Theresa Marie "Terri" Schiavo (December 3, 1963 – March 31, 2005) was a woman from St. Petersburg, Florida whose medical circumstances and attendant legal battles fueled significant media attention and led to several high-profile court decisions and involvement by politicians and interest groups. Schiavo experienced cardiac arrest due to a potassium imbalance and collapsed in her home in 1990, incurring massive brain damage. She remained in a coma for ten weeks. Within three years, she was diagnosed as being in a persistent vegetative state (PVS) with little chance of recovery.
Beginning in 1998, Terri's husband and guardian Michael Schiavo petitioned the courts to remove the gastric feeding tube keeping Schiavo alive; Schiavo's parents Robert and Mary Schindler fought a series of legal battles opposing Michael. The courts consistently found that Schiavo was in a PVS and had made credible statements that she would not wish to be kept alive on a machine. By 2003, the matter, while still local to Florida, had received some national attention.
ByMarch 2005, the legal history around the Schiavo case included fourteen appeals and numerous motions, petitions, and hearings in the Florida courts; five suits in Federal District Court; Florida legislation struck down by the Supreme Court of Florida; a subpoena by a congressional committee in an attempt to qualify Schiavo for "witness protection"; federal legislation (Palm Sunday Compromise); and four denials of certiorari from the Supreme Court of the United States.[1]
Despite these interventions, the courts continued to find that Schiavo was in a PVS with no hope for recovery, and would want to cease life support. Her feeding tube was removed a third and final time on March 18, 2005. She died at a Pinellas Park, Florida hospiceonMarch 31, 2005, at the age of 41.
Schiavo grew up in the Huntingdon Valley area of Lower Moreland Township, Pennsylvania, a suburb of Philadelphia, Pennsylvania, as the eldest of three children of Robert and Mary Schindler. Her younger siblings were Robert Jr. (Bobby) and Suzanne (now Suzanne Vitadamo). By her senior year in high school, Schiavo was overweight, with a height of 5 feet, 3 inches (160 cm) and a weight of around 200 pounds (90 kg). She went on a NutriSystem diet and lost about 55 pounds (25 kg).[2] She may have developed an eating disorder around this time.[3] In 1981, she graduated from Archbishop Wood Catholic High School.
She met Michael Schiavo in 1982 in a sociology class at Bucks County Community College. He was her first boyfriend. After dating for five months, the couple became engaged. They were married on November 10, 1984, at Our Lady of Good Counsel Church in Southampton, Pennsylvania. They moved to St. Petersburg, Florida, in April 1986. Schiavo's parents also moved to St. Petersburg three months later. In Florida, she worked as an insurance claims clerk for the Prudential insurance company, and Michael was a restaurant manager.
In 1989, the Schiavos began visiting an obstetrician and receiving fertility services and counseling in the hopes of having a child. At this time Schiavo's weight had dropped to 120 pounds, and she had stopped menstruating. The physician who examined her did not take a complete medical history, which might have indicated an eating disorder.
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Terri Schiavo suffered a cardiac arrest at her home in 1990. She was fitted with a feeding tube for nutrition and hydration. She was diagnosed as being in persistent vegetative state and was provided with standard care for such a case and was also provided with some extraordinary procedures in pursuit of a cognitive recovery. That latter pursuit was not successful.
Michael fought and won a malpractice suit with a large monetary award against Terri's obstetrician based on the premise that Terri had an undiagnosed eating disorder. The Schindlers continue to present statements to the public that question this diagnosis, but the issue has not further been addressed by the courts.
In 1994, Michael Schiavo indicated that he saw no hopes for his wife's recovery, and that she would not want to continue her life under those circumstances. He requested that treatment for infections be halted. Terri's parents and, in several cases, medical administrative staff moved to oppose these measures and thus began a long and complicated legal struggle. In 1998, Michael requested that Terri's nutrition be withheld with the obvious intention that Terri's life should come to an end in the near future. The courts determined that Terri was in a persistent vegetative state from which she had little chance of ever recovering. There were many legal conflicts over the next five years between Michael Schiavo and Terri's parents.
In March of 2000, the Schindlers filed a motion to permit oral feeding of Schiavo, which is not considered a life-prolonging procedure under Florida law. They would do so again in 2005. The Schindlers released an influential video of Terri and her mother in what appeared to be some form of interaction. As the legal conflict escalated to the state level, the Schindlers began to use Randall Terry as their spokesman. Pro-life groups had begun to actively come to the aid of the Schindlers and the story was receiving increasing publicity at the state level. By the summer of 2003, Michael's pursuit of having Terri's feeding tube removed had progressed to the point where removal seemed imminent.
In 1995, Michael began a relationship with another woman, Jodi Centonze. In the fall of 2002, their first child was born.
OnSeptember 11, 2003, the Schindlers petitioned the court to forestall removal of the feeding tube to provide for "eight weeks' therapy". The petition was denied.
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.
One of the nurses, Carla Sauer Iyer said in her affidavit that her initial training in 1996 consisted solely of the instruction, "do what Michael Schiavo tells you or you're terminated." She stated that on five different occasions, she tested Schiavo's blood sugar levels after Michael visited her, and she found that her blood sugar levels were so low it wouldn't even register a number. She stated that it was medically possible that Michael injected his wife with insulin in an attempt to kill her. Iyer stated that standing orders were not to contact the Schindler family, but that she "would call them anyway." Iyer stated that she eventually called the police and was fired the next day.
OnSeptember 17, Judge George Greer 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 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 [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." [4]
OnOctober 15, 2003, Schiavo's feeding tube was removed. Within a week, the Florida legislature passed and Florida Governor Jeb Bush signed "Terri's Law", enabling Bush to intervene. See "Government involvement" for additional details.
Bush immediately sent the Florida Department of Law Enforcement to remove Schiavo from the hospice. She was taken to a hospital, where her feeding tube was surgically reinserted. [5] She was then returned to the hospice. Part of the legislation required the appointment of a guardian ad litem, Dr. 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 Terri's legal guardian and did not otherwise obstruct him legally.
Throughout 2004, the legal struggle continued, but it received less publicity. By the start of 2005, feeding tube removal again seemed imminent and the case again began to reach a national audience.
Wolfson visited Schiavo at least daily over the course of a month. In December, 2003, he submitted his report, referring to himself in the third person as "the GAL". His central finding was: "The GAL was not able to independently determine that there were consistent, repetitive, intentional, reproducible interactive and aware activities." He notes further, that when joined by her parents no success was gained in eliciting a repetitive or consistent response from Schiavo.
In examining medical records and consultations surrounding the case, Wolfson concluded: "(that there is) well documented information that she is in a persistent vegetative state with no likelihood of improvement, and that the neurological and speech pathology evidence in the file support the contention that she cannot take oral nutrition or hydration and cannot consciously interact with her environment." He observed further that while there appeared to be agreement about Schiavo and PVS: "the Schindlers have adopted what appears to be a position that Theresa is not in a persistent vegetative state, and/or that they do not support the fact that such a medical state exists at all."
Wolfson addressed two criticisms that media attention had affixed to the Schindlers and Michael Schiavo, respectively. That the Schindlers would keep their daughter alive to the point of her "limbs being amputated," was not accurate according to Wolfson. Of suggestions that Michael Schiavo refused to relinquish his guardianship because of financial interests or to cover up previous abuse, Wolfson reported that "there is no evidence in the record to substantiate any of these perceptions or allegations."
In addressing the issue of law surrounding the case, Wolfson concluded "that the trier of fact and the evidence that served as the basis for the decisions regarding Theresa Schiavo were firmly grounded within Florida statutory and case law, which clearly and unequivocally provide for the removal of artificial nutrition in cases of persistent vegetative states."
The Schindlers filed two motions in an effort for forestall the removal of Terri's feeding tube. No stay was granted by the appellate courts, and on March 18, 2005, Schiavo's feeding tube was removed for a third time.
OnFebruary 23, 2005, the Schindlers filed a motion for relief from judgment pending medical evaluations[6] The Schindlers wanted Schiavo to be tested with an fMRI and given a swallowing therapy called VitalStim. The motion was accompanied by thirty-three affidavits from doctors in several specialties, speech pathologists and therapists, and a few neuropsychologists, all urging that new tests be undertaken. [7] [8] 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." [9] Judge Greer formally denied the motion and ordered the "removal of nutrition and hydration from the ward" . Anderson argued that Greer did not specify "artificial nutrition and hydration" versus "oral nutrition and hydration" and stated that "the withholding of food and water...was not ordered by the Court but by Michael Schiavo." [10] In his order, Greer also set a time and date for the removal of the feeding tube: "1:00 p.m. on Friday, March 18, 2005." [11]
OnFebruary 28, 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. [12] 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." [13] 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 "[m]ost 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..." [14]
Both the state government of Florida and the U.S. Congress made use of extraordinary measures to support the Schindlers.
Earlier, in October of 2003, when the Schindlers' final appeal was exhausted, the Florida Legislature passed "Terri's Law,"[15] giving Governor Jeb Bush the authority to intervene in the case. Bush immediately ordered the feeding tube reinserted. Michael Schiavo opposed the Governor's intervention, and was represented, in part, by the ACLU. At the same time, Robert and Mary Schindler, Terri's 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 6th Circuit, the same circuit as for Judge George W. Greer. They appealed, and, on February 13, the Florida Second District Court of Appeal (2nd DCA) reversed Baird's ruling,[16] allowing them to participate. On March 17, Baird denied the Schindlers the right to intervene a 2nd time,[17] and the Schindlers, represented by the conservative American Center for Law and Justice (ACLJ), appealed the right to participate in the "Terri's Law" case, with the court scheduling an oral argument [18] date for June 14.[19] The Schindlers' other attorney, Pat Anderson, was concurrently challenging Michael Schiavo's right to be Terri's guardian, and, on June 16, [20] she made a petition for writ of Quo Warranto, a pleading that asks "by what right" someone acts in an official capacity.
OnMay 5 2004, Baird found "Terri's Law" unconstitutional, and struck it down.[21] Bush appealed this order to the 2nd DCA, but, on May 12, they 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."[22] The 2nd DCA, in sending it directly to the Florida's Supreme Court, invoked "pass through" jurisdiction.[23]
The Florida Supreme Court then overturned the law as unconstitutional.[24]
Following Greer's order on March 18 2005 to remove the feeding tube, Republicans in the United States Congress subpoenaed both Michael and Terri Schiavo to testify at a congressional hearing.[25] It is contempt of Congress to prevent or discourage congressional witnesses from testifying.[26] The purpose of the subpoenas was thus to postpone the feeding tube removal.
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.[27][28] Although Senate Majority Leader Bill Frist, Senator Rick Santorum, and House Majority Leader Tom DeLay, brought the possibility of sanctioning Greer on charges of contempt of Congress, Congress did not attempt to enforce the subpoenas or take any action against Greer.
Governor Bush 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.[29]OnMarch 20, 2005, the Senate (with only three members present) passed their version of the resolution, followed by the House of Representatives, a private bill which came to be called the "Palm Sunday Compromise" (S-686), transferring jurisdiction of the Schiavo case to the federal courts. The bill passed the House on March 21 at 12:41 a.m. EST. President Bush flew to Washington D.C. from his vacation in Texas in order to sign the bill into law at 1:11 a.m. EST. 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, effectively ending the Schindlers' legal options.
At the same time, the so-called Schiavo memo surfaced, causing a political firestorm. The memo was written by Brian Darling, 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, a Democrat from Florida who is up for reelection in 2006, because he had refused to co-sponsor the bill.[30]
OnMarch 24 2005, Greer denied a petition for intervention by the Department of Children & Families (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 2nd DCA 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 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 Schiavo 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."[31]
OnMarch 26, 2005, Bob and Mary Schindler announced that their legal options had been exhausted. The next day, Schiavo was given the Anointing of the Sick ("Last Rites"). In accordance with the Catholic ritual of Viaticum, she received the Eucharist for the last time; it had been administered to her once through her feeding tube just before it was removed. The Eucharist, according to the teaching of the Catholic Church, can be received under the consecrated species of either bread (referred to as the host) or wine. As her tongue was too dry to receive a small piece of the host, she received under the species of wine, one drop being placed on her tongue.
Terri Schiavo died at 9:05 a.m. EST on Thursday, March 31, 2005, with her husband Michael at her side. Her parents, who had been denied access to her during her last hours, went to the hospice to visit her when they were informed she might be approaching death; they arrived half an hour after her death. The Schindler family was allowed into the room after Michael Schiavo had left.[32]
After her death, Schiavo's body was taken to the office of the medical examiner for Pinellas and Pasco counties. The autopsy occurred on April 1 2005. It revealed extensive brain damage and generally supported the PVS diagnosis. The manner of death was certified as "undetermined", but acute dehydration was noted.
The autopsy was lead by Dr. Jon Thogmartin. Thogmartin also arranged for specialized cardiac and genetic examinations to be made. The official autopsy report[33] was released on June 15, 2005. Examination of Schiavo’s nervous system revealed extensive injury. The brain itself weighed 615 g, only half the weight expected for a female of her age, height, and weight.
Microscopic examination revealed extensive damage to nearly all brain regions, including the cerebral cortex, the thalami, the basal ganglia, the hippocampus, the cerebellum, and the midbrain. 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 that comprise some 70 percent 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, is also typical. There was marked damage to important relay circuits deep in the brain (the thalami)—another common pathologic hallmark 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."[34] Dr. Stephen J. Nelson, P.A., cautioned that "[n]europathologic examination alone of the decedent’s brain – or any brain for that matter – cannot prove or disprove a diagnosis of persistent vegetative state or minimally conscious state."[35] The vegetative state is a behaviorally defined syndrome of complete unawareness, to self and to environment, that occurs in a person who nevertheless experiences wakefulness. As the condition is defined in clinical terms, it can therefore only be diagnosed in persons who, at some point, are shown to meet those clinical terms. Ancillary investigations, such as CT scans, MRI, EEGs, and lately fMRI and PET scanning, may only provide support for the clinical impression—as might the pathologic findings, after death. In the case of Terri Schiavo, seven of the eight neurologists who examined her in her last years stated that she met the clinical criteria for PVS; the serial CT scans, EEGs, the one MRI, and finally, the pathologic findings, were consistent with that diagnosis.
Aside from a localized, healed inflammation, the cardiac pathologist who studied Schiavo's heart found it and the coronary vessels to be healthy. Although it was stated that Schiavo suffered from an eating disorder that caused a serious electrolyte disturbance, stopping her heart, the autopsy itself showed did not provide, and could not have provided, evidence to support this claim. The examiners also found no evidence that Schiavo had been the victim of trauma (such as domestic violence).
Regarding the cause and manner of Schiavo’s death, Thogmartin wrote, "Mrs. Schiavo suffered severe anoxic brain injury. The cause of which [sic] cannot be determined with reasonable medical certainty. The manner of death will therefore be certified as undetermined."
Schiavo's body was cremated following the autopsy. Her parents offered a memorial Mass for her at the Holy Name of Jesus Catholic Church in GulfportonApril 5. Father Frank Pavone, an activist with Priests for Life,[36] delivered the main sermon (Audio: MP3 Format).[37]
OnMay 7, Schiavo's parents made public a complaint that they hadn't been informed of when and where the ashes of their daughter had been (or were to be) buried by Michael Schiavo. He was under court order to provide this information to them.
OnJune 20, the cremated remains of Terri Schiavo were buried. The Schindlers' attorney stated that the family was notified by fax only after the memorial service; by then, the family had already started getting calls from reporters.[38] The ashes were interred at Sylvan Abbey Memorial Park in Clearwater, Florida.
OnJanuary 23, 2006 Schiavo married his long-term fiancée, Jodi Centonze, whom he met in a dentist's office in 1995.
David Gibbs III, the lead lawyer for Terri Schiavo’s parents, supported Vatican statements which condemned her treatment as euthanasia. Pope John Paul II stated that health care providers are morally bound to provide food and water to patients in persistent vegetative states. This led to a challenge by Schiavo's parents, who requested a new trial about whether their daughter, as a devout Catholic, would wish to go against the Church's teaching. Judge Greer rejected their request.[39]
Schiavo's husband insisted that she had expressed her wishes not to be kept on life support with no hope for improvement. During a trial in 2000, testimony was heard from witnesses on both sides to establish Schiavo's wishes regarding life support. The court determined that she had made "credible and reliable" statements that she wouldn't want to be "kept alive on a machine," based on expert testimony, finding that Americans don't want to live "with no hope of improvement," and that her condition in a persistent vegetative state had "long since satisfied" the requirement that there be no hope of improvement.[40]
In 2003, guardian ad litem Dr. Jay Wolfson was appointed by Florida legislature to "deduce and represent the best wishes and bests interests of Theresa Schiavo." He reported to Governor Jeb Bush that "the evidence that served as the basis for the decisions regarding Theresa Schiavo were firmly grounded within Florida statutory and case law, which clearly and unequivocally provide for the removal of artificial nutrition in cases of persistent vegetative states," and that the evidence regarding Schiavo's medical condition and intentions had been "deemed, by the trier of fact to be clear and convincing." and "The reasonable degree of medical certainty associated with her diagnosis and prognosis is very high."[41]
The Terri Schiavo case held the attention of both American and international audiences and had major political ramifications. A number of opinion polls were carried out, particularly on the question of federal involvement in the Terri Schiavo case, with conflicting results. The case drew notable figures on both sides of the debate, as well as many pressure groups and public protesters. Although the vast majority of protests were nonviolent, two of the more extreme acts included death threats aimed towards Michael Schiavo. The Schindlers' legal fight was funded by a variety of sources on the political right.[42]
OnMarch 11, 2005, media tycoon Robert Herring (who believes that stem cell research could have cured Schiavo's condition) offered $1 million (USD) to Michael Schiavo if he agreed to cede his guardianship to his wife's parents.[43] The offer was rejected; George Felos, attorney for Michael Schiavo, described it as "offensive," adding that Michael had rejected other monetary offers, including one of $10 million (USD).
During the final stages of the court battle in March 2005, around 30 individuals made a variety of complaints to the DCF, alleging various abuses. These included Terri supposedly being in pain from recent dental work, Terri not having had any dental work for years prior to that, and the blinds in her room not being open wide enough. DCF investigators found the claims to be groundless, stating that there were "no indicators" of abuse in any of the cases and concluding that "[t]he preponderance of the evidence shows that Michael Schiavo followed doctors' orders [regarding] Ms. Schiavo's diagnosis of being in a persistent vegetative state and that he provided her with appropriate care."[44]
(legal documents relating to the Schiavo case)
Opposing removal of Terri Schiavo's feeding tube |
Supporting removal of Terri Schiavo's feeding tube |
