EDITORIAL: Why did Terri Schiavo have to die?
by Peter Westmore
News Weekly, April 9, 2005
By the time you read this article, Terri Schiavo may have died of dehydration and starvation. This 41-year-old woman will die because her estranged husband instructed medical staff to remove the feeding tube which kept her alive for 15 years, and it seems that the American legal system will not save her life, despite her family's efforts.
The legal and family battles over her fate represent a test case on euthanasia in the USA, and will have important implications for other countries, including Australia.
Euthanasia is not, as its advocates state, a good death. It is a deliberate action taken with the purpose of bringing about the death of a person, so as to avoid present or future suffering.
The Schiavo case highlights an extremely dangerous trend in which the courts - not the legislature, and often against the expressed intention of the legislature - are being used to redefine the law.
The background to Terri Schiavo's sad case is well known. A married woman, she suffered a heart attack at the age of 25. During her emergency medical treatment, she suffered a type of stroke, and consequently suffered severe brain damage.
For three years she underwent rehabilitation; but within months of a $1.2 million medical negligence payout, her husband, Michael Schiavo, discontinued rehabilitation, and had a "do not resuscitate" notice posted over her bed.
There was an immediate breach between Michael Schiavo, who is his wife's legal guardian, and her family, who want to give her proper care. This has continued to the present day.
Michael Schiavo, who has since become engaged to another woman and has had two children with her, had obtained court orders for the cessation of nutrition, alleging that Terri Schiavo is in a permanent vegetative state, and that she had previously told him that she did not want to live if permanently incapacitated.
Her family contested this, asserting that she is severely brain injured, but is interacting with family and medical staff, without being able to verbalise her intentions. In other words, she is in the "locked-in state", in which she is aware of what is going on around her, interacts with family and friends, but cannot communicate verbally with them. The visible evidence, shown repeatedly on TV, strongly supports her family's position.
The injustice of the present situation is highlighted by comments made by Dr William Hammesfahr, a physician with lengthy experience in treating patients with brain injuries, who examined her several times, for a period of some ten hours.
He said before her feeding tube was removed, "There are many approaches that would help Terri Schiavo. I know, because I had the opportunity to personally examine her, her medical records, and her X-rays. It is time to help Terri, instead of just warehousing her. She would have benefited from treatment years ago, but it is not too late to start now."
Clearly, she was not dying as a result of her brain injury, nor was she terminally ill, and so the argument that she should be allowed to "die in peace" does not apply.
Further, the provision of nutrition and hydration are not forms of medical treatment but, like warmth and shelter, are simple necessities for sustaining life.
The withdrawal of nutrition and hydration must therefore be seen as acts to terminate life, rather than ending burdensome medical treatment.
However, the Florida and Federal Courts have consistently endorsed her husband's right to order the feeding tube removed, disregarding efforts by both the Florida State Government as well as President Bush to continue to support her.
While the US Supreme Court refused to overturn these judgments, the Supreme Court's previous decisions seem to support the right to live. In Cruzan (1990), the Court recognised that the State is entitled to guard against potential abuses by surrogates who may not act to protect the patient.
In 1997, when a group of pro-euthanasia doctors sought to overturn a Washington state law against assisted suicide, the Supreme Court held that the state law was constitutional.
Since these cases were decided, there has been constant pressure, in the US as well as other countries, to permit euthanasia. In Belgium, for example, where euthanasia was legalised in 2002, official declarations have reported around 200 cases a year of physician-assisted suicide, although the actual number is believed to be much higher.
In some other countries, including Holland and Canada, euthanasia has been legalised and is now widely used not only on the incurably ill, but against people judged to have no "quality of life", including babies with disabilities and people suffering from Alzheimer's disease.
While attempts to legalise euthanasia have been defeated in Australia, medical practice here has too often succumbed to the utilitarian temptation.
- Peter Westmore is President of the National Civic Council