Terri Schiavo case

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Theresa Marie Schiavo (born December 3, 1963), commonly known as Terri Schiavo (pronounced SHY-vo), is an American woman from St. Petersburg, Florida, the daughter of Robert and Mary Schindler, and the wife of Michael Schiavo. On February 25, 1990, she suffered severe brain damage caused by a cardiac arrest, believed to be brought on by bulimia. The efforts of Schiavo's husband to discontinue food and water have prompted a fierce debate over bioethics, euthanasia, legal guardianship, federalism, and civil rights, as well an active counter-effort to keep her alive [1] [2].

Terri Schiavo is hospitalized at the Hospice of the Florida Sun coast in Pinellas Park, in the Tampa Bay area. On March 18, 2005, her gastric feeding tube was removed under court order. The removal of the feeding tube will result in Schiavo's death by dehydration, which experts argue is an exceptionally cruel way to kill someone.

Michael Schiavo, her husband and legal guardian, contends that he is carrying out his wife's wishes not to be kept alive in her present state. Mrs. Schiavo's parents, Bob and Mary Schindler, who are both practicing Catholics, dispute Mr. Schiavo's position, as do Mrs. Schiavo's brother and sister. The courts have all ruled in favor of Mr. Schiavo thus far, but her parents have vigorously appealed the decisions. Vatican officials, U.S. President George W. Bush, Florida Governor Jeb Bush, many Republicans, and several Democrats in the Florida Legislature and U.S. Congress have sided with Mrs. Schiavo's parents. Other groups and individuals, including the American Civil Liberties Union, many Democratic and several Republican legislators, have expressed support for the position of Michael Schiavo.

Schiavo was born as Theresa Marie Schindler. Her parents named her after Saint Theresa of Avila. She grew up in the Huntingdon Valley area of Lower Moreland Township, Pennsylvania, a suburb of Philadelphia, as the oldest of three children; her younger siblings are Robert, Jr. (Bobby) and Suzanne. Her childhood and high school years were spent as a chubby and shy girl who loved animals and kept hamsters and birds as pets. By her senior year in high school, Terri was overweight, with a height of 5'3" and a weight of 250 pounds. Terri went on a NutriSystem diet and was able to lose 100 pounds. [3] Terri may have developed an eating disorder around this time in order to cope with her weight problem. [4] In 1981, Terri graduated from the private Catholic high school, Archbishop Wood High School, in nearby Warminster Township.

After Terri lost weight, her sister Suzanne claims that Terri fell for the first guy who came along and paid attention to her. [5] Terri met Michael Schiavo in 1982 in a sociology class at Bucks County Community College in Newtown, where they were both students. After dating for five months, the couple got engaged and were married on November 10, 1984. The couple moved to St. Petersburg, Florida in April 1986. Bob and Mary Schindler, Terri Schiavo's parents, also moved to St. Petersburg three months later. In Florida, Schiavo worked as an insurance-claims clerk for the Prudential insurance company and her husband was a restaurant manager. Terri Schiavo's friends began to have suspicions about her eating habits. After meals out, she would immediately excuse herself to go to the bathroom. Michael Schiavo was aware of her strange eating patterns but did not realize their potential danger.

In 1989, the Schiavos began visiting an obstetrician and receiving fertility services and counseling in the hopes of having a child. At this time, Terri Schiavo's weight had dropped to 110 pounds and she had stopped menstruating. However, the physician who examined Terri Schiavo did not take a complete medical history, which would have indicated an eating disorder. [6]

On the morning of February 25, 1990, around 5:30 a.m. EST, Schiavo collapsed in the hallway of her St. Petersburg apartment. Michael Schiavo awoke out of bed and immediately called Terri's family and dialed 911 emergency services. Schiavo had suffered a cardiac arrest, and while waiting for the paramedics to arrive, she experienced a loss of oxygen to the brain. Attempts were made to resuscitate Schiavo, but she remained unconscious and slipped into a coma. In order to keep her alive, Schiavo was intubated, ventilated and trached; she was also given a percutaneous endoscopic gastrostomy (PEG) to provide nutrition and hydration. Schiavo emerged from her coma two and a half months later at Humana Northside Hospital, but she has never exhibited any evidence of higher cortical function.

According to her discharge summary from Humana Hospital, Schiavo suffered cardiac arrest and anoxic brain damage, accompanied by seizures, respiratory failure, and an injured knee from the fall. The cause of her cardiac arrest is believed to be due to a bulimia nervosa-induced hypokalemia (abnormally low levels of potassium in the blood). At the time of her hospital admission, her blood potassium level was 2.0 mEq/L; the normal range for adults is 3.5–5.0. Medical records noted 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." [7]

On May 12, 1990, Schiavo was discharged to the College Park Skilled Care and Rehabilitation facility. The court appointed Michael Schiavo as Terri's legal guardian without objection from the Schindlers on June 18. Schiavo was transferred to Bayfront Hospital for further rehabilitation efforts on June 30. Terri Schiavo came home to her family in September, but after being overwhelmed with Schiavo's needs, the family sent her back to the College Park facility. In November, Michael Schiavo took Terri to California for an experimental procedure involving the placement of a thalamic stimulator implant in Terri's brain. The experimental treatment took several months, and Michael returned to Florida with her in January 1991.

In 1992, Michael Schiavo brought a medical malpractice suit against the obstetrician who had been treating Terri for infertility, charging that the doctor had failed to diagnose the hypokalemia. The jury concluded that Schiavo had indeed suffered from bulimia, which had caused her hypokalemic blood imbalance and subsequent cardiac arrest, and had not been properly diagnosed by the obstetrician. The case was appealed and then settled in January 1993 before the appeal could be decided; Terri Schiavo received $750,000 and Michael Schiavo received $300,000. Florida's Second District Court was also later to find that Schiavo's cardiac arrest had been the result of a potassium imbalance.

Schiavo's condition and prognosis are disputed between Mrs. Schiavo's parents, and the courts and medical authorities. The only facts that the parents appear not to dispute are that she is not in a coma, she is severely brain damaged, and she is partially blind. Following her collapse, she was fed through a gastric feeding tube. This is the life support mechanism around which the case revolves.

Since 1991 the Schiavos' personal physicians and six different court-appointed physicians have concluded that Schiavo is in a persistent vegetative state (PVS). Patients in a persistent vegetative state have severe brain damage and are in a state of "wakefulness without awareness". In many cases the persistent vegetative state occurs after coma, which is consistent with Schiavo having been in a coma following her collapse. Patients in a persistent vegetative state are usually considered to be unconscious and unaware. They may experience sleep-wake cycles or be in a state of chronic wakefulness. They may exhibit some behaviors that can be construed as arising from partial consciousness—reflex or random behaviors such as grinding of teeth, swallowing, smiling, shedding tears, grunting, moaning or screaming without any apparent external stimulus. They are unresponsive to external stimuli, except, possibly, painful stimuli.

Schiavo's parents claim that their daughter does not meet the definition of a persistent vegetative state. Her parents claim that she smiles, laughs, cries, moves and makes childlike attempts at speech and that she attempts to say "Mom" or "Dad" or "yeah" when they ask her a question. They claim that when they kiss her she looks at them and sometimes "puckers up" her lips. Schiavo's parents videotaped Terri for four and a half hours and produced six video segments totaling four minutes and twenty seconds. Schiavo's parents cite the testimony and affidavits of 33 physicians and therapists (including 15 neurologists) who, after reviewing these four and a half minutes of video segments, believe that Schiavo should receive further tests and/or would likely respond to therapy. Only two of these physicians had access to her full medical history and examined her in person. Some of these physicians have claimed that there is a "strong likelihood that Mrs. Schiavo is in a 'minimally conscious state'". None of the physicians saw the full four and a half hours of video. (The six video segments have been released publicly. The rest of the recorded video has not been released by Schiavo's parents.) [8]

Schiavo's parents stated that several days after the removal of the feeding tube, Schiavo made an attempt to say "I want to live" in response to their attempts to coach her. An emergency motion to restore the feeding tube claims that "she managed to articulate the first two vowel sounds, first articulating AHHHHHHH and then virtually screaming WAAAAAAAA." The incident occurred only in the presence of family members and has not been independently confirmed; Schiavo has not been able to speak since her heart attack in 1990. Judge Greer said that Schiavo's utterances came only after being touched, which was consistent with evidence presented in 2002. "All of the credible medical evidence this court has received over the last five years is that this is not a cognitive response, but rather something akin to a person jerking his/her hand off a hot stove long before he/she has thought about it," Greer wrote. [9]

The lack of oxygen to the brain suffered after Schiavo's heart attack in 1990 caused catastrophic brain damage. Schiavo's cerebral cortex has been completely destroyed and replaced by cerebrospinal fluid. The upper brain is about 80 percent destroyed, and there is also damage to the lower brain. The only part of the brain that remains intact is the brain stem, which controls functions such as breathing and heartbeat—allowing Schiavo to survive (with a feeding tube) even though she no longer has any cognitive function.

Dr. Ron Cranford, a neurologist at the University of Minnesota, assessed Schiavo's brain function in 2001 as part of a court-ordered assessment. He was quoted in Florida Today as saying "[Schiavo] has no electrical activity in her cerebral cortex on an EEG (electroencephalogram), and a CT (computerized tomography) scan showed massive atrophy in that region." [10]

Three Florida neurologists viewed 12 of Schiavo's CT scans on March 22 [11]. After viewing the scans, Dr. Leon Prockop (a professor and former chairman of the neurology department at the University of South Florida's College of Medicine) was quoted by the Sun-Sentinel as saying that Schiavo's scan exhibits the "most severe brain damage as I've ever seen". Dr. Walter Bradley, the chairman of neurology at the University of Miami's Miller School of Medicine, said that he "doubts there's any activity going on in the higher levels of her brain". [12]

In 2002, a trial was held to determine whether or not any new therapy treatments would help Schiavo restore any cognitive function. A new computed axial tomography scan (CAT scan) was done, and showed severe cerebral atrophy. An EEG showed no measurable brain activity.

Five doctors were selected to provide their expert opinions to the trial: two by Schiavo's parents, two by Michael Schiavo, and one by the court. These five doctors examined Terri Schiavo's medical records, brain scans, the videos, and Schiavo herself. The physicians were divided in their conclusions. The two doctors selected by Schiavo's parents (one of whom was a radiologist, not a neurologist; the other of whom made several claims about therapies supposedly developed by him which the court found spurious) supported their conclusion; the two doctors selected by Schiavo's husband and the doctor appointed by the court supported Mr. Schiavo's position. Greer ruled with the latter that Terri Schiavo was in a PVS and was beyond hope of significant improvement. [13]

Florida's Second District Court of Appeal reviewed all the evidence and upheld the trial court's decision, saying had they heard the case themselves they would have ruled the same as Greer. Judge Greer reviewed a six-hour tape of Schiavo and concluded that her vegetative condition was factual and not subject to legal dispute.

Schiavo could be evaluated with a PET scan in her current condition. However, an MRI cannot be done without first surgically removing experimental electrodes which were implanted within her brain in 1992, something that Michael Schiavo has chosen not to do. [14] At any rate, neither a PET nor an MRI could change the fundamental finding of both X-rays and CAT, which is that over 50 percent of Terri's brain is destroyed.

Neurologists have noted that if Schiavo is indeed in a PVS, she is not experiencing pain, hunger or thirst due to the removal of the feeding tube. [15] Perry G. Fine, the vice president of medical affairs at the National Hospice and Palliative Care Organization, was quoted in the Los Angeles Times as saying that "What my patients have told me over the last 25 years is that when they stop eating and drinking, there's nothing unpleasant about it. In fact, it can be quite blissful and euphoric...the word 'starve' is so emotionally loaded. People equate that with the hunger pains they feel or the thirst they feel after a long, hot day of hiking. To jump from that to a person who has an end-stage illness is a gigantic leap." [16][17] However, Auschwitz survivors did not paint such a nice picture of death by starving, and it was universally regarded as one of the intensely cruel practices of Nazi Germany. Also, the same newspapers who reported claims that starvation is "blissful" have also reported on starving people in India "clutching their stomachs in pain".

On March 25, Robert Schindler told the media that his daughter's lips and eyes were "bleeding" from lack of hydration, that her skin was "peeling," and that she was "fighting like hell to stay alive". [18] This is consistent with known cases of death by dehyration.

In a news conference the following day, Michael Schiavo's attorney, George Felos, a leading euthanasia advocate, disputed that there was bleeding, saying "she looked beautiful. In all the years I've seen Mrs. Schiavo, I've never seen such a look of peace and beauty upon her." [19] However, critics argue that if Terru were truly in a PVS, then she would not be peaseful by definition. On March 27, Schindler family attorney David Gibbs stated that Schiavo was receiving morphine, again unnecessary if she truly were in a PVS. [20]

In most cases, patients die ten to 14 days following the removal of a feeding tube.

Under Florida law, Michael Schiavo, Terri's husband, is her legal guardian. Schiavo says his wife would not have wanted to live as a "vegetable" and that he is fighting for her right to die. As a result, he has had her placed in a hospice. Following a falling out with the Schindlers, he has placed limits on the time her family is allowed to visit her. To date, he has successfully fought the efforts of Terri Schiavo's parents to replace him as guardian and take control of her care.

Although his wife never wrote a living will expressing a wish to refuse nutrition or medical treatment if disabled, Mr. Schiavo says they had conversations which make him sure she would not want to continue living in such a state; Michael's brother and sister-in-law (Terri's best friend) both testified in support of this claim. Michael Schiavo recalled Terri saying, "I don't want to be kept alive on a machine."

In 1994, after three years of trying traditional and experimental therapies, Schiavo accepted the diagnosis of an irreversible persistent vegetative state. In consultation with Terri's physician, Schiavo halted most therapy for his wife. In May 1998, seven years after Terri's collapse, Michael Schiavo filed a petition to discontinue life support for Terri Schiavo.

In an appearance on ABC News's Nightline on March 15, 2005, Michael Schiavo cited the willingness that Mrs. Schiavo's family expressed to keep her alive by multiple extreme measures, including quadruple amputation if needed, as an important reason for denying transfer of guardianship to the family or other parties with similar desires. [21]

Hospice staff describe Mr. Schiavo as a very supportive husband who berated nurses for not taking better care of his wife; in 1994 the hospice attempted (unsuccessfully) to get a restraining order against him because he was demanding more attention for his wife at the expense of other patients' care. Due to the attention she has received in the 15 years she has been bedridden, Terri Schiavo has never developed any bedsores.

Raising the issue of a possible conflict of interest is the fact that Mr. Schiavo stands to inherit the remainder of Mrs. Schiavo's malpractice settlement upon her death. Mr. Schiavo has publicly responded to this charge by claiming that of the original $1,050,000 awarded in the malpractice suit, less than $50,000 is left, the rest having been spent under a judge's supervision on medical care for Mrs. Schiavo and the ongoing legal battle. He had also had a contract drafted stating that should the Schindlers refrain from any further legal action, he will donate whatever his inheritance may be to charity. The Schindlers refused the offer.

On March 11, 2005, media tycoon Robert Herring (who believes that embryonic stem cell research could cure Schiavo's condition in the future) offered $1 million to Michael Schiavo if he agreed to waive his guardianship to his wife's parents. The offer was rejected, Schiavo having reportedly found it "offensive". Schiavo's attorney, George Felos, stated that Schiavo has received other monetary offers, also rejected, including one of $10 million. These offers may have been made under the misconception that the removal of Mrs. Schiavo's feeding tube remains simply a matter of Mr. Schiavo's choice. It was ruled in February 2000 that Mrs. Schiavo would choose to have the tube removed, and Michael Schiavo does not have legal standing to overrule this legal determination.

A bone scan [22] performed one year after her 1990 injury showed, according to the radiologist who evaluated it, that Mrs. Schiavo had suffered prior traumatic injuries to multiple ribs (on both sides), to both sacroiliac joints, both knees, both ankles, several thoracic vertebrae, and to her right thigh, in addition to a minor compression fracture of the L1 vertebra. Mrs. Schiavo's family did not know of the existence of this scan until November 2002, 12 years after her brain damage and entry into an incapacitated state. Forensic pathologist Dr. Michael Baden, provided with the scan but not with her history, suggested that physical trauma, specifically a head injury, probably caused Mrs. Schiavo's collapse, [23], though in a later interview [24], after learning her history, he agreed that the bulimia/hypokalemia explanation was also possible. The trauma is consistent with her cardiac arrest, fall, CPR attempts and eventual resuscitation.

Upon becoming aware of the bone scan report possibly suggesting previous abuse, the Schindlers petitioned the Pinellas-Pasco Circuit Court for a full evidentiary hearing to evaluate the new evidence. On November 22, 2002, probate judge George Greer denied the motion, stating that the issue of trauma 12 years earlier was irrelevant to the current case. [25]

Mrs. Schiavo's family and Dr. William Hammesfahr, a neurologist they hired to examine her in 2002, claim that she had been battered by her husband. Hammesfahr was later to be disciplined by the Florida Board of Medicine in 2003 regarding over billing charges for a stroke treatment [26] (the same treatment that he proposed to use in order to treat Terri in 2002). Hammesfahr has also been accused of incorrectly claiming to be a Nobel Prize nominee for a prize for which his nominator was ineligible to nominate him. [27]

Terri Schiavo's family has been battling her husband over her fate since 1993. Even though the courts have consistently upheld the ruling that Schiavo would choose to have her life support discontinued, her family members have used every legal measure available to them to prevent the disconnection of her feeding tube.

The Schindlers have taken videos of Terri that purportedly show her responding to them. They have enlisted the services of Galaxywave, Inc., "psychic healers" who claim to possess "Remote Healing ADAM Technology". On several occasions, the Schindlers put Schiavo in contact with these psychics via cell phone during their visits with her [28].

Her family claims that Schiavo was a devout Roman Catholic who would not wish to violate the Church's teachings on euthanasia by intentionally starving or dehydrating herself to death, and that she never expressed such a desire to anyone in her own family or circle of friends. The Schindlers' legal fight has been and continues to be funded by a variety of sources on the political right [29].

Schiavo's father, Bob Schindler, has stated that Florida State Judge George Greer, who has pronounced several of the recent decisions in the case has never called her into the courtroom or visited her to observe her condition first-hand. Schindler feels that if his daughter dies in accordance with the court order to have her feeding tube removed, it will be an instance of "judicial homicide".

In a court case in 2003, the Schindlers submitted two affidavits filed by nurses who cared for Schiavo between 1995 and 1997. [30] [31]. The nurses claim that Schiavo was responsive, that Michael Schiavo did not allow any therapy for her and was eager to see her die; one affidavit even claims that he attempted to kill her with insulin injections. Judge Greer ruled that these statements were "incredible to say the least" as they were contradicted by medical records and other testimony [32].

The cause of the breakdown in communication between the Schindlers and Michael Schiavo is controversial. There was an apparent confrontation on Valentine's Day of 1993 [33].

Michael Schiavo claims that he was in Terri's nursing home room studying to become a nurse so he could personally care for his wife. When the Schindlers arrived, Michael maintains that Bob Schindler began to demand money, became belligerent and stormed out of the room.

Mary's testimony showed a far different story. Mary Schindler testified that Michael Schiavo had promised to reimburse the Schindlers for letting him live rent-free at their condominium and for other financial assistance. While conversing about financial issues, the Schindlers were suggesting that they could now afford specialized care for Terri with the money from the malpractice suit. Michael denied this request and threatened that the Schindlers would never again see their daughter.

Michael Schiavo first sought permission to remove his wife's feeding tube in November 1998. Her feeding tube was removed first on April 26, 2001, but was reinserted two days later on an appeal by her parents.

On October 10, 2003, the final remaining appeal filed by the Schindlers was dismissed. Five days later, on October 15 Schiavo's feeding tube was removed for the second time. On October 21, the Florida Legislature, in emergency session, passed "Terri's Law" which gave Florida Governor Jeb Bush the authority to intervene in the case. Bush immediately ordered the feeding tube reinserted.

On May 19, 2004, Florida Judge W. Douglas Baird overturned the law saying that it "summarily deprived Florida citizens of their right to privacy". Bush appealed the ruling to the Florida Supreme Court and on September 23, 2004 they reached a unanimous decision [34], ruling that the legislative and executive branches of government unconstitutionally intervened in a judicial matter (against the separation of powers under the U.S. Constitution) and that "Terri's Law" was unconstitutionally retroactive legislation. [35] The family immediately appealed to the U.S. Supreme Court. On January 24, 2005, the Supreme Court refused to hear the case.

Thomas Sowell on the other hand argued:

The liberal line, both in politics and in the media, is Congress somehow behaved unconstitutionally (in the Terri Schiavo case). All federal courts except the Supreme Court are created by Congress. The Constitution itself gives Congress the authority to define or restrict the jurisdictions of federal courts, including the Supreme Court. Is the Constitution unconstitutional?[36]

Nineteen different Florida state court judges have at various times considered the Schindlers' request on appeal in six state appellate courts. Appellate courts do not reconsider evidence, but can only rule whether a trial is conducted properly; [37] none of these courts have found legal grounds to overturn the initial ruling [38]. The final ruling came on February 25, 2005 when Judge George Greer ordered the feeding tube removed on March 18, 2005.

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There has been a large outcry from Christian right groups demanding that Schiavo's tube be restored so that she continue to live. Some disability rights groups, such as Not Dead Yet, have also protested the removal of Schiavo's feeding tube.

Dozens of protesters, including many children, have been arrested outside the hospice where Schiavo is located. Most of these have arranged non-violent staged arrests, usually by crossing a police line in a symbolic attempt to bring water to Schiavo, to make a statement. One man, a family therapist by profession, ran past police and reached the front door of the hospice; he was stunned with a Taser and apprehended.

Arrests have been made in two separate murder plots against Michael Schiavo: one in which a North Carolina man is accused of offering $250,000 for the murder of Michael Schiavo and $50,000 for the murder of Judge Greer; and the other in which an Illinois man robbed a Florida gun store as part of an effort to "rescue Terri Schiavo". Additionally, the wife of one of Michael Schiavo's brothers has been targeted; a white car drove by her home three times over the course of several hours, and on the last pass the driver shouted to her "If Terri dies, I'm coming back to shoot you and your family." Another of Michael Schiavo's brothers says that he receives death threats every time the case is in the news [39].

However, it should be noted that, while Michael Schiavo's home address is a well known matter of public record that has been visited by many of the Schindlers' supporters, no harm or threat of harm has ever been directly directed towards him. Instead, those who have visited the house merely laid flowers on his front lawn in an act of silent protest against Schiavo's actions. [40]

Judge Greer and his family are under protection from U.S. Marshals due to death threats for having ruled against restoring Terri Schiavo's feeding tube. Additionally, he left his Southern Baptist congregation, Calvary Baptist Church, in Clearwater, after they agreed that Terri should not be starved and dehydrated to death. [41]

Most polls show that a majority of Americans believe that Michael Schiavo should have the authority to make decisions on behalf of his wife and that the United States Congress overstepped its bounds with its intervention in the case. [42]

According to an ABC News poll from March 21, 70 percent of Americans believe that Terri Schiavo's death should not be a federal matter, and are opposed to the legislation transferring the case to federal court. In the same poll, a 63 percent majority said that they support the removal of Schiavo's feeding tube. A 67 percent majority agreed with the statement that "elected officials trying to keep Schiavo alive are doing so more for political advantage than out of concern for her or for the principles involved." [43]

A poll by CBS News showed that 82 percent of respondents believe the Congress and President should stay out of the matter, while 74 percent thought it was "all about politics". Only 13 percent think Congress acted out of concern for Terri Schiavo. Furthermore, Congressional approval ratings sank to 34 percent, the lowest number since 1997. [44]

One of the effects of this case is that Americans are showing an increased interest in living wills. Legal experts say that the entire court battle could have been avoided if Schiavo had properly documented her wishes prior to her collapse. Many newspapers ran articles and editorials on the importance of having a living will.

On March 17, 2005, members of the Florida Legislature were considering a bill that would make removing food and water from patients in a persistent vegetative state illegal without a living will. Although this bill was passed by the Florida House of Representatives by a vote of 78 to 37, the Florida Senate defeated a similar measure hours later, 21 to 18. On March 23, 2005 the Florida Senate again debated this proposed law, and it was again rejected, 21 to 18.

Schiavo's feeding tube was removed again on March 18, 2005 at 1:45 p.m. EST. Around the previous midnight, U.S. Senate Majority Leader Bill Frist, a Republican from Tennessee, and Michael Enzi of Wyoming, also a Republican, announced that Terri Schiavo would be called to testify before the U.S. Senate Committee on Health, Education, Labor, and Pensions on March 28, 2005 in Washington. Frist serves on the committee; Enzi is its chairman. Because of her condition, Schiavo cannot testify, but the letter that they sent gave her federal protection as a prospective witness (a law used in the 1950s and 1960s, designed for Mafia witnesses, makes it a federal crime to prevent a person from testifying before Congress).

Republican leaders in the House of Representatives, including Dennis Hastert of Illinois, Tom DeLay of Texas, and Tom Davis of Virginia, opened a congressional inquiry of the House Government Reform Committee, to take place in Clearwater on March 25, and issued subpoenas for Terri and Michael Schiavo and several hospice workers. Greer struck down the subpoenas as unconstitutional and let the order that gave Schiavo permission to remove the feeding tube stand. Greer ordered that the tube be removed immediately, per Mr. Schiavo's request. Congress subsequently took no action to attempt to enforce the subpoenas.

On March 19, congressional leaders announced that they were drafting a bill which would transfer the case from state court to federal court. In the very early hours of March 21, Congress approved emergency legislation. Despite an absence of quorum, the Senate approved the bill (S. 686 CPS) by voice vote. The bill passed unanimously, with 97 Senators not present. Meanwhile, in the House of Representatives, deliberation continued during an unusual Sunday session. When it came to a vote, the motion was passed 203-58 (156 Republicans and 47 Democrats in favor, 5 Republicans and 53 Democrats against), with 174 Representatives (74 Republicans and 100 Democrats) not present on the floor at the time of the vote. The vote concluded at 12:41 a.m. EST; Bush returned from vacation at his Prairie Chapel Ranch in Crawford, Texas to Washington, D.C. and signed the bill at 1:11 a.m. when it became Public Law 109-3 [45].

The bill, colloquially known as the Palm Sunday Compromise, was extremely controversial. It only applied to Terri Schiavo and gave federal courts jurisdiction to review alleged violations of her constitutional rights, without regard to prior state court rulings. However, Congress did not attempt to create any new substantive rights for Schiavo, or include any provision requiring the federal court to order reinsertion of the feeding tube pending review.

President Bush came under fire from right-to-die supporters, who claimed a double-standard because as Governor of Texas he had personally signed into Texas law a right-to-die law, the Advance Directives Act.[46] This law, one of only three in the nation, allows a hospital under certain circumstances to end life-prolonging measures even against a living will or the will of the patient's family.

The U.S. Congress may also consider another bill to prevent Schiavo's death, called the "Incapacitated Person's Legal Protection Act" (House Resolution 1151).

Politically, views on the case have been roughly divided along traditional political lines, although there is significant variance on both sides. Editorials in publications such as National Review, The Weekly Standard, and The Wall Street Journal have supported keeping the feeding tube in place (with some of their commentators dissenting); The New York Times, among others, have supported the position of Michael Schiavo. On the other hand, some conservatives, such as former Representative Bob Barr, have expressed concern about the implications for federalism of a bill that involves the federal government in a matter traditionally left to the states. [47] Many Democrats have simply stayed away from the controversy.

Republican House Representatives Tom DeLay of Texas and Senator Bill Frist of Tennessee, a cardiologist, have spoken in favor of keeping Schiavo alive, as has President George W. Bush. Critics say that Frist's stance on this issue appears to indicate a reversal in his personal opinion, as he has previously argued for the definition of brain death to be extended to include anencephalic conditions of the type seen in this case. Democratic Senators Tom Harkin and Kent Conrad have also supported federal intervention in the Schiavo case, although Republican Representative Dave Reichert was against it. Especially outspoken Democratic congressmen who have protested the federal intervention include Henry Waxman, Robert Wexler, Barney Frank, and Debbie Wasserman Schultz.

On March 22, 2005, the Los Angeles Times reported on then-Gov. George W. Bush's signing of a 1999 bill which allowed medical professionals to remove life support from a patient, even over the objections of family members, if they determined that there was no further hope for the patient. Many people felt this was inconsistent with his position in the Schiavo case. White House Press Secretary Scott McClellan said that those raising the 1999 bill were "uninformed" and that the "legislation that he signed into law actually provided new protections for patients"; however, these "new protections" were in comparison to an earlier bill. By signing the bill, Bush did give his support to medical professionals making end-of-life decisions for patients unable to express their wishes, such as Sun Hudson, a 6-month-old boy whose breathing tube was removed that week at Texas Children's Hospital over the objection of his mother. [48]

On March 26, 2005, the Los Angeles Times reported that Congressman DeLay and his family decided, in 1988, to allow his father to die after he was badly injured in a tram accident. "Extraordinary measures to prolong life were not initiated," said the medical report of Charles DeLay, and cited "agreement with the family's wishes". The Los Angeles Times contrasted this with his current stance on the Terri Schiavo case. [49].

According to a talking points memo circulated among Republican senators and reported on by ABC News and The Washington Post, the Schiavo case offered "a great political issue" that would appeal to the party's base (core supporters). [50] Senate Majority Leader Bill Frist denounced the memo and asserted that the Republican Party's interest in the case was solely based on moral grounds. Various commentators from the Weekly Standard [51][52], Slate [53], and bloggers[54] have raised questions about the authenticity of the memo. The source of the memorandum has not been disclosed by either ABC News or the Washington Post, but both news organizations are standing behind the story. Howard Kurtz of the Washington Post, however, has reported the controversy about the memorandum's authenticity. [55]

Schiavo's parents, Bob and Mary Schindler, filed a request for an emergency injunction with the U.S. District Court for the Middle District of Florida in Tampa on March 21. The claims were chiefly that the rulings of the state court judges were biased or unfair, and that removal of the feeding tube constituted a risk that Schiavo, as a Roman Catholic, would face extended time in purgatory. A two-hour hearing on the injunction was held on March 21 before Judge James D. Whittemore.

Early on March 22, he refused to order the feeding tube reinserted. In his opinion, he applied the mandatory four-prong test set out by the 11th Circuit for preliminary injunctions, and concluded that the Schindlers were "exceedingly unlikely to prevail on the merits of the case," one of the four prongs.

The case was appealed. In the early morning of March 23, 2005 the 11th Circuit Court of Appeals in Atlanta denied the request to reinsert the feeding tube. The three-judge panel ruled 2-1. The majority opinion agreed with the district court that Schiavo's parents had failed to prove one of the four required prongs: that they had "failed to demonstrate a substantial case on the merits of any of their claims". In affirming the district court's analysis, the panel pointed out that Congress had considered the issue of expressly directing the district court to order the reinsertion of the feeding tube pending litigation on the merits, and had refrained from including such a directive. Thus, Congress had left the 11th Circuit's existing procedural law in place, and the district judge had applied the circuit's existing test correctly.

Later that day, the 11th Circuit refused to rehear the case as a whole (en banc) by a 10-2 vote.

On March 30, the Court agreed to consider a petition by Mrs. Schiavo's parents to have a new hearing to decide whether the feeding tube should be reinserted.

Schiavo's parents appealed again to the U.S. Supreme Court late on the night of March 23. They argued that Congress intended for the feeding tube to be reinserted when they passed the "Relief of the Parents of Theresa Marie Schiavo Act" (S 686 ES). The case first went to Justice Anthony Kennedy, who is responsible for all emergency appeals from the 11th Circuit. Although he could have acted alone, Kennedy chose to refer the case to the entire Supreme Court.

The Court declined to grant certiorari on the morning of March 24 in an unsigned one-sentence order (as is typical for nearly all rejections of appeals). One reason why the Court may not have accepted the case is that doing so might force the Court to develop a uniform nationwide test for the issuance of preliminary injunctions under Rule 65 of the Federal Rules of Civil Procedure. The Court has consistently denied review in every case raising that possibility for the past few decades, which is why every circuit has its own test for when such injunctions should be issued.

Following the Supreme Court's refusal to hear the case, Florida Governor Jeb Bush announced that he was going to investigate whether or not the Florida Department of Children and Families could take over Schiavo's care, on the grounds that the organization has the legal right to gain custody of incapacitated adults in emergency situations. On March 24, Judge Greer issued an injunction denying the Florida state government's right to take such an action. Governor Bush subsequently announced that he would take no action, denying that he had the authority to do so. This assertion was contested by Randall Terry and others, who claim that the governor has the executive power to take custody of Schiavo. [56]

On March 26, 2005, one day before Easter, Bob and Mary Schindler announced that their legal options were exhausted. Paul O'Donnell, Franciscan monk and spiritual adviser to the Schindler family, announced to those holding a vigil outside the hospice in Pinellas Park, Florida, "The family would request that everyone go home, be with your children, hold them close and share every moment you have with them."

On March 27 she was given the Anointing of the Sick ("Last Rites"). In accordance with Catholic tradition, a drop of wine was applied to her tongue, but a small piece of bread was unable to be offered due to the dryness of her mouth in her severely dehydrated condition. Prior to the removal of the feeding tube, she had taken communion.

On March 29, the Reverend Jesse Jackson prayed with the Schiavo family outside of her Florida hospital. Jackson called for Schiavo's feeding tube to be reinserted.

Michael Schiavo has announced that his wife will undergo an autopsy after her death, [57] to be performed by Pinellas County's chief medical examiner, Dr. Jon Thogmartin. [58]

Individuals who played significant roles in public debates and/or legal action regarding the issue of removal of life support:

• Sun Hudson
• Spiro Nikolouzos
• Karen Ann Quinlan
• Nancy Cruzan

Rhetorical terms used during the public and political debates:

• Culture of Life
• Culture of Death

• Terri Schiavo Case: Legal Issues Involving Health care Directives, Death, and Dying. Findlaw. A detailed compilation of legal documents related to the Schiavo case. [59]
• The New York Times Database (1996-present): An index of 71 articles from The New York Times relating to the Schiavo case (requires free registration) [60].
• "Before fight over death, Terri Schiavo had a life." CNN. October 25, 2003. [61]
• Breed, Allen G., and Matt Crenson. "Doctors: Schiavo tapes don't tell story." Associated Press. March 26, 2005. [62]
• Carey, Benedict, and John Schwartz. "Schiavo's condition holds little chance of recovery." The New York Times. March 26, 2005.
• "Excerpts from diagnoses of 6 Schiavo doctors." Associated Press. March 24. [63]
• Fackelmann, Kathleen. "Schiavo not likely to experience a painful death, neurologists say." USA Today. March 23, 2005. [64]
• Graham, Judith. "Schiavo's expressions misleading, experts say." Chicago Tribune. March 25, 2005. [65]
• Lamendola, Bob. "Neurologists see little sign of activity in Schiavo's brain." South Florida Sun-Sentinel. March 23, 2005. [66]
• Rufty, Bill. "Doctors lament misuse of proper terminology in Schiavo debate." The Ledger. March 23, 2005. [67]

• Report of Dr. Pearse, guardian ad litem, December 1998 (temporary guardian ad litem for 6 months in 1998) (pdf)
• Report of Dr. Wolfson, guardian ad litem appointed as a result of "Terri's Law," December 2003 (temporary guardian ad litem for 30 days in 2003) (pdf)
• Conclusions of neurologist William P. Cheshire, M.D., for the Florida Dept. of Children and Families (March, 2005) (pdf)
• Terri's Law (pdf)
• Florida Supreme Court Decision overturning Terri's Law as unconstitutional (pdf)
• Schiavo case timeline maintained by University of Miami Ethics Programs

• Terri Schiavo Information Page
  • Timeline and Legal Decisions
• Reference Page by Eric Zorn of the Chicago Tribune

• Online home of the Terri Schindler-Schiavo Foundation
• Blogs For Terri

• A Living Will Is The Best Revenge