Edit: I've also thrown in a very interesting piece from Bloggerman, part of which is an interview with the professor who had been Terri Schiavo's appointed independent representative.
August 27, 2003
Florida Bishops Urge Safer Course For Terri Schiavo
We continue our fervent prayers for Terri Schiavo, for her family, and all involved in this most difficult and heart wrenching situation. After a fourth consideration of her case, the 2nd District Court of Appeals has upheld the latest order of the trial court judge to withdraw her hydration and nutrition tube. An emergency appeal to the Florida Supreme Court was denied. Barring unforeseen legal intervention, the trial court will soon re-schedule the removal of Mrs. Schiavo’s feeding tube. It is most unfortunate that family members have not been able to agree on her care, forcing the Court’s involvement.
Bishop Robert N. Lynch of the Diocese of St. Petersburg has spoken in detail to this case (Concerning Terri Schiavo).* His statement followed careful consultation with his brother Bishops and we fully support it. Because of so much uncertainty and dispute, we reiterate his plea that her treatment be continued while all parties pursue a more clear understanding of her actual physical condition.
Bishop Lynch’s statement clarifies the teaching of the Church that nourishment or hydration may be withheld or withdrawn where that treatment itself is causing harm to the patient or is useless because the patient’s death is imminent. Church teaching is clear that there should be a presumption in favor of providing medically assisted nutrition and hydration to all patients as long as it is of sufficient benefit to outweigh the burdens involved to the patient.
The Church cannot make this decision, but her teaching guides those who must: the patient or those legally entitled to do so if the patient is unable. If Mrs. Schiavo’s feeding tube were to be removed because the nutrition she receives is of no use to her, or because she is near death, or because it is unreasonably burdensome for her, her family, or caregivers, it could be seen as permissible. But if her feeding tube were to be removed to intentionally cause her death, or because her life is perceived to be useless, or because it is believed that the quality of her life is such that she would be better off, this would be wrong.
Without question, removal of Mrs. Schiavo’s feeding tube will result in her death. We respect the need for finality of the court’s decision, but we urge additional time to allow greater certainty as to her true condition. We respect, too, the limitations on new evidence being considered by the court, but in matters of life and death, exceptions should be made. If additional medical treatment can be shown to be helpful to her condition, we urge that all parties involved take the safer course and allow it to be used.
Just as we are concerned for Terri Schiavo, we are also concerned for others who are weak and vulnerable. There is an inherent danger in assuming that food and water can simply be withheld without clearly knowing a patient’s wishes. There is reason to be circumspect and ever careful in these cases. We reject outright the euthanasia movement and its utilitarian standard that some lives are not worth living. Every life is precious and unrepeatable.
And finally, we remember there are times when one may refuse treatment that will result in a precarious and burdensome prolongation of life. Properly, this may be seen as an expression of our hope in the life to come. Let each of us communicate ahead of time with our families and loved ones, our wishes for treatment at the end of our lives. To do so will give great comfort to them in an emotionally stressful time.
We join our prayers with the family and loved ones of Terri Schiavo in this most difficult time.
Archbishop John C. Favalora
Archdiocese of Miami
Bishop John J. Nevins
Diocese of Venice
Bishop Norbert M. Dorsey, CP
Diocese of Orlando
Bishop John H. Ricard, SSJ
Diocese of Pensacola/Tallahassee
Bishop Victor Galeone
Diocese of St. Augustine
Bishop Robert N. Lynch
Diocese of St. Petersburg
Bishop-Designate Gerald M. Barbarito, JCL
Diocese of Palm Beach
Coadjutor Bishop Thomas G. Wenski
Diocese of Orlando
Bishop Lynch's statement concerning Terri Schiavo
* ( http://www.dioceseofstpete.org/news.php?NID=9 )
October 23, 2003
May God Bless and Keep Terri Schiavo
Tallahassee -- Following recent action by the Florida Legislature and Governor Jeb Bush to reinsert her feeding tube, we urge continued prayers for Terri Schiavo, and all in her family.
In the face of certain criticism and strongly expressed legal objection, the Governor and lawmakers have bravely risked erring on the side of protecting life. We applaud this courage and pray with them that clarity and resolution will follow in this tragic case.
In their August 27, 2003 statement, the Florida Bishops acknowledged the limitations on the court’s ability to consider new evidence, but said in matters of life and death exceptions should be made. They urged additional time to allow greater certainty as to Terri Schiavo’s true condition. The court’s order to withdraw her feeding tube, repeatedly upheld by the appellate court and refused for consideration by the Florida Supreme Court, is based on its finding of “clear and convincing evidence” that she would wish to have her feeding tube discontinued. The courts’ rulings reflect careful deliberation. Still, strong and genuine belief persists that new medical treatment will help her condition, and affidavits by physicians and others have created doubt that removal of her feeding tube is what she would want.
In their statements concerning Terri Schiavo, the Florida Bishops and Bishop Robert N. Lynch of the Diocese of St. Petersburg, have clarified the Church’s teaching about when it is permissible to withhold or withdraw nutrition and hydration. They have made clear that there should be a presumption in favor of providing medically assisted nutrition and hydration as long as it is of sufficient benefit to outweigh the burdens involved to the patient. They clarified also that there are times when one may refuse treatment, if it would result in a burdensome prolongation of life and that this may be properly seen as an expression of our hope in the life to come.
The Legislature will undoubtedly consider Florida’s Life-Prolonging Procedure Act during the 2004 session. The statutory definition of Persistent Vegetative State (PVS) does not square with clinical diagnoses of this condition. Clarity is needed here, but regardless of how this case is resolved, it must never be assumed that a PVS patient should automatically have nutrition and hydration removed. This should never be done without clearly knowing the patient’s wishes.
It is our ardent hope that while the judicial system further considers this extraordinary and extremely difficult case, that a true and convincing picture of Terri’s wishes and her condition will emerge. This case is even more tragic because the courts are to decide this matter instead of her family. A clear message to all of us is the responsibility to convey to our families and loved ones our wishes for treatment at the end of our lives.
May God bless and keep Terri Schiavo.
EDIT: Oh, and I found this entry from MSNBC's "Bloggerman" to be useful....
• March 24, 2005 | 8:00 a.m. ET
Some truths in the Schiavo case (Keith Olbermann)
SECAUCUS— The e-mail arrived over a week ago. It asked me to stop telling the “lie” that Terry Schiavo was brain-damaged. When I replied politely that independent physicians had concluded otherwise, the e-mailer wrote back.
She called me a “Nazi.”
Hysteria is a strong term to use, but it may be the correct one in the Schiavo case. A poll released Wednesday night by CBS News poll showing that an amazing 82 percent of all respondents believe the Congress and the president should not have gotten involved in the Schiavo case— and the interior numbers were even more startling. 76 percent of all Conservatives thought what the government did over the weekend was inappropriate. 72 percent of all Republicans. And even 68 percent— of all white, evangelical Christians.
The story is missing only two things: an explanation of how just one of the estimated 30,000 cases of individuals in a persistent vegetative state was elevated— and funded— into international prominence (we’ll address that below), and an obvious and respected, neutral observer, a fact-finder— someone acting not for Terry Schiavo’s husband, or her parents, or her congressman, or the politicians— but acting for her.
Actually, it once had such an individual, aman who, in October 2003, was appointed by a Florida court to spend 30 days reviewing every aspect of the Schaivo case— legal and medical (two areas in which he is fully accredited)— and then recommend to Governor Jeb Bush, how to proceed. He is Jay Wolfson, professor at the University of South Florida, a PhD in public health, with a law degree and I spoke with him on the Wednesday Countdown.
OLBERMANN: Let me start with this news of the day, the governor's announcement that there is a neurologist who thinks that perhaps Mrs. Schiavo is not in a persistent vegetative state but might have been misdiagnosed and could be minimally conscious. Is that plausible to you, or is it a red herring?
WOLFSON: There are several physicians across the country who have expressed that very opinion. I'm not familiar with what he did nor when he did it, nor how he did it. I understand from what you just said that he did not actually evaluate nor examine Terri. People are going to have different opinions.
And honest people are going to differ about their opinions. The fact is we're dealing with 15 years worth of medical evidence and legal evidence that were admitted through the Florida judicial system, based on laws that were created by the legislature, rules of evidence in the Florida courts, rules of civil procedure and the guardianship law in particular, which over 15 years evolved with very carefully designed bipartisan political and religious cooperation.
And you're either going to believe the facts that have been accepted by the courts, using the standards of competent evidence and clear and convincing evidence, or you're not.
And there's a reason why you won't. The reason why you won't is because it's hard. For those of us who are parents, I've got three sons. It's incomprehensible for to us imagine what it's like for these really good— the Schiavos are really good, decent people. I've got to tell you. They're the people I grew up with in Chicago. Their kids are the kids I played with. These are fine, decent people. But I cannot imagine one of my sons or anybody's son in a position where they're no longer capable of interacting and the idea of them dying by pulling a tube. It's extraordinary.
But the evidence that was submitted and the process that was used throughout the Florida judicial system and the federal judicial system substantiated that information about her state and about the evidence that was used to establish her intentions.
OLBERMANN: In your term as guardian at law, as the person asked by the court to represent Terri Schiavo and not her husband and not her parents, as good people as they might be, just her, what was the core issue about her health that you thought you needed to understand and what did you find out about it?
WOLFSON: Well, I sat with Terri for— I had only a month to do this, and I had to review 30,000 pages of document: medical records, legal records, extraordinary amounts of information. I spent time with her family. I tried to get to know Terri indirectly, and I spent about 20 days when I was in town by her bedside, as many as four hours at a time.
I spent time with her parents, with her husband. And I held her hand, and I held her head and I looked in her eyes and I stroked her. And I played music for her, and I asked her to help me.
I was looking for some consistent pattern of responsiveness, some consistent evidence that she was responding, as opposed to reflexing. And the clinical data, the clinical information about persistent vegetative states is that it consists of waking periods and sleeping periods.
And during the waking periods, the eyes move, the eyes are open. People make noises. And some of those noises sound like cries and some of them sound like laughter and some of them are groans, which some of your listeners may have heard. But there was, as hard as I tried, I couldn't get a consistent responses. I couldn't solicit any evidence.
And again, going back to the data in the files, the medical evidence and the legal evidence, there was nothing to indicate that she was not in a persistent vegetative state, given the standards of evidence and the medical knowledge that we have. The best we can do.
Justice Rehnquist said in the Cruzan case that we've got good law. We've got to apply the good law as well as we can. And I extrapolate that and say we've got to take best science and the best medicine we have.
I've got tremendous respect for Governor Bush. He's a wise and conscientious man. In his heart, I know what he feels. I really do.
And the Schindlers are wonderful people. It's not about Governor Bush, and it's not about the Schindlers, and it's not about the decent people outside of the hospice, and it's not about the Florida legislature. It's not about the Florida courts. It's not about the United States Congress. It's not about the U.S. courts. This is about Terri. It's about what her intentions might have been.
And if you don't believe what Michael and others have said about what she expressed after two funerals of her family members, which would have been in context, who were on respirators and who died. And she said, "I don't want to be like that." If you don't believe that, then nothing is going to change your mind.
But if the evidence is credible, and it was deemed so through the legal process, as much as any of us would say, God -- I'm not saying -- people say, do you want Terri to die? Goodness, no. Any more than I want my mother to die or my children to die. You and I don't know each other. I don't want to you die.
But this is a family private matter. How do we resolve these terrible things? I just pray that in the end, Terri's interests will be served best through this process.
OLBERMANN: You investigated, as part of this, not just the medical but the legal and the husband. How much insurance money this was worth to the husband? The children outside the marriage, his relationship that ensued outside the marriage. The conflict with the in-laws. What were your conclusions about the bona fides and the goodness of Michael Schiavo?
WOLFSON: I found nothing in the evidence, nothing— and some of the people who have been presenting evidence recently saying that there's been abuse. They shared that evidence with me a year and a half ago, as well. And I've seen it rather recently again.
There's no evidence to support that she was abused. For 15 years, she hasn't had a bed sore. Ken Connors, who was the governor's attorney was a plaintiff's attorney who made a lot of success in nursing home -- nursing home injuries. She's never had a bed sore in 15 years.
For many years, Michael kept such good care of her that the nursing home staff tried to get a restraining order against him at one point, because he was demanding so much. I think she's been cared for very much by Michael.
And you know, the issue of his other relationship, I'm not going to pass judgment on anybody, Keith. That's not why I'm here. But, you know, just because I love my mother doesn't mean I can't love my wife. Nor does it mean that relationships I had with people that were very intimate years ago, make it impossible for me to continue to care for those people.
Michael is not a warm and fuzzy man. His parents, the Schindlers are, but that doesn't make him a bad guy.
OLBERMANN: Ultimately, when you were involved in this case, what were your recommendations to Governor Bush and would you give the same recommendations under these circumstances today?
WOLFSON: My recommendations were that additional swallowing tests and neurological tests should be performed for the purpose of resolving the dispute between the parties. Because the legal process and the medical process, I felt, had been competent and had met the standards of proof. But only if the parties agreed in advance as to how the results of those tests could be used.
If you'll look at my final report, we had a draft agreement. And we almost got there. At 11:50 p.m. on the 30th of November, Sunday night, before my report was due on the first, all of us were pretty much agreeing to walk into that room and talk about how we would do that.
Mr. Felos called me at 11:50, Michael's attorney. And he said, "Jay, I can't do it. I can't do it, because I'm challenging the law that appointed you, the constitutionality of it. And if I accept anything that you're proposing, then I am diluting my legal and constitutional challenge. I can't."
He was right in doing that legally. And as you know, the law was deemed unconstitutional and then everything I did was technically moot.
OLBERMANN: What about now? What would happen if someone said to you, we need your opinion on this and we need it in a hurry, what would it be?
WOLFSON: My opinion doesn't count. I'm just a guy. You know, I just attempted to use the modest legal skills and clinical and technical skills and scientific skills I have. And I brought to the table the issue of using good medicine, good science and good law.
This is not about me. It's not about anybody else. It's really about Terri.
OLBERMANN: And that, sir, is perhaps the best answer to the question, "what is your opinion" that I have heard yet in this case and the coverage of it.
Besides Mr. Wolfson, I was joined by an individual who gave us a glimmer into how Terry Schiavo’s parents have been able to survive literally millions of dollars’ worth of legal bills over the years they have fought their son-in-law.
Glenn McGee is the director of the New York Institute For Bioethics, and editor-in-chief of The American Journal Of Bioethics.
OLBERMANN: Do you know where this money is coming from? The Schindlers can't possibly have afforded this on their own, can they?
MCGEE: Well, Keith, my research group at Albany Medical College has been looking for the past couple of days into the question you just raised. Namely, if there were 30,000 persistent vegetative state patients around the country, how is it that this one case attracted so much attention and so much litigation?
And what we found is that on both sides of the aisle on this set of legal actions, there's been an enormous amount of money. Some of it's actually been money to support lawyers but most of it has been gifts from large law firms and lobbyists to enable multitasking firms, the kind of
thing we saw in the O.J. trial, on behalf, mostly, of the Schindlers.
OLBERMANN: Do you know where that money came from? Do you know how much it amounted to?
MCGEE: Well, we don't know exactly how much it amounted to. Because as I said most of is it what you would call in kind contribution by lawyers who, in essence, agree with the cause.
So for example, among the representatives of Michael Schiavo's side, the American Civil Liberties Union most recently, and a number of different lawyers who work for firms that specialize in this sort of thing.
But more interesting, the Schindlers have enlisted legal assistance that's amounted to millions of dollars at this point, mostly from national right to life associated groups.
OLBERMANN: Millions of dollars.
MCGEE: At least $20,000 for each filing. And on top of that, there's procedural funding and funding for each and every action that moves up through the system.
You have to remember, Keith, when a case gets to the 11th District Court, it's moved through at least 25 different judges. And appellate lawyers have examined constitutionality questions in teams of 20 and 30. Many of these lawyers billing as much as $500 or $600 an hour.
OLBERMANN: You said 30,000 persistent vegetative cases in the country. Do you have any idea how often two parts of a family in a case like this disagreeing about whether or not to continue care? And are those cases resolved simply in the courts? Simply by arbitration? Or are all the other cases going to wind up in the public eye like this one
MCGEE: Well, in all my years in bioethics, I've never, of course, seen a case that's as much of a train wreck or has involved so much national grief as this one.
But it is regularly the case that when a patient ends up in a persistent vegetative state, the family is aghast. I mean, they don't know what to do. And even relationships that are good can fall apart, because people want the best for that family member, and they can't quite recall what someone said.
And particularly, in my own state of New York, where there's no real law about who's in control, those fights can be exacerbated.
OLBERMANN: What do the very carefully crafted tenets of bioethics say?
MCGEE: Well, these days, we're not feeling like we've done such a great job. But I can tell you that bioethics does agree on one thing. And that is that this kind of decision needs to be made early. It shouldn't be made in this kind of last-minute fashion.
And you know, it sounds like Monday morning quarterbacking, to not be glib about this horrible situation, but frankly, a lot of this really could have been avoided. And around the country, people are asking themselves, do they have it written down? Have they really express what had they want?
In this case, Michael Schiavo may very well be relaying what he believes that his wife said. But the very possibility of those doubts is what's created this problem.