From Private Ordeal to National Fight: The Case of Terri Schiavo

Her surname in Italian means “slave,” and is pronounced skee-AH-vo. Grim as it may be, the word could apply to Theresa Marie Schiavo, even with its Americanized pronunciation: SHY-vo. For 15 years, Terri Schiavo was effectively a slave — slave to an atrophied brain that made her a prisoner in her body, slave to bitter fighting between factions of her family, slave to seemingly endless rounds of court hearings, slave to politicians who injected themselves into her tragedy and turned her ordeal into a national morality play.

To this day, the name Schiavo is virtually a synonym for epic questions about when life ends and who gets to make that determination. It would be nice to believe that since Ms. Schiavo’s death nine years ago, America has found clear answers. Of course it has not, as is evident in Retro Report’s exploration of the Schiavo case, the latest video documentary in a weekly series that examines major news stories from the past and their aftermath.

Ms. Schiavo, a married woman living in St. Petersburg, Fla., was 26 years old when she collapsed on Feb. 25, 1990. While her potassium level was later found to be abnormally low, an autopsy drew no conclusion as to why she had lost consciousness. Whatever the cause, her brain was deprived of oxygen long enough to leave her in a “persistent vegetative state,” a condition that is not to be confused with brain death. She could breathe without mechanical assistance. But doctors concluded that she was incapable of thought or emotion. After her death on March 31, 2005, an autopsy determined that the brain damage was irreversible.

Between her collapse — when she “departed this earth,” as her grave marker puts it — and her death — when she became “at peace” — the nation bore witness to an increasingly acrimonious battle between her husband, Michael Schiavo, and her parents, Robert and Mary Schindler. Mr. Schiavo wanted to detach the feeding tube that gave her nourishment. Terri never would have wanted to be kept alive that way, he said. The Schindlers insisted that the tube be kept in place. That, they said, is what their daughter would have wanted. To Mr. Schiavo, the woman he had married was gone. To the Schindlers, a sentient human was still in that body.

Florida courts, while sympathizing with the parents, consistently sided with the husband as a matter of law. That did not satisfy Florida politicians. In 2003, the State Legislature passed a bill giving the governor, Jeb Bush at the time, the authority to prevent removal of the feeding tube. This legislation, later declared unconstitutional by the Florida Supreme Court, was called Terri’s Law. (This is a common legislative tactic: identifying a bill by some unfortunate’s name to enhance its emotional appeal. It is worth noting that first names and diminutives tend to be used when the person is a woman or a child. Men are usually accorded greater dignity. Hence, we had the Brady Bill, a federal gun-control law named for James S. Brady, President Ronald Reagan’s press secretary, who was shot in 1981. No one thought to call it Jim’s Bill.)

As if the failed attempts at intervention by Florida politicians were not enough of a cautionary tale, Congress and President George W. Bush plunged into the fray in early 2005, enacting legislation with dazzling speed to transfer jurisdiction of the case from state courts to the federal judiciary. More legal to-ing and fro-ing ensued, but it did not last long. State court orders prevailed. The feeding tube was removed, and Ms. Schiavo died at a hospice in Pinellas Park, Fla.

What, if anything, is the enduring legacy of this painful episode?

For what it is worth, USA Today, on its 25th anniversary in 2007, put together a list of 25 lives that had “indelible impact.” Terri Schiavo ranked No. 12, just below Mother Teresa and Oprah Winfrey. (No. 1 was “9/11 heroes.”) But the Schiavo case was then still fresh in collective memory. Seven years later, would she rank so high? Similarly, when she was in the news almost daily, there was a discernible increase in the number of Americans who prepared living wills and comparable directives, according to groups like Aging With Dignity, a nonprofit organization that supports end-of-life wishes.

Perhaps some politicians have learned a lesson: that these life-or-death decisions are probably best left to families and, should irreconcilable differences surface, to the courts. Was anyone well served, for example, when Bill Frist, the Republican Senate majority leader in 2005 and a transplant surgeon, said it was clear to him that Ms. Schiavo responded to external stimuli, a pronouncement based on his having seen a videotape of her?

Larger questions remain, affecting an estimated 25,000 Americans deemed by doctors to be in a vegetative state. Complicating matters are studies like those reported last week by a team in Belgium and earlier by Adrian M. Owen, a British neuroscientist working in Canada. They have found through brain-imaging techniques that residual cognitive capacity may exist in some people classified as vegetative.

Another issue is what qualifies as death with dignity. Is it allowing a person to go gentle into that good night of Dylan Thomas? Or does providing him or her with tools like a feeding tube allow the person to rage if possible against the dying of the light?

In recent months, two cases focused new attention on such questions. In one, Jahi McMath, 13, was declared brain-dead, the result of complications after surgery to correct a sleeping disorder. Her parents have fought, thus far successfully, to keep a hospital in Oakland, Calif., from shutting off Jahi’s ventilator. The second case, in Fort Worth, is a polar opposite. There, Marlise Muñoz, 33, was declared brain-dead after collapsing with a blood clot while 14 weeks pregnant. Her family wished to have the ventilator turned off, but the hospital refused, citing a state law that required life-sustaining measures for pregnant women. Finally, a judge ordered the removal of the life support. On Jan. 26, Ms. Muñoz’s heart stopped.

In both those ordeals, the Schiavo case was not a guide, and it may not be in new situations likely to arise. Then again, the woman born Theresa Marie Schindler had no control over the powerful forces that controlled her own fate. Just as if she were a schiavo, a slave.