In 1990, Teri Schiavo apparently suffered from a chemical imbalance that caused her heart to stop beating for an extended period which resulted in severe brain damage. Most doctors who have examined her believe that she has been in a persistent vegetative state since her heart stopped. The brain damage has meant that Teri has required a life-sustaining feeding tube for her hydration and nutrition. Thirteen years later Teri has become the center of a political firestorm in Florida and a national debate on who has the right to make decisions about whether to allow someone to live or die. There has been a ten-year battle between Michael Schiavo, Teri’s husband and legal guardian, and the Schindlers, Teri’s parents. It is Michael Schiavo’s contention that Teri verbally expressed to him her wish that she not be kept artificially alive should she ever be in a permanent vegetative state. The Schindlers claim that Teri never expressed any such wish to them. The controversy has reached the Florida State House, the Governor’s Mansion, the Florida State Supreme Court and may be headed to the U.S. Supreme Court.
The disagreement that surrounds the life and death of Teri Schiavo raises many legal and constitutional issues; however had Teri Schiavo expressed her wishes in a “living will,” the public and often bitter battle between Michael Schiavo and the Schindlers might have been avoided. In situations such as this one, where a rift develops between family members about whether to continue or withhold life-sustaining treatments, the medical protocol is to continue with treatments. Had Teri’s wishes been written, family members and medical professionals would have been aware of her intentions and allowed her to die with dignity, or the resources that have been spent litigating what her intentions were could have been put towards her health care, therapy and improved quality of life. The moral here is that no matter how young and healthy one is, it is never too early to make wishes known in writing.
In Pennsylvania an Advance Health Care Directive is the formal designation of what is known as the “living will.” An Advance Health Care Directive is simply a power of attorney in which an individual appoints someone he or she trusts to act as an agent should he or she be in a temporary or permanent condition where he or she is unable to make his or her wishes known to health care professionals. The document is called an Advance Health Care Directive because ideally it is signed long before the individual enters a situation where tough decisions about whether or not to refuse life-sustaining treatment need to be made. Presumably making decisions in advance of the stress and emotion associated with emergency medical procedures will lead to rational choices.
An Advance Health Care Directive guides the agent through the litany of difficult decisions that can occur in almost any medical scenario. The document is drafted to spring into effect only (a) when the individual is in a terminal condition or in a state of permanent unconsciousness, including a persistent vegetative state or irreversible coma, and (b) is unable to express him or herself. If the conditions are met to activate the Advance Health Care Directive, the agent is given the authority to instruct health care providers as to what the intentions of the individual are, this may include that no artificial means be invoked to extend or sustain life.
Teri Schiavo was only 26 years old when she was afflicted. In the tragic dispute over what her desires were, there are no winners. Her case highlights the importance of creating an Advance Health Care Directive which is often drafted in conjunction with other estate documents such as wills, trusts and powers of attorneys. If you would like to discuss Advance Health Care Directives, or other aspects of your estate plan, please do not hesitate to contact us.
— J. Kenneth Butera