Tube is Removed after a Chaotic Day

Right to Die Issues

Newspaper article

By: William R. Levesque, Anita Kumar, Chris Tisch, and Graham Brink.

Date: March 19, 2005

Source: Lesvesque, William R., Anita Kumar, Chris Tisch, and Graham Brink. "Tube Is Removed After a Chaotic Day." St. Petersburg Times (March 19, 2005).

About the Author: This article was written by four journalists for the St. Petersburg Times, a daily newspaper based in Florida with a circulation of more than 300,000.

INTRODUCTION

On February 25, 1990, twenty-six-year-old Terri Schiavo suffered a cardiac arrest thought to have been caused by a chemical imbalance triggered by an eating disorder. The oxygen supply to her brain was cut off for five minutes, causing irreversible brain damage and leaving the young woman in a persistent vegetative state (PVS). Neurological examinations revealed minimal brain activity, and it was necessary to provide artificial nutrition and hydration through a tube from then on to maintain Terri Schiavo's life.

According to Florida law, Michael Schiavo, Terri's husband, became her legal guardian. In 1998, he filed a petition to have the feeding tube removed so she could die naturally. This, he claimed, is what she would have wanted, since there was no hope for her recovery. The case might have ended there, except that Terri's parents, Bob and Mary Schindler, disagreed. They argued that she might recover. The feeding tube was first removed on April 24, 2001, but was reinserted only two days later. In 2002, a Florida trial court judge conducted six days of hearings, including evidence from neurologists called by Michael Schiavo and the Schindlers. The latter relied on video evidence showing signs of apparent alertness and responsiveness on Terri's part; such signs are not uncommon in PVS and can appear somewhat deceptive, since there is still no meaningful brain activity.

Terri Schiavo's feeding tube was removed for a second time on October 15, 2003, but a few days later, Florida's lower house passed what became known as "Terri's Law," which gave Governor Jeb Bush the power to order doctors to reinsert the tube. On October 23, 2003, the tube was reinserted a second time and shortly thereafter, Michael Schiavo asked a Florida court to rule "Terri's Law" unconstitutional. On September 23, 2004, Florida's Supreme Court struck down the law. Jeb Bush and the Schindlers' supporters, including those in the U.S. Congress, fought on. Judge Greer, who had been involved from the start, rejected these appeals and ordered removal of the tube for the third, and final, time on March 18, 2005, as described in the article below.

PRIMARY SOURCE

Pinellas Park, March 19— The U.S. Marshals had delivered the congressional subpoena for Terri Schiavo.

As the clock ticked to 1 p.m.—the hour a judge had ordered Schiavo's feeding tube be removed—a leading House Republican appeared before television cameras and reassured the nation that "Terri Schiavo will not be forsaken."

Fifteen years after Schiavo collapsed and seven years since the start of a bitter battle between her family to remove her feeding tube, Congressional leaders thought they had saved her.

Minutes later it all changed, again.

Pinellas-Pasco Circuit Judge George Greer faced off with lawyers for the U.S. House seeking to delay removal of the feeding tube. He stood his ground, and wondered why the federal government had suddenly shown up after all these years.

"The fact that … your committee chooses to do something today doesn't create an emergency, sir," Greer said. "I'm sorry. My order will stand."

A lawyer standing by at the Hospice House Woodside where Schiavo lives asked if the order was effective immediately.

"The word was forthwith," the judge repeated. Now.

At 1:45 p.m. a doctor uneventfully removed Schiavo's feeding tube. A crowd of over 200 protesters outside awaited word and prayed.

It was the climax of another remarkable day of legal and political intrigue in a case that has captured the attention of the world, from the halls of the Vatican to the chambers of both Congress and the Florida Legislature.

White House spokesman Scott McClellan said President Bush discussed the case with his brother, Gov. Jeb Bush, and members of the state's congressional delegation during his swing through Florida on Friday to discuss Social Security. "The president believes when there are serious questions or doubts in a case like this that the presumption ought to be in favor of life," McClellan said.

This is the third time Schiavo's feeding tube has been removed, and she is expected to die within two weeks unless her parents, Bob and Mary Schindler, find a way around court orders.

Even with the tube removed, few are willing to predict events in the coming days given a case whose unpredictable and complicated history is thought unprecedented for any right-to-die case.

Two previous times, the Schindlers have won orders to reinsert the tube, the last time in 2003 when state law-makers passed a law to accomplish it. The courts declared it unconstitutional.

Lawmakers in the nation's capitol were shocked their 11th hour tactic to subpoena witnesses and win delay didn't work, and described the removal of Schiavo's feeding tube as barbaric.

"Mrs. Schiavo's life is not slipping away—it is being violently wrenched from her body in an act of medical terrorism," House Majority Leader Tom DeLay said.

This time, the Schindlers lawyers acknowledge they are nearly out of legal options. "We're now up against a very tight clock because Terri is in the process of being starved to death," David Gibbs III said. "It looks like she's going to have a hungry weekend."

George Felos, attorney for Schiavo's husband, Michael Schiavo, condemned political interference.

"It was odious. It was shocking. It was disgusting," Felos said. "They cannot walk over the dying body of Terri Schiavo for their own political gain."

But the Schindlers remain hopeful. Congress may yet pass a bill on Monday to keep their daughter alive. Michael Schiavo is just as hopeful the feeding tube won't be reinserted.

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The day opened with The U.S. House Government Reform Committee issuing five subpoenas to Schiavo and her husband, two doctors and a hospice employee to appear at a hearing at the Pinellas Park hospice March 25 and to maintain "in its current operating state," the nutrition and hydration systems that have kept Schiavo alive.

A Senate committee sent a letter to Schiavo and her husband to appear at a March 28 hearing in Washington.

Congressional lawmakers had moved into action once it became clear the U.S. House and Senate wouldn't immediately draft new legislation to delay the removal of Schiavo's feeding tube.

"This is about getting all the facts," said Rep. Tom Davis, R-Va., chairman of the House Government Reform Committee, which issued the subpoenas. "The Senate and the House remain dedicated to saving Terri Schiavo's life," Senate Majority Leader Bill Frist said. The hearings are supposedly to review health care policies and practices of non-ambulatory persons or long-term care of incapacitated adults. But congressional leaders were not expected to go through with them since they were supposed to be used as a delay tactic only.

Federal criminal law protects witnesses called before official congressional committee proceedings from anyone who may obstruct or impede a witness attendance or testimony, and those who violates this law is subject to criminal fines and imprisonment.

Rep. Henry Waxman of California, senior Democrat on the Government Reform Committee, called the subpoenas a "flagrant abuse of power."

"The committee has no business inserting itself in the middle of an excruciating private family matter," he said.

In Tampa, the Schindlers' attorney filed a petition in U.S. District Court, a "last-ditch" effort to get the courts to stop removal of the feeding tube. Within hours, a judge tossed it out.

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Schiavo was 26 when she suffered cardiac arrest on Feb. 25, 1990. Her brain went without oxygen for five minutes. Doctors believe she suffered a chemical imbalance possibly caused by an eating disorder.

While the court, based on doctors' testimony, ruled she is in a vegetative state, her parents say she isn't. People in a persistent vegetative state may sleep and wake, grimace or laugh. But such movements are involuntary. They are not conscious, have no awareness of their surroundings, and have no thinking abilities.

On Friday, the Government Reform Committee petitioned Greer to intervene in the case so it could ask for a delay. Greer called an emergency hearing in Clearwater.

As the legal drama unfolded, a hospice priest administered communion to Schiavo, a Catholic, through the tube, and the last rites.

With events breaking quickly, Greer, lawyers for the House, Michael Schiavo and the Schindlers along with reporters crowded into a conference room at the courthouse as a telephone conference was set up.

At 12:30 p.m., just a half hour to the planned tube removal, Greer hadn't called into the conference.

Pinellas-Pasco Circuit Judge David Demers, chief of the circuit, got on the line and said he was trying to get in touch with Greer, who was guarded at an undisclosed location. Demers temporarily barred removal of the feeding tube, but ordered everyone to remain on standby.

Minutes later, Greer contacted a bailiff by cell phone and the hearing began. Greer quickly dispensed with the House motion to intervene. As a House attorney explained why lawmakers wanted a delay to hold a hearing March 25 at the hospice, Greer cut him off. "How many other field trips are scheduled for people on feeding tubes?"

"I'm not aware that there are any others at this time," said attorney Kerry Kircher.

Minutes after Greer's confirmed his order, hospice staff asked family to leave Schiavo's room.

An unidentified representative of Michael Schiavo and a doctor, and hospice staff, were in the room before the tube was removed. They said a prayer, Felos said, and shed some tears.

"It was a very calm, peaceful procedure," he said. "Of course with a degree of emotion."

Michael Schiavo came to the room shortly after the tube was removed, Felos said.

Schiavo's brother-in-law, Michael Vitadamo, also was inside Terri's room when family was asked to leave. They were allowed back in about 4 p.m.

In that time, Schiavo had been moved from her bed to a chair. The room had been rearranged so a police officer could observe any visitors inside the room. The tube was gone.

The Rev. Patrick Mahoney, director of the Christian Defense Coalition, said protesters will try to bring bread and water into the hospice today. Mahoney said when police officers stop the protesters, they will say "I'm sorry, I must feed my sister."

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Gibbs said he had one remaining legal option: an appeal to the federal 11th Circuit appeals court in Atlanta that he planned to file quickly.

And he hasn't given up hope that Florida lawmakers may yet step in. The Florida House has passed a bill, but few expect their measure to gain approval in the Senate.

The U.S. House appealed Greer's order to the Florida Supreme Court. The court quickly dismissed it. Late Friday, the House went to the U.S. Supreme Court and asked it to order the feeding tube to be reinserted while it pursues appeals to have its subpoenas recognized.

House and Senate leaders are meeting behind closed doors this weekend, and expect to return to the Capitol Monday afternoon to vote on a bill.

As of late Friday, the two chambers still had major differences.

Both bills sought the same result: moving the case to federal court, where a judge would hold a new trial to review the facts and determine whether Schiavo's rights were violated.

Late Friday, Republican House members were told to remain accessible throughout the weekend.

"We will fight for Terri's life and spend all the time necessary to do that," DeLay said. "For friends, family and the millions of people praying around the world this Palm Sunday weekend, Terri Schiavo will not be forsaken."

SIGNIFICANCE

Terri Schiavo died on March 31, 2005. The thirteen days between the final removal of her feeding tube and her death were marked by a further flurry of legal activity involving President George W. Bush himself. On March 20, the Senate passed an emergency bill calling for a review of the case. This was backed by the House of Representatives and the president signed it in the early hours of March 21 to bring the law into effect immediately. Next day, a Florida judge refused to order the resumption of feeding and appeal judges backed the decision. The Supreme Court then refused to hear an emergency appeal from the Schindlers and, over the next few days, five further appeals were rejected.

The Schiavo case caught the attention of the U.S. and, indeed, of the world. It is being seen as a landmark in the ethical, legal, and political debate over the right to die. Most cases of PVS do not attract this level of attention, because the family is usually united over what the patient would have wanted. It also helps if the patient has left a living will, describing his or her wishes in the event of losing the ability and competence to make medical decisions. Terri had not left a living will, so it was up to her husband to decide. The breakdown in relationship between the husband and the parents—with so many "right to life" campaigners (including Governor Bush and the president himself) siding with the parents—made this an immensely complex case. Besides arguing that Terri could recover from PVS, the Schindlers pointed out that Michael had been living with a woman with whom he had two children and that this complicated his attitude towards his wife.

The case signifies that, under the U.S. Constitution, there is a limit placed on the ability of politicians to interfere in individuals' lives. It is up to judges to interpret the law. Of course, many still think the judges were wrong to order the removal of Terri Schiavo's feeding tube for the third and final time. The Vatican, for instance, strongly condemned the decision. But doctors largely agree that although Terri, technically, starved to death, she would not have suffered, since she had no conscious awareness. Many medical experts also agree that to prolong her life artificially would have been both unethical and illegal.

FURTHER RESOURCES

Books

Lynne, Dianna. Terri's Story: The Court-Ordered Death of an American Woman. Grants Pass, Ore.: WND, 2005.

Periodicals

Quill, Timothy E. "Terri Schiavo—A Tragedy Compounded." New England Journal of Medicine 352 (2005): 1630-1633.

Web sites

BBC News. "Schiavo Case Tests America." 〈http://news.bbc.co.uk/1/hi/programmes/from_our_own_correspondent/4400865.htm〉 (accessed November 11, 2005).