What If This Was Our Daughter or Sister or Wife? What If It Was "Only" A Stranger's Life? Part II

This posting builds on a previous posting about Terri Schindler-Schiavo.

Digging further into the case only raises additional deeply unsettling questions, questions that deserve thoughtful responses and not the casual ending of a human life.

The first major question has to do with Terri’s physical and mental condition. As you read the following, remember that she has been denied any rehabilitation therapy since at least 1993:

Nurses who tended to Terri Schiavo…have stated in affidavits provided by her family that the 41-year-old has exhibited clear-cut behavior indicating she is conscious and aware of her surroundings.

In stunning testimony, one nurse, Heidi Law, a certified nursing assistant who took care of Terri when she was at Palm Gardens Nursing Home in Largo, Florida, in 1997, said that the severely disabled woman formed words such as "mommy, "momma," and most hauntingly, "help me."

"While it is true that those patients will flinch or make sounds occasionally, they don't do it as a reaction to someone on a constant basis who is taking care of them, the way I saw Terri do," claimed Law in a formal deposition…

The testimony…contradicts widespread perceptions that Terri is a nearly brain-dead or comatose woman living in a vegetative state…

That the disabled woman acknowledges the presence of her parents, responds to music, and follows the movement of objects such as a balloon has long been known and documented by videos…

…attested by a second caretaker, Carla Sauer Iyer, a registered nurse who was at Palm Garden from 1995 to 1997:

"Terri's medical condition was systematically distorted and misrepresented," stated Iyer in her own affidavit..."When I worked with her, she was alert and oriented. Terri spoke on a regular basis while in my presence, saying such things as 'mommy' and 'help me.' 'Help me' was, in fact, one of her most frequent utterances. I heard her say it hundreds of times. Terri would try to say the word 'pain' when she was in discomfort, but it came out more like 'pay.' When I came into her room and said 'Hi, Terri,' she would always recognize my voice and her name, and would turn her head all the way toward me, saying, 'Haaaiiiii,' sort of, as she did. I recognized this as a 'hi,' which is very close to what it sounded like, the whole sound being only a second or two long. When I told her stories about my life, or something I read in the paper, Terri would sometimes chuckle, sometimes more a giggle or laugh.”

Numerous affidavits on Terri's condition, including some referenced in this posting, can be found here and here. An overview of medical observations on Terri over the last 15 years can be found here. All of this information paints an entirely different picture of Terri from what Terri's husband and his attorney have been stating publicly for years now.

There have been frequent media reports that Terri suffered from eating disorders. However, this posting notes:

…there was never a determination by any court nor the Florida Department of Health that Terri Schiavo ever suffered from any eating disorder, bulimia, anorexia or compulsive behavior that would lead to a heart failure at the age of 26.

Indeed, Florida’s Department of Health had completely and absolutely cleared Terri’s general practitioner of any negligence or wrong-doing in her case. This was after the physician had been accused by Terri’s husband of ignoring evidence of an eating disorder.

Additionally, at the time of her mysterious medical episode, Terri Schiavo stood 5’3” and weighed somewhere between 115 and 118 pounds – a slim, but normal stature and weight. [Her husband is said to be 6'6" tall and weigh about 250 pounds.]

This posting notes:

Dr. William Hammesfahr, a world renowned neurologist wrote a complete report…in September, 2002, revealing that medical tests conducted after her collapse did not show evidence of a heart attack. In the emergency room, a possible diagnosis of heart attack was briefly entertained but then dismissed after blood chemistries and serial EKG’s did not show evidence of a heart attack.

I would strongly encourage you to read the entirety of Dr. Hammesfahr's report. Among other things, it will allow you to contrast the depth of his examination analysis with the shallow analyses of a doctor who has twice "examined" Terri and then declared her to be in a persistent vegetative state. Here are some impressions and observational excerpts from Dr. Hammesfahr's examination of Terri:

Impressions: The patient is not in coma. She is alert and responsive to her environment. She responds to specific people best. She tries to please others by doing activities for which she gets verbal praise. She responds negatively to poor tone of voice. She responds to music. She differentiates sounds from voices. She differentiates specific people's voices from others. She differentiates music from stray sound. She attempts to verbalize. She has voluntary control over multiple extremities. She can swallow. She can feel pain...

Communication: She can communicate. She needs a Speech Therapist, Speech Pathologist, and a communications expert to evaluate how to best communicate with her and to allow her to communicate and for others to communicate with her…

ENT[Ear, Nose, Throat]: The patient can clearly swallow, and is able to swallow approximately 2 liters of water per day (the daily amount of saliva generated). Water is one of the most difficult things for people to swallow. It is unlikely that she currently needs the feeding tube…

Spinal Exam: The patient's exam from a spinal perspective is abnormal. The degree of limitation of range of motion, and of spasms in her neck, is consistent with a neck injury.

All of these observations explain why her parents are seeking further medical tests of Terri before any action to starve her to death is taken. Terri’s husband and the judge have been blocking these testing requests.

The second big question is whether her husband’s past behaviors and current intentions are ethical. As her husband, he is Terri’s legal guardian. Ask yourself whether he is acting in her best interest and deserves to remain her guardian where he has the power over life/death decisions.

There is significant uncertainty about what happened on February 25, 1990, the day Terri sustained her injuries:

The main evidence comes from a bone scan taken on March 5, 1991…This scan indicated numerous broken bones in various stages of healing, including compression fractures, a broken back, pelvis, ankle, bone bruises and ossifications.

Board certified radiologist Dr. Walker read the scan in 1991 and interpreted the results as abnormal, which he attributed to either an accident or earlier trauma…a) the injuries indicated by the scan occurred on or around the time that Terri Schiavo collapsed; b) the abnormalities on the bone scan were not typical of someone suffering cardiac arrest and collapsing to the floor; and, c) the fractures…are not typical of patients bedridden only thirteen months…

On October 24, 2003, renowned forensic pathologist Dr. Michael Baden [former chief medical examiner for New York City]…disclosed that with low potassium and no elevated enzymes, it would be extremely rare for a young woman to collapse as Terri did from a heart attack. When asked what the bone injuries suggest to him, Dr. Baden replied, “Some kind of trauma. The trauma can be from a fall, or the trauma can be from some kind of beating…It’s something that should have been investigated in 1991 when these findings were found.”

The same posting contains the thoughts of psychiatrist and expert witness Dr. Carole E. Lieberman, including a profile of Michael Schiavo. The posting also states:

Prior to Terri’s collapse, there were serious financial problems in her marriage and her husband tried to control her behavior. He was fired from six jobs in two years, some of which he held only two weeks. They often lived on her income, which Michael often spent on himself. He monitored her odometer and isolated her from her family and friends. On the day of her collapse, Michael and Terri had a bad fight after he accused her of spending too much money at the hairdresser…

So, what really happened on February 25, 1990? We know that Terri fell in her home and sustained serious injuries. We know that Michael Schiavo, who was trained in CPR, oddly did not administer CPR to his wife.

A previously mentioned posting add the following observations:

Why isn’t [Judge] George Greer and the court interested in how Terri Schiavo sustained the injuries in 1990?…

…after the Schindlers became aware of the bone scan report in November, 2002, they tried to file a report with the police of a possible battery on Terri but that the police refused to get involved…

Prior to 2002, Terri’s medical records had been kept sealed under court order at the request of Michael Shiavo. The bone scan surfaced when the Schindler’s former attorney, Patricia Anderson, obtained some of the medical records through discovery…

The hospital admittance records from 1990 show evidence of trauma to Terri Schiavo’s neck…

There is reportedly an order on file issued by Michael Schiavo that upon her death, Terri Schiavo will immediately be cremated, no autopsy.

Dr. Hammesfahr's report includes these words:

Interestingly, I have seen this pattern of mixed brain (cerebral) and spinal cord findings in a patient once before, a patient who was asphyxiated.

Another posting discusses how Terri did not receive adequate care and offers further insight into their marital problems at the time Terri sustained her injuries:

...medical records show that Terri has never been evaluated or treated by an orthopedic surgeon for the multiple injuries revealed in the bone scan, which may have a profound bearing on her current medical condition...

In testimony given during the 2000 trial, Terri's girlfriend and co-worker said [see item #6 on left side listing] Terri discussed getting a divorce and moving in with her. She also testified that the couple had a violent argument on the day of Terri's collapse, which prompted her to urge Terri to not stay at home that night – a suggestion Terri disregarded.

"There are only two people who know what happened that night that she collapsed. And one of them is trying to kill the other who is too disabled to speak," Anderson told WND at the commencement of the trial last month.

What has her husband Michael been doing over the years since 1990? Denying her any rehabilitation services, for starters, as this excerpt notes:

Michael Schiavo, although being awarded nearly $1.7 million from medical malpractice claims on the representation that he would provide rehabilitation services for his wife, refused to do so shortly after receiving the money and instead has used the money earmarked for Terri’s rehab to be used for legal fees to obtain a court order to end her life.

But it hasn't been just a failure to provide rehab over the years. I would strongly encourage you to read closely the information at this site, which highlights the numerous times since her injuries that her husband has ensured Terri did not receive either quality care or humane treatment. Equally powerful reading is selected information on Michael's character and actions from this site. In aggregate, the documents paint a damning picture of the man.

Here is some additional information on questionable behavior by her husband and Terri’s responses to him during these intervening years:

"I made numerous entries into the nursing notes in her chart, stating verbatim what she said and her various behaviors, but by my next on-duty shift, the notes would be deleted from her chart," claimed Iyer in potentially devastating detail. "Every time I made a positive entry about any responsiveness of Terri's, someone would remove it after my shift ended. Michael always demanded to see her chart as soon as he arrived, and would take it in her room with him."

Iyer claims that she "became fearful for my personal safety" and was terminated after she called police about comments and activities at the nursing home relative to the Schiavo woman. "When Michael visited Terri, he always came alone and always had the door closed and locked while he was with Terri," the affidavit alleges. "He would typically be there about twenty minutes or so. When he left Terri would be trembling, crying hysterically, and would be very pale and have cold sweats. It looked to me like Terri was having a hypoglycemic reaction, so I'd check her blood sugar." The glucometer reading would be so low it was below the range where it would register an actual number reading. I would put dextrose in Terri's mouth to counteract it. This happened about five times on my shift as I recall. Normally Terri's blood-sugar levels were very stable due to the uniformity of her diet through tube feeding." [These events led Iyer to speculate the unproven/unprovable idea that Michael Schiavo could have been injecting Terri with insulin.]

Added Law, the nursing assistant, "When she was upset, which was usually the case after Michael was there, she would withdraw for hours... Several times when Michael visited during my shift, he went into her room alone and closed the door. When he left, Terri was very agitated, was extremely tense with tightened fists, and sometimes had a cold sweat. She was much less responsive than usual and would just stare out the window, her eyes kind of glassy."

A previously referenced posting shares the following:

Nurses have reported hearing Michael Schiavo make such comments as "When is that bitch going to die?"… [Iyer] says that she recalls him making statements such as "Can’t anything be done to accelerate her death, won’t she ever die?" "Michael would be visibly excited, thrilled even, hoping that she would die", Iyer recalled. "He would blurt out, 'I'm going to be rich' and would talk about all the things he would buy when Terri died which included a new car, a new boat and going to Europe."

This posting has further information on George Felos, Michael Schiavo's attorney, and the information does not reflect well on Felos' personal values.

Another posting notes that:

On September 3, 2004 Father Rob Johansen wrote in his blog ["Thrown Back"] about what Cheryl Ford, a nurse from Tampa who has been very active in the efforts to save Terri's life, found in her review of Terri's medical records.

... Cheryl had recently undertaken, on behalf of the Schindlers, a review of medical records from when Terri was first admitted to Woodside Hospice. Woodside Hospice is run by Hospice of the Florida Suncoast.

It is of interest to note that Michael Schiavo's attorney, George Felos, was a member of the Board of Directors of Hospice of the Florida Suncoast until the Terri Schiavo case began to attract widespread public attention a few years ago.

In her research, Ms. Ford found a document titled "Exit Protocol" in Terri's file. The document is on Hospice of the Florida Suncoast "Patient Care Notes" stationery, and is dated April 19, 2001. This document lays out, in clinical detail, the procedures to be followed in bringing about Terri's death by starvation and dehydration.

That protocol is part of a broader set of questions regarding the role the hospice is playing in this case:

The original hospice mission is to care for, support and manage the symptoms of the terminally ill until a death occurs in its own natural timing. Every hospice nurse and physician knows that hospice is supposed to neither hasten death nor seek to cure the terminal illness. Hastening the death of a patient goes against everything hospice stands for.

Although Terri Schiavo's case will be decided in a Pinellas County courthouse, any hospice that accepts a chronically ill patient has violated not only the spirit of hospice and the mission of hospice, but the federal regulations governing hospice.

In addition, there have been a series of very questionnable decisions by the judge plus some seriously overlapping conflicts of interest between the judge, his colleagues, the hospice, and George Felos. I find the number and nature of these conflicts to be most troubling, raising further ethical concerns.

Many of the ethical issues in this case are discussed in this article:

[George] Felos's well-known ties to the euthanasia movement...has been a member of the infamous Hemlock Society...

Michael Schiavo's principal witness, Dr. Ronald Cranford,...perhaps the leading medical proponent of the pro-death movement...

[One peer reviewed medical journal article] revealed that 43% of patients sent to that hospital with a diagnosis of PVS [persistent vegetative state] were not in a vegetative state at all...

The growing awareness of the difficulty in diagnosing PVS, and the widespread errors in making the diagnosis, have led many leading hospitals...to routinely reassess patients referred to them as PVS...

...[Terri's parents'] were informed [in 1993] that Michael had cut off their access to Terri's medical information...Michael had the legal authority to issue the order, which remains in place to this day...

[Later in 1993,] Terri had a serious urinary tract infection and that Michael had ordered the nursing home not to give her treatment, which would have consisted of a simple course of antibiotics...the nursing home eventually gave Terri the antibiotics anyway. [Could this be an example of why she was then moved from the nursing home to the hospice?]...Michael admitted [in a court hearing] that he had ordered the nursing home to deny Terri treatment for the infection and that he knew the infection, left untreated, would have caused Terri's death...

In 1998, Michael petitioned the court to remove Terri's feeding tube...was the first time that Michael had ever claimed such a wish on Terri's part [not to be kept alive in her condition]...

The judge then appointed a guardian ad litem, Richard Pearse, to investigate Michael's fitness as guardian and to make a recommendation about Terri's feeding tube. Pearse interviewed the various parties, including doctors, and issued his report in December 1998 recommending against Michael's fitness as guardian and against removing Terri's feeding tube...In February 1999, George Felos filed a "suggestion of bias" against Pearse and demanded he be removed as guardian ad litem...In April 1999, Pearse filed a request that he either be given further instructions or discharged...[noting] that there would be due process difficulties if the case proceeded to trial without Terri having an independent guardian ad litem...[the judge] discharged Pearse without appointing a successor...

All of which is why the following comment makes so much sense:

You have to ask yourself, why a Judge would continue to allow this [ceasing to provide a feeding tube] without ordering that Terri Schiavo have, at the very least, six months of therapy just to make sure that he's not killing someone that has every right to continue fighting for her life…

As observers from afar, we cannot independently confirm the veracity of all of the information described above. But reasonable people must admit that the information pattern raises enough material questions about the behavior of Terri’s husband and the judge to have grave concerns.

And that leads us back to the more fundamental question about what value we will place on human life, including that of a disabled woman. If we begin to say it is okay to kill off "weak" human beings, think where that will take us over time. It will take us to a place where certain people will seek to play "God" so they can set the criteria for who lives and who dies. Why not then an elderly parent or a young child, should either become a financial or emotional burden? The freedom to do such great evil will only invite more profound evil over time.

Holocausts do not begin with operational concentration camps; they start on a smaller scale and steadily break down our resistance while many people plead that they are "too busy" to pay attention and get involved.

The stakes are enormous here and there is no neutral ground. Not to decide is to decide. The fight for Terri’s life is another battle to determine whether we are to live in a culture of life or a culture of death.