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Terri Schiavo R.I.P.

The controversy's aftermath one year later

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Terri Schiavo's tombstone reads "Born December 3, 1963: Departed this Earth February 25, 1990: At Peace March 31, 2005." Terri Schiavo may be "at peace" now, but the controversy over the removal of her feeding tube a year ago has not gone away. This week saw the publication of dueling books by her family members. Michael Schiavo's book is Terri: The Truth and her parents' book is A Life That Matters.

As part of the publicity for his new book, Michael Schiavo appeared on NBC's Dateline, saying that he chose to have his wife's feeding tube removed based on his understanding of her wishes. He recounted a conversation that they once had about a very disabled uncle who had to live with his mother. According to Schiavo, "Terri said to me, 'If I ever become a burden to anybody, don't ever let me live like that.' And I said, 'OK, and you do the same for me.'" Her parents claim that Terri would never have said something like that. Since none of us were there, we will never know who is right.

However, courts generally allow a spouse to make medical decisions for a patient if he or she is unable to communicate. Spouses, when acting as medical surrogates, are supposed to consider not what they think is best for the patient but what they believe the patient would want. According to recent studies, surrogates get it wrong about one-third of the time. Part of the problem is that over the course of a year about 70 percent of patients change their minds. While recognizing this problem, the presumption that such medical decisions nevertheless should be left in the hands of patients' loved ones is probably the best that physicians, hospitals and courts can do. And so despite abusive meddling by the state government of Florida and the Congress of the United States, the courts properly left the ultimate decisions about Terri Schiavo's care up to her husband.

And the interference was massive. Who can forget the physician, Senate majority leader, and Republican presidential hopeful Bill Frist's (R-Tenn.) long distance diagnosis of Schiavo on the floor of the Senate. "I have had the opportunity to look at the video footage upon which the initial facts of this case were based," declared Frist, adding "Based on the footage provided to me, which was part of the facts of the case, she does respond." Rep. Phil Gingrey (R-Ga.), another congressional Republican doctor, insisted that Schiavo could improve "with proper treatment, now denied." The Sooner State family doctor Sen. Tom Coburn (R-Okla.) said, "All you have to do is look at her on TV. Any doctor with any conscience can look at her and know that she does not have a terminal disease and know that she has some function." Pennsylvania Sen. Rick Santorum (R-Penn.) likened pulling Schiavo's feeding tube to an "execution."

After making their video diagnoses, our legislators got busy. After all, a leaked memo from a Republican staffer had also diagnosed Schiavo's plight as "a great political issue" that would help the GOP rally conservative Christians for the 2006 election. In March, three Senators during an extraordinary Palm Sunday session passed "emergency" legislation to throw the Schiavo case into the federal courts by a "unanimous" vote. The members of the House of Representatives rushed back from their Easter holiday to vote 203 to 58 for the bill. Those voting in favor included 156 Republicans and 47 Democrats. And President George W. Bush melodramatically flew back from his Texas ranch to sign the legislation. All for naught, because the federal courts all quickly ruled in favor of Michael Schiavo.

On March 18, doctors removed Schiavo's feeding tube and on March 31, more than 15 years after she collapsed, Terri Schiavo was at last at peace. In June, Jon R. Thogmartin, a pathologist in Florida's sixth judicial district, released his autopsy report of Schiavo. Thogmartin found that Schiavo's brain had shrunk to half its normal weight, and her brain damage was so severe that "no amount of treatment or rehabilitation would have reversed" it.

What about all those videos that Congress had used to diagnose Schiavo? Didn't the videos show her looking at people and following balloons with her eyes? Thogmartin found that Schiavo's visual cortex was so damaged that she was almost certainly blind, though there was the very remote possibility that she did experience the phenomenon of blindsight. The consulting neuropathologist found that the condition of Schiavo's brain was "consistent with a persistent vegetative state." In other words, in any relevant sense Schiavo had indeed departed this world well before March 31, 2005.

But a vindictive Florida Gov. Jeb Bush was not finished. After the autopsy report was released, Bush asked a Florida prosecutor to open another investigation into Schiavo's 1990 collapse. In July, the prosecutor informed Gov. Bush that he could find no proof that a crime had been committed and closed the case.

This week an ABC News poll shows that 64 percent of the American public believes removing Schiavo's feeding tube was the right thing to do. Remember that cynical Republican memo about what "good politics" the Schiavo case was? The new poll finds 61 percent of evangelical white Protestants and 73 percent of white Catholics agree that removing the tube was the right decision. Perhaps the ghoulish politicians who meddled in this private family tragedy have miscalculated and will be punished by the voters in November 2006. One can only hope.

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