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| Life - A Liberal Conundrum |
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The American Civil Liberties Union, backed Michael Schiavo's position and generally the liberal sections of the media supported his stance. The key point that garnered support for his position in the court of public opinion, which he emphasised repeatedly, is that the discontinuation of treatment was a personal decision - Terri's decision - which the government had no right to interfere with. His position in court was that there was no hope that any combination of treatments or procedures would rehabilitate Terri. In addition, he contended that his wife's "directive" expressed months before her accident was that she would not want her life artificially maintained on life support machines were such a situation to arise. Therefore, as her guardian Michael had the legal right to bring treatment - such as the feeding tube used to feed her nutrients - to an end, in accordance with what he said were her wishes.
The Schindlers disputed both elements of this position in the courts between 1994 and 2005, arguing that Terri was responsive to her environment and therefore should not be considered to be in PVS, and that further therapeutic techniques could improve her quality of life. In addition they disputed the contention that Terri had indicated a desire that treatment be stopped if she were dependant on life support machinery. They produced videotaped evidence for use in their cases (and subsequently for circulation on the internet) that appeared to show Terri exhibiting responses to questions and the actions of her relatives. They also averred that, as a believing Catholic, Terri would never consent to the deliberate termination of her life by slow dehydration.
In the media the political mudslinging frequently took aim at the motivations and past conduct of both Michael Schiavo and the Schindlers, based partly on accusations brought at different times during the numerous court cases both parties were involved in. For his part, Michael was accused of being a possible wife-beater, with one of his attacks being the cause of Terri's initial hospitalisation. People asked why he still played the devout husband when he had started a relationship with another woman, having two children with her while still holding guardian status over his wife. For their part, the parents were accused of wanting to take guardian status in order to claim inheritance of money won in a malpractice suit in 1990, and profiting from the sale of their supporters' email addresses.
One of the key issues that the case has raised is that the express will of the patient should be the basis of future treatment, through 'living wills'. This will is an 'advance health care directive', which people are being encouraged to draw up, with the help of a solicitor, in order to give clear directives of the circumstances in which they would want to have treatment withdrawn, or perhaps their desire that treatment should continue no matter how their situation deteriorates. The living will can also be used to appoint a health care proxy, who will take all decisions about treatment on behalf of the patient, thus avoiding disputes between family members or with medical staff about what should be provided. Following the publicity surrounding the Schiavo case, there has been an upsurge in requests for such documents; for example the New Jersey-based U.S. Living Will Directory reported an increase in hits on their website from 500 - 600 a day to over 5000. For supporters of the "err on the side of life" position such documents serve as a clear record of their desire that treatment be continued in all situations, to prevent medical staff or relatives taking the decision that treatment be halted. Those who support a "dignified end" to life are likewise being encouraged to do the same to ensure that they are not kept alive artificially when there is no prospect or recovery.
However, the efficacy of living wills in resolving disputes between doctors and relatives, or ensuring that the patient's desires are followed is in fact contentious, in contrast to much of the opinion expressed in the media about them during the case.
First of all, one of the key bones of contention in the case was Michael Schiavo's claim (supported by his sister-in-law) that Terri had stated to him that she would not want to remain on life support if she were ever in that situation. Her parents and siblings said that she would not have said such a thing because of her religious beliefs. Therefore the media pundits claimed that much of the dispute would have been avoided if Terri had prepared a living will. However, such a document would not have been enough for the doctors to withhold treatment legally, at least in Florida, since the legislation regarding living wills would not have allowed this in a disputed case. The Florida legislation regarding advance health care directives states that before physicians follow the directions in the living will it must be determined that: "any limitations or conditions expressed orally or in a written declaration have been carefully considered and satisfied." Therefore any written or verbal statement contrary to the contents of the living will would be sufficient to require investigation, and bring a halt to any actions based on the living will, pending some confirmation of the patient's intentions. So if the Schindlers claimed that Terri had mentioned that treatment should not be stopped if she were ever in such a situation, or she had indicated somehow after the accident, then the case would have proceeded on the same course, and with the same bitterness.
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