on Mrs. Schiavo on the day of, in the days after, or in the months after her initial collapse. Indeed, within an hour of her initial hospital admission, radiographic examination of her cervical spine was negative. Specifically, external signs of strangulation including cutaneous or deep neck injury, facial/conjunctival petechiae, and other blunt trauma were not observed or recorded during her initial hospital admission. Autopsy examination of her neck structures 15 years after her initial collapse did not detect any signs of remote trauma, but, with such a delay, the exam was unlikely to show any residual neck findings."
Regarding the cause and manner of Schiavo's death, Thogmartin wrote, "Mrs. Schiavo suffered severe anoxic brain injury. The cause of which cannot be determined with reasonable medical certainty. The manner of death will therefore be certified as undetermined."
Burial
Schiavo's body was cremated
Cremation is a method of final disposition of a dead body through burning.
Cremation may serve as a funeral or post-funeral rite and as an alternative to burial. In some countries, including India and Nepal, cremation on an open-air pyre i ...
. Her parents offered a memorial Mass
Mass is an intrinsic property of a body. It was traditionally believed to be related to the quantity of matter in a physical body, until the discovery of the atom and particle physics. It was found that different atoms and different elementar ...
for her at the Holy Name of Jesus Catholic Church in Gulfport on April 5, 2005. Father Frank Pavone, the founder of the Priests for Life
Priests for Life (PFL) is an anti-abortion organization based in Titusville, Florida. PFL functions as a network to promote and coordinate anti-abortion activism, especially among Roman Catholic priests and laymen, with the primary strategic goal ...
anti-abortion organization, delivered the main homily.
On June 20, 2005, the cremated remains of Terri Schiavo were buried. The Schindlers' attorney stated that the family was notified by fax
Fax (short for facsimile), sometimes called telecopying or telefax (the latter short for telefacsimile), is the telephonic transmission of scanned printed material (both text and images), normally to a telephone number connected to a printer o ...
only after the memorial service; by then, the family had already started getting calls from reporters. The ashes were interred at Sylvan Abbey Memorial Park in Clearwater, Florida
Clearwater is a city located in Pinellas County, Florida, United States, northwest of Tampa and St. Petersburg. To the west of Clearwater lies the Gulf of Mexico and to the southeast lies Tampa Bay. As of the 2020 census, the city had a populat ...
.
The epitaph (pictured) reads:
Ethical and legal issues
Right to die
The Schiavo case has been compared to the Karen Ann Quinlan case
''In re Quinlan'' (70 N.J. 10, 355 A.2d 647 (NJ 1976)) was a landmark 1975 court case in the United States in which the parents of a woman who was kept alive by artificial means were allowed to order her removal from artificial ventilation.
Kare ...
and Nancy Cruzan case, two landmark right-to-die cases. Quinlan entered a persistent vegetative state in 1975, and her family was allowed to remove her from a ventilator in 1976 after a ruling by the New Jersey Supreme Court
The Supreme Court of New Jersey is the highest court in the U.S. state of New Jersey. In its current form, the Supreme Court of New Jersey is the final judicial authority on all cases in the state court system, including cases challenging the ...
based on her right of privacy. She died of pneumonia
Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity ...
in 1985. Cruzan was diagnosed with PVS in 1983 and her legal case reached the Supreme Court, which ruled that "clear and convincing evidence" of her wishes to die under such circumstances was needed. Cruzan's family did not have enough evidence of that, but later produced more. She died after being removed from life support in 1990.
The "Terri Schiavo case" actually refers to a series of cases. It differed from the Quinlan and Cruzan cases by involving settled law rather than breaking new legal ground on the right-to-die issue. In 2006, Shepherd said that it was "unclear" whether the Schiavo case represents a landmark decision
Landmark court decisions, in present-day common law legal systems, establish precedents that determine a significant new legal principle or concept, or otherwise substantially affect the interpretation of existing law. "Leading case" is commonly u ...
. The Schiavo case instead involved a dispute between family members over what Schiavo's wishes would have been for such a situation. According to medical ethicist Matthew Stonecipher, "The movement to challenge the decisions made for Terri Schiavo threatened to destabilize end-of-life law that had developed over the last quarter of the 20th century, principally through the cases of Karen Ann Quinlan and Nancy Cruzan." The outcome of the Schiavo case was also in part determined by a 1990 Florida case, ''Guardianship of Estelle Browning''. In that case, George Felos, the attorney for Michael Schiavo in the Schiavo case, represented a Browning relative. Felos successfully argued before the Florida Supreme Court
The Supreme Court of Florida is the highest court in the U.S. state of Florida. It consists of seven members: the chief justice and six justices. Six members are chosen from six districts around the state to foster geographic diversity, and one ...
that Browning's feeding tube should be removed. The elderly Browning had expressed, in a living will, her wish not to be kept alive by any artificial means, including receiving food and water "by a gastric tube or intravenously." At that time, it was common to remove people from ventilators, but the law in Florida was not clear on removing them from feeding tubes. In a landmark ruling, the Florida Supreme Court decided that Browning had "the constitutional right to choose or refuse medical treatment, and that right extends to all relevant decisions concerning one's health."
Disability rights
During the years of legal proceedings, disability rights
The disability rights movement is a global social movement that seeks to secure equal opportunities and equal rights for all people with disabilities.
It is made up of organizations of disability activists, also known as disability advocat ...
groups and activists closely monitored and involved themselves in the case. In March 2003, twelve disability rights groups, led by Not Dead Yet
Not Dead Yet (NDY) is a United States disability rights group that opposes assisted suicide and euthanasia for disabled people. Diane Coleman, JD, is the founder and president of this national group. Stephen Drake, a research analyst with NDY ...
, along with four other ''amici'' filed an ''amicus curiae
An ''amicus curiae'' (; ) is an individual or organization who is not a party to a legal case, but who is permitted to assist a court by offering information, expertise, or insight that has a bearing on the issues in the case. The decision on ...
'' brief in which they opposed the removal of Schiavo's feeding tube. They also used the Schiavo case to advocate for federal review in cases where third parties decide to withdraw life support from patients unable to give consent.
They argued that persistent vegetative state is frequently misdiagnosed, and that the reasons for withdrawal of life support from a patient should be scrutinized since even family member surrogates can have conflicts of interest. The Palm Sunday Compromise granted the federal review they sought, but it was limited to only the Schiavo case.
Public opinion and activism
The seven-year case generated a great deal of public attention and activism. There was extensive media coverage and both sides courted public opinion. In 2000, the Schindlers created the Terri Schindler-Schiavo Foundation to garner support. During the weeks when Schiavo's feeding tube was removed in 2005, activists kept up an around-the-clock vigil outside her hospice. The protests were described as loud but non-violent. There were dozens of arrests, with most being for crossing a police line with water for Schiavo.
Two polls conducted shortly after Schiavo's feeding tube was removed for the final time in 2005 showed that a large majority of Americans
Americans are the Citizenship of the United States, citizens and United States nationality law, nationals of the United States, United States of America.; ; Although direct citizens and nationals make up the majority of Americans, many Multi ...
believed that Michael Schiavo should have had the authority to make decisions on behalf of his wife and that the U.S. Congress
The United States Congress is the legislature of the federal government of the United States. It is Bicameralism, bicameral, composed of a lower body, the United States House of Representatives, House of Representatives, and an upper body, ...
overstepped its bounds with its intervention in the case.
Developments since Schiavo's death
Since Terri Schiavo's death in March 2005, her family and Michael Schiavo have clashed a number of times. Each side has also worked to promote their own causes related to the case. In April 2005, the families disagreed over Schiavo's burial. The Schindlers had wanted her body to be buried in Florida, while Michael Schiavo said at the time that he would cremate her body and then have her ashes buried in her home state of Pennsylvania
Pennsylvania (; ( Pennsylvania Dutch: )), officially the Commonwealth of Pennsylvania, is a state spanning the Mid-Atlantic, Northeastern, Appalachian, and Great Lakes regions of the United States. It borders Delaware to its southeast, ...
. In June 2005, however, Schiavo's ashes were buried in Florida instead. The words "I kept my promise" were included on the marker, referring to his promise to follow what he said was her wish not to be kept alive artificially. The statement angered the Schindlers.
In December 2005, Michael Schiavo created a political action committee, TerriPAC. It was formed to raise money to support right-to-die candidates and oppose candidates who had voted for government involvement in the Schiavo case. In 2007, TerriPAC paid a $1,350 fine to the Federal Election Commission
The Federal Election Commission (FEC) is an independent regulatory agency of the United States whose purpose is to enforce campaign finance law in United States federal elections. Created in 1974 through amendments to the Federal Election Cam ...
for failing to file complete and timely records. Schiavo shut down the PAC later that year.
The Schindlers continued operation of the Terri Schindler Schiavo Foundation, with a new goal of helping individuals in situations similar to Terri's. In April 2010, Michael Schiavo charged that the Schindlers were improperly using Terri's name, as he held the rights to it, and that the family was using the foundation in order to make money. A Florida television station looked at the foundation's tax records and found that for 2008, it paid 64% of the $91,568 it raised in salaries to Terri's father, Robert Schindler Sr., her sister, Suzanne Vitadamo, and her brother, Robert Schindler Jr. Their attorney said the foundation does its work effectively and that the high percentage for salaries was due to the small amount of money the foundation raises. He also said that the Schindlers had the right to use Terri's name as she is a public figure. The foundation had been fined $1,000 shortly before Schiavo's death for failing to file timely paperwork. In September 2010, the Schindlers renamed the organization the "Terri Schiavo Life and Hope Network".
In 2006, both Michael Schiavo and the Schindlers released books telling their sides of the story. Schiavo's was called ''Terri: The Truth'', while the Schindlers' was titled ''A Life that Matters: The Legacy of Terri Schiavo – A Lesson for Us All''.
Despite the extended emotion-laden legal struggle, the case broke no new legal ground: it remains settled law that the spouse is the next of kin
A person's next of kin (NOK) are that person's closest living blood relatives. Some countries, such as the United States, have a legal definition of "next of kin". In other countries, such as the United Kingdom, "next of kin" may have no legal d ...
in decisions where the patient is incompetent. However, it is now more generally recognized that the next of kin's decisions should be carried out in a timely fashion, even on matters of life and death. The case has raised public awareness of the value of having an advance medical directive
An advance healthcare directive, also known as living will, personal directive, advance directive, medical directive or advance decision, is a legal document in which a person specifies what actions should be taken for their health if they are no ...
.
At the ten-year anniversary of Schiavo's death, several news sources offered retrospectives on the case, some still attempting to explain how this particular case became so notable.
Schiavo memo
During the Terri Schiavo case in March 2005, a talking point
A talking point, often used in the plural, is a pre-established message or formula used in the field of political communication, sales and commercial or advertising communication. The message is coordinated ''a priori'' to remain more or less inv ...
s memo on the controversy was written by Brian Darling
Brian Darling (born 1965) is the president and founder of the firm Liberty Government Affairs. He was Senior Communications Director and Counsel for Senator Rand Paul (R-KY) and a former senior fellow in government studies at The Heritage Foundat ...
, the legal counsel to Republican
Republican can refer to:
Political ideology
* An advocate of a republic, a type of government that is not a monarchy or dictatorship, and is usually associated with the rule of law.
** Republicanism, the ideology in support of republics or agains ...
Senator Mel Martinez
Mel, Mels or MEL may refer to:
Biology
* Mouse erythroleukemia cell line (MEL)
* National Herbarium of Victoria, a herbarium with the Index Herbariorum code MEL
People
* Mel (given name), the abbreviated version of several given names (including ...
of Florida
Florida is a state located in the Southeastern region of the United States. Florida is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Bahamas and Atlantic Ocean, and to ...
. The memo suggested the Schiavo case offered "a great political issue" that would appeal to the party's base (core supporters) and could be used against Senator Bill Nelson
Clarence William Nelson II (born September 29, 1942) is an American politician and attorney serving as the administrator of the National Aeronautics and Space Administration (NASA). Nelson previously served as a United States Senator from Flor ...
, a Democrat
Democrat, Democrats, or Democratic may refer to:
Politics
*A proponent of democracy, or democratic government; a form of government involving rule by the people.
*A member of a Democratic Party:
**Democratic Party (United States) (D)
**Democratic ...
from Florida
Florida is a state located in the Southeastern region of the United States. Florida is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Bahamas and Atlantic Ocean, and to ...
who was up for reelection in 2006, because he had refused to co-sponsor the bill which came to be known as the Palm Sunday Compromise
The Palm Sunday Compromise, formally known as the ''Act for the relief of the parents of Theresa Marie Schiavo'' (), is an Act of Congress passed on March 21, 2005, to allow the case of Terri Schiavo to be moved into a federal court. The name ...
. Bill Nelson was nevertheless reelected as Senator on November 7, 2006 with 60% of the vote.
Martinez stated that he had not read the memo before he inadvertently passed it to Iowa
Iowa () is a state in the Midwestern region of the United States, bordered by the Mississippi River to the east and the Missouri River and Big Sioux River to the west. It is bordered by six states: Wisconsin to the northeast, Illinois to the ...
Senator Tom Harkin
Thomas Richard Harkin (born November 19, 1939) is an American lawyer, author, and politician who served as a United States senator from Iowa from 1985 to 2015. A member of the Democratic Party, he previously was the U.S. representative for Iowa' ...
, a Democratic supporter of the Palm Sunday Compromise legislation which gave federal courts
Federal court may refer to:
United States
* Federal judiciary of the United States
** United States district court, a particular federal court
Elsewhere
* Federal Court of Australia
* Federal courts of Brazil
* Federal Court (Canada)
* Federal co ...
jurisdiction
Jurisdiction (from Latin 'law' + 'declaration') is the legal term for the legal authority granted to a legal entity to enact justice. In federations like the United States, areas of jurisdiction apply to local, state, and federal levels.
Jur ...
to review the Terri Schiavo case. Then it became public knowledge.
After the existence of the memo was reported by ABC News
ABC News is the news division of the American broadcast network ABC. Its flagship program is the daily evening newscast ''ABC World News Tonight, ABC World News Tonight with David Muir''; other programs include Breakfast television, morning ...
and ''The Washington Post
''The Washington Post'' (also known as the ''Post'' and, informally, ''WaPo'') is an American daily newspaper published in Washington, D.C. It is the most widely circulated newspaper within the Washington metropolitan area and has a large nati ...
'', Senate Majority Leader Bill Frist
William Harrison Frist (born February 22, 1952) is an American physician, businessman, and politician who served as a United States Senator from Tennessee from 1995 to 2007. A member of the Republican Party, he also served as Senate Majority Lea ...
denounced the memo and asserted that the Republican Party's interest in the case was solely based on moral grounds. Darling remained silent about his authorship of the memo as commentators from the conservative magazine ''Weekly Standard
''The Weekly Standard'' was an American neoconservative political magazine of news, analysis and commentary, published 48 times per year. Originally edited by founders Bill Kristol and Fred Barnes, the ''Standard'' had been described as a "red ...
'' and other publications questioned its authenticity. The source of the memo had not been disclosed by either ABC News or ''The Washington Post''. ''The Washington Post'' says that it neither implied that the memo originated from a Republican source nor that it was circulated by Republicans, though it did in fact make these assertions when it published the story by reporters Mike Allen and Manuel Roig-Franzia on its wire service on March 19, 2005. The authorship claim was removed before publication of the print version on March 20, 2005. On April 6, 2005, Darling admitted to writing the memo, and resigned his position as legal counsel to Senator Martinez.
See also
* Government involvement in the Terri Schiavo case
The legislative, executive, and judicial branches, of both the United States federal government and the State of Florida, were involved in the case of Terri Schiavo. In November 1998 Michael Schiavo, husband of Terri Schiavo, first sought permissi ...
* Haleigh Poutre
* Terri Schiavo timeline
* Vincent Lambert case
References
Further reading
*
* ''Silent Witness: The Untold Story of Terri Schiavo's Death'' by Mark Fuhrman
Mark Fuhrman (born February 5, 1952) is a former detective of the Los Angeles Police Department (LAPD). He is primarily known for his part in the investigation of the 1994 murders of Nicole Brown Simpson and Ron Goldman in the O. J. Simpson murd ...
(2005),
* ''Fighting for Dear Life: The Untold Story of Terri Schiavo and What It Means for All of Us'' by David C. Gibbs III (2006),
* ''Remembering Terri Schiavo: Reflections of a Health Care Warrior'' by Audrey Ignatoff (2005),
* ''Terri's Story: The Court-Ordered Death of an American Woman'' by Diana Lynne (2005),
* "Terri Schiavo: When Does Personhood End?" in ''The Elements of Bioethics'', Gregory Pence (2007),
* ''Terri: The Truth'' by Michael Schiavo, Michael Hirsh (2006),
* ''A Life That Matters: The Legacy of Terri SchiavoA Lesson For Us All'' by Mary and Robert Schindler (2005),
External links
; Compilations
These are compilations of legal documents relating to the Schiavo case:
Findlaw's compilation
; Information sites
* Conigliaro, Matt, Esq., Editor of "Abstract Appeal" Legal Blog. (2005)
Retrieved 2005-08-31.
Hospice Patients Alliance
Retrieved 2005-08-30. Includes the initial 199
police report
(PDF).
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1998 establishments in Florida
2005 disestablishments in Florida
1990s controversies in the United States
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Deaths by person in Florida
Medical controversies in the United States
People with disorders of consciousness
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