Update: I did not expect this diary to get recommended, so I just wrote some quick thoughts and then posted them with links to more detailed information. Now that this has gotten recommended, I have re-written the diary to be more informative.
Okay, back to the diary:
First, I believe that we all have a right to determine our own medical care and that since the courts have found that Terri did not want to be kept alive artificially, she should be allowed to die with dignity. Everything else is just window dressing.
That being said, I have always been curious about the backstory. (Note, this is just about the family and Michael, not about the medicine or the law.)
Update 2: advisorjim has taken a break from writing his book to weigh in with more fact based analysis. Damn those pesky facts. Both he and
atrios discuss the “Nobel Nominated” doctor who claims to have a therapy for Terri. If you want some more info on this doctor, you can read the court report on him. Essentially, the court ordered both sides to bring two neurologists in to explain Terri’s condition and hope for “new” therapies. In one of the most diplomatic summaries I’ve ever read, he essentially calls the doctors for the Schindlers liars, braggarts and hucksters. You can
read the court report here, but the relevant portion about the “Nobel nominated” doctor is this:
Dr. Hammesfahr feels his vasodilatation therapy will have a positive affect on Terry Schiavo. Drs. Greer, Bambakidis and Cranford do not feel it will have such an affect. It is clear that this therapy is not recognized in the medical community. Dr. Hammesfahr operates his clinic on a cash basis in advance which made the discussion regarding Medicare eligibility quite irrelevant. A lot of the time also was spent regarding his nominations for a Nobel Prize. While he certainly is a self-promoter and should have had for the court's review a copy of the letter from the Nobel committee in Stockholm, Sweden, the truth of the matter is that he is probably the only person involved in these proceedings who had a United States Congressman recommend him for such an award. Whether the committee "accepted" the nomination, "received" the nomination or whatever, it is not that significant. What is significant, however, and what undemises his creditability is that he did not present to this court any evidence other than his generalized statements as to the efficacy of his therapy on brain damaged individuals like Terry Schiavo. He testified that he has treated about 50 patients in the same or worse condition than Terry Schiavo since 1994 but he offered no names, no case studies, no videos and no tests results to support his claim that he had success in all but one of them. If his therapy is as effective as he would lead this court to believe, it is inconceivable that he would not produce clinical results of these patients he has treated. And surely the medical literature would be replete with this new, now patented, procedure. Yet, he has only published one article and that was in 1995 involving some 63 patients, 60% of whom were suffering from whiplash. None of these patients were in a persistent vegetative state and all were conversant. Even he acknowledges that he is aware of no article or study that shows vasodilatation therapy to be an effective treatment for persistent vegetative state patients. The court can only assume that such substantiations are not available, not just catalogued in such a way that they can not be readily identified as he testified.
Update 3: Apparently CNN's Inside Politics quoted my diary today. I didn't see it, but others did and wrote comments. If anyone else saw it, let me know.
Update 4: Well, thanks to Tillie630 for finding the transcript of the mention on CNN today. Here is what they said:
SCHECHNER:
Now the report I was talking about is actually a 38- page report by a guardian ad litem, who was appointed by Governor Jeb Bush back in 2003. He was appointed because they wanted a neutral party to help both sides cut through the mudslinging. This report is now available. You can get it easily through "Daily Codes" (ph). And Corndog has a posting there. He says that he changed his opinion about Michael Schiavo based on this report. He's upset with himself for buying into the hype, he says. And if you go down on the bottom, here's his conclusion: "My take on all of this is that the Schindlers are loving parents who don't want their daughter to die. Michael is a loving husband who doesn't want to see his wife forcefully kept alive against her will." He calls it a "must-read," and says if have you the time, he highly recommends it.
Okay, on to the diary:
I first heard about Terri Schiavo a couple years ago when her husband, Michael, got the second court order to remove her feeding tube. Most news stories only dealt superficially with the background on the story, but all alluded to the fact that Michael Schiavo was less than an ideal husband. The most substantive article I read then (and since) detailed how proximate the decision to remove life support was to the malpractice award Terri received. This CNN article described how questionable his behavior was and how his actions were seemingly motivated by money and a desire to get remarried once Terri died.
As I said above, none of that really matters, but I always thought that, at best, Michael Schiavo was a sketchy bastard and at worse, a money grubbing, adultering, abusive, uncaring, mean man who just wanted to kill Terri. Basically, I bought the spin (how stupid am I?!?!?!). I have changed my opinion.
I found this really good blog that is by a lawyer in Florida tracking the case. He is neutral on the case but is very thorough in documenting it. I highly recommend anyone who wants to know more to check out his blog. He links to almost all the court documents and it is one particular document that I think lays out both the tragedy of the situation and the truth about Michael Schiavo.
After Florida passed “Terri’s Law” in 2003, Jeb Bush had to appoint a Guardian Ad Litem (GAL). I am not a lawyer, but my understanding is that a GAL is a neutral party who helps the court cut through the mud slinging and get to the truth. This GAL was to spend 30 days investigating and report back to Gov. Bush. His report,, (pdf) is excellent reading for anyone who is interested in the history of this case. The GAL details everything from the family relations to the court cases to the medical information. It is also very readable which is helpful.
Some of the interesting parts (all from the GAL report):
From the beginning, Michael appeared from the beginning to be Terri’s best advocate:
Theresa’s husband, Michael Schiavo and her mother, Mary Schindler, were virtual partners in their care of and dedication to Theresa. There is no question but that complete trust, mutual caring, explicit love and a common goal of caring for and rehabilitating Theresa, were the shared intentions of Michael Shiavo and the Schindlers.
…
His [Michael’s] demanding concern for her well being and meticulous care by the nursing home earned him the characterization by the administrator as “a nursing home administrator’s nightmare”. It is notable that through more than thirteen years after Theresa’s collapse, she has never had a bedsore.
He even went to extraordinary lengths to pursue any treatment that held promise. After “aggressive physical and voice therapy” failed to show signs of improvement,
In late Autumn of 1990, following months of therapy and testing, formal diagnoses of persistent vegetative state with no evidence of improvement, Michael took Theresa to California, where she received an experimental thalamic stimulator implant in her brain. Michael remained in California caring for Theresa during a period of several months and returned to Florida with her in January of 1991.
During all this, for nearly two years, Michael lived with the Schindlers. It was during that time that they even brought Terri home for a period and tried to give her around the clock care with family taking shifts. This proved unworkable and after a couple of months, Terri went back to the skilled nursing facility. Michael struggled with moving on. In fact, it was the Schindlers, Terri’s parents, that urged him to move on romantically:
It took Michael a long time to consider the prospect of getting on with his life – something he was actively encouraged to do by the Schindlers, long before enmity tore them apart. He was even encouraged by the Schindlers to date, and introduced his in-law family to women he was dating.
It was, however, shortly after this that the malpractice settlement happened. The GAL report delicately sidesteps the question of what went wrong between Michael and the Schindlers, but the malpractice settlement appears to be when it happened. Reading between the lines, I got the impression that it was the parents who started the fight, but I could be wrong. So, what about all that money that Terri got in a malpractice settlement?
Michael Schiavo, on Theresa’s and his own behalf, initiated a medical malpractice lawsuit against the obstetrician who had been overseeing Theresa’s fertility therapy. In 1993, the malpractice action concluded in Theresa and Michael’s favor, resulting in a two element award: More than $750,000 in economic damages for Theresa, and a loss of consortium award (non economic damages) of $300,000 to Michael. The court established a trust fund for Theresa’s financial award, with SouthTrust Bank as the Guardian and an independent trustee. This fund was meticulously managed and accounted for and Michael Schiavo had no control over its use. There is no evidence in the record of the trust administration documents of any mismanagement of Theresa’s estate, and the records on this matter are excellently maintained.
…
Michael Schiavo had earlier, formally offered to divest himself entirely of his financial interest in the guardianship estate [in order to remove any hint of bias in his decision to remove the feeding tube].
I have read in other sources, including quotes from the Schindlers’ attorney that the Schindlers refused to go along with Michael’s plan to disinherit himself. Interestingly, they also are not asking themselves to be the new guardian, but rather they are asking for Terri’s siblings to be appointed guardian.
After several years, the aggressive physical therapy appeared to be not working.
By 1994, Michael’s attitude and perspective about Theresa’s condition changed. During the previous four years, he had insistently held to the premise that Theresa could recover and the evidence is incontrovertible that he gave his heart and soul to her treatment and care. This was in the face of consistent medical reports indicating that there was little or no likelihood for her improvement.
The courts would not let Michael remove the feeding tube though since they needed proof she would want the tube removed. Most media would have you believe he was the only source of that information. It turns out that two others testified as to her wishes. The conversations happened after funerals, which makes quite a lot of sense (and is hard to fake).
The hearings and testimony before the trial court leading to the decision to discontinue artificial life support included admitted hearsay from Theresa’s brother-in-law (Michael Schiavo’s brother) and his wife (Michael’s Schiavo’s sister-in-law) along with testimony from Michael. The testimony of these parties referenced specific conversations in which Theresa commented about her desire never to be placed on artificial life support. The testimony reflected conversations at or proximate to funerals of close family members who had been on artificial life support. The context and content of the testimony, while hearsay, was deemed credible and consistent and was used by the court as a supporting bases for its decision to discontinue artificial life support.
The Schindlers, however, were not willing, under any circumstances, to let Terri die. This is some particularly tragic information and my hat is really off to the GAL who went to some pretty heroic lengths to write this both fairly and with kindness.
The Testimony provided by members of the Schindler family included very personal statements about their desire and intention to ensure that Theresa remain alive. Throughout the course of the litigation, deposition and trial testimony by members of the Schindler family voiced the disturbing belief that they would keep Theresa alive at any and all costs. Nearly gruesome examples were given, eliciting agreement by family members that in the event Theresa should contract diabetes and subsequent gangrene in each of her limbs, they would agree to amputate each limb, and would then, were she to be diagnosed with heart disease, perform open heart surgery. There was additional, difficult testimony that appeared to establish that despite the sad and undesirable condition of Theresa, the parents still derived joy from having her alive, even if Theresa might not be at all aware of her environment given the persistent vegetative state. Within the testimony, as part of the hypotheticals presented, Schindler family members stated that even if Theresa had told them of her intention to have artificial nutrition withdrawn, they would not do it. Throughout this painful and difficult trial, the family acknowledged that Theresa was in a diagnosed persistent vegetative state.
My take on all this is that the Schindlers are loving parents who don’t want their daughter to die. Michael is a loving husband who doesn’t want to see his wife forcefully kept alive against her will. (In the GAL report the GAL list four possibilities and one of them is a Johnny Got His Gun type in which the GAL hypothesizes she may be somewhat aware and unable to communicate and slowly going crazy trapped inside her own mind.) Since the only way to keep her alive is to demonize Michael, the Schindlers, a la mamma bears, are viciously attacking Michael. Kudos to him for staying out of that discussion and refusing to be drawn into it.
I HIGHLY recommend reading this GAL report if you are at all intrigued by the case. It not only has the history, but also explains the law and the science. It is 38 pages, but has huge margins and double spacing and you can skip all the intro and legalese.