Beyond Terri's Law
What we can learn from the Schiavo
case.
by Wesley J. Smith
The Weekly Standard
IT IS THE CALM before the storm in the Terri Schiavo case. The
who was in the throes of a
court-ordered death by dehydration last October
when
receive tube-supplied food and
water. But this good news may not last. In December,
as her family and many
supporters celebrated her 40th birthday, their joy was
tempered by the knowledge that
powerful cultural forces are adamant that Terri
Schiavo not live to see age 41.
The Schiavo case was one of the
most important stories of 2003. The big news
wasn't that she was ordered
dehydrated to death: Conscious and unconscious
cognitively disabled people like
Terri are often denied tube-supplied food and
water in
was the successful public
campaign mounted by Terri's parents Bob and Mary
Schindler to prevent their daughter from suffering a slow
and potentially
agonizing death. As a result,
millions of people awakened to the ugly reality that we
treat helpless humans in a way
that would be criminal if done to a horse.
When more than 100,000 people contacted
that he intervene and save
Terri's life, the result was the passage of "Terri's
Law," a measure that permits the governor to suspend
the removal of a feeding
tube from patients (a) who do
not have a written advance directive
instructing that they not be
nourished and (b) whose families disagree with the decision
to dehydrate. Bush acted and
Terri's food and water were restored.
But Michael Schiavo, Terri's
quasi-estranged husband--he's lived with another
woman for several years and has
two children with her--remains adamant that
Terri die. Assisted by the
American Civil Liberties Union (ACLU) and cheered on
by the bioethics establishment
and media, which view the case through a
distorting "right to
die" prism, Michael Schiavo sued to have Terri's
Law declared
unconstitutional. If he
succeeds, Judge George Greer of
Judicial Circuit will undoubtedly order Terri's feeding
tube removed as he has done
twice before.
As we await further court proceedings, it is a good time
to take stock of the
case, clear up some common
misperceptions, and see whether anything can be
done to prevent future Terri Schiavos.
The Myth of 19 Judges: Supporters of Terri's dehydration
often argue that
Terri's rights have been fully protected through
extensive judicial oversight.
Michael Schiavo put it this way
on "Larry King Live": "Nineteen judges have come
to the conclusion that this
[dehydration] was Terri's wish." His attorney
George Felos then added,
"This case has gone from the trial court to the
appellate Court to the Florida
Supreme Court, to the U.S. Supreme Court, to the
the facts, and have found that
Mike acted properly."
Well, bunk. The case has been shunted back and forth
between the Sixth
Judicial Circuit Court and the Florida Second District
Court of Appeal, where the
rulings have been repeatedly
replayed like a looping audio tape. Only one trial
judge and one appellate court
actually reviewed the evidentiary record.
Moreover, contrary to Felos's assertion, the Florida Supreme Court and the
Supreme Court did not look at the facts. Rather, both
declined to review the case.
Refusing to rule is not the same thing at all as studying
the record.
This is a crucial point because many important and highly
relevant facts have
never been fully litigated. For
example, because the Schindlers could not
afford to hire a neurologist to
examine Terri at the time of the original trial,
Judge Greer heard only one perspective about Terri's
medical condition.
This situation has now changed. Several doctors and
rehabilitation experts
have signed affidavits asserting
not only that Terri is conscious, but also that
she could be weaned off her
feeding tube with rehabilitation. Judge Greer
refused to permit this evidence
to be presented fully in open court, however,
because to do so, he said, would
be to retry the case.
But the case should be retried. A human life is at stake.
And there are many
other issues in addition to the
heterodox expert medical opinions about
Terri's condition that must be considered if justice is
to prevail over mere legal
procedure.
For example, Michael Schiavo
was not cross-examined at the first trial about
the two different stories he has
told to two different courts, from which he
wanted two different verdicts.
When he wanted a money award from a medical
malpractice jury, he presented
evidence that Terri would have a normal life span,
that she would need extensive
and expensive rehabilitation throughout her
life, and that he would provide
her this care as long as he lived. (In cases such
as this, the longer the patient
is likely to live, the higher the award
probably will be.)
Six years later, when he wanted his wife's feeding tube
removed, he changed
his story, contending that she
told him she wouldn't want to live "on anything
artificial." Surely, the
credibility gap created by this 180-degree turnabout
is worth considering, given that
Michael's testimony and that of his brother
and sister-in-law constituted
the only evidence presented to Judge Greer that
Terri would want to die.
There are other inconsistencies in Michael Schiavo's story: After the medical
malpractice jury money was
safely in the bank, he withheld antibiotics from
Terri when she developed an infection. Because of this,
the Schindlers sued to
remove him as Terri's guardian.
When Michael was questioned in a deposition
about a conversation he had with
a doctor about removing Terri's feeding tube,
he testified, "I said [to
the doctor] I couldn't do that to Terri." He also
admitted that he did not want
Terri to regain consciousness because he did not
think it in her best interests.
There is also considerable evidence that would be
presented in a new trial
casting doubt on Michael's good
intentions toward Terri. Several nurses who
cared for Terri in the mid-1990s
have come forward and signed sworn affidavits
that are highly relevant to the
dispute over Terri's medical condition and
Michael's good faith. For
example, the nurses testified in their affidavits that
Terri was responsive and could even speak on occasion.
The affidavit of Carla Sauer Iyer,
RN, is especially damaging to Michael's
case. She testified that Michael
refused medical recommendations that Terri be
given therapy, insisting that
"Terri should not get any rehab, that there
should be no range of motion
[therapy], whatever, or anything else. . . . One time
I put a wash cloth in Terri's hand to keep her fingers
from curling together,
and Michael saw it and made me
take it out, saying that was therapy."
Even more disturbing, Iyer has
stated under penalty of perjury:
> Throughout my time at Palm Gardens [Terri's former
nursing home], Michael
> Schiavo was focused on
Terri's death. Michael would say, "When is she going to
> die?" "Has she died yet?" and "When
is that bitch going to die?"
Of course, Iyer's accusation
should not be accepted at face value and should
be tested by rigorous
cross-examination. But so too should Schiavo's
version
of his disputes with care
providers. He admits clashing with Terri's nurses,
but claims he was angry because
they were not providing her with good enough
care.
These matters are sufficiently serious to warrant a
thorough airing in a
full-blown trial. This should be
uncontroversial. After all, if Terri were a
condemned murderer facing
execution and factual matters of this import and
relevance had not been
adequately addressed in the original proceeding, the ACLU would
never stop suing. Yet, even
though Terri's case is just as much a death case
as any murder proceeding, the
ACLU wants Terri to die.
Unfortunately, the judges of the Sixth Judicial Circuit
are not eager to face
new facts. Indeed, Judge Greer's
Sixth Judicial Circuit colleague, W.
Baird, has now refused to permit Governor Bush's
attorneys to conduct any
factual discovery in the lawsuit
over the constitutionality of Terri's Law.
This is to stack travesty upon travesty. Despite the
general legal rule that
laws are to be presumed valid
when being challenged constitutionally, Baird
instead declared Terri's Law
"presumptively unconstitutional" before Governor
Bush had even filed pleadings in the case. Such a
statement at least presents a
sufficient appearance of bias to
require Baird be removed. Instead, the
looping tape brought the
controversy back to the Second District Court of Appeal,
which true to form refused to
order that Baird be disqualified. And now, even
though Judge Baird has been
transferred to a criminal court, he has nonetheless
held on to the Schiavo case.
The Missing Guardians ad Litem:
"I have never seen anything like the Terri
Schiavo litigation," the Schindlers' attorney Pat Anderson told me recently. "I
call it the 'Rule of Terri's
Case.' If following a legal procedure will likely
result in Terri dying, it will
be adhered to. But if a procedure could make
that outcome more difficult to
attain, it will not be followed. It's the most
frustrating experience of my
legal career."
Bitter words from a lawyer who has, so
far, lost her case? I don't think so.
Consider the fact that Terri does not currently have a
guardian ad litem who
would be duty-bound to look out
for her interests. This, despite a
statutory requirement that an ad
litem be appointed whenever a conflict of
interest may arise between a
guardian and a ward, as it clearly has between Michael
and Terri.
Terri once had a guardian ad litem,
attorney Richard L. Pearse Jr. of
should not be permitted and
further urging that she continue to be represented by
a guardian ad litem, he was dismissed from the case and no replacement
has
ever been appointed. When the Schindlers appealed, the Second District Court of
Appeal brushed their concerns aside, ruling in essence
that Judge Greer could
serve both as Terri's advocate
and as a neutral arbiter of her fate. As a
consequence, Terri was sentenced
to die without having an unbiased, zealous
advocate acting solely on her
behalf.
The same pattern has now occurred under Terri's Law,
which explicitly
requires a guardian ad litem be appointed for a patient whose dehydration has been
suspended by the governor.
Accordingly, David A. Demers, chief judge of the
Sixth Judicial Circuit, appointed health law professor
Jay Wolfson to represent
Terri and ordered him to review the case and report back
to the court and to the
governor within 30 days. Wolfson filed a 38-page report on
While accepting Judge Greer's ruling that Terri is in a
persistent vegetative
state, he recommended that Terri
be given a swallow test--she has not had one
since 1992--opining that if she
"has a reasonable hope of regaining any
swallowing function," her
feeding tube should not be removed. Wolfson also
expressed
his belief that "due
process requires that the ward's interests continue to
be represented in all further
proceedings herein" by a guardian ad litem or
"other appropriate
fiduciary."
Judge Demers was having none of that. He thanked Wolfson for his report and
dismissed him from further
service. Thus, Terri is yet again being denied an
advocate to call her own.
The Lack of a Legal Presumption for Life: The Terri Schiavo case shows the
acute dangers posed to the most
weak and vulnerable among us by the so-called
right to die. We are now a
society that too often gives the benefit of the doubt
to death in cases such as
Terri's. Terri's Law was merely a stopgap measure.
A more thorough and well-thought-out law is clearly
needed. Such legislation
has been filed in
session, would create an
explicit legal presumption in favor of providing
tube-supplied food and fluids to
cognitively disabled patients. But this general rule
would not be ironclad. The
presumption would not apply for patients who had
signed a written advance medical
directive instructing that the tube-supplied
sustenance be withheld if it
"would not contribute to sustaining the incompetent
person's life or provide comfort
to the incompetent person."
Such a common sense law would strike a proper balance
between the right to
make our own medical decisions
and the right to life of our most vulnerable
citizens. It would also go far
in preventing bitter intra-family litigation such
as the Schiavo
case that has roiled the nation in recent years. A just and
compassionate society should
accept no less.
Wesley J. Smith is a senior fellow at the Discovery
Institute, an attorney
for the International Task Force
on Euthanasia and Assisted Suicide, and a
special consultant to the Center
for Bioethics and Culture.