The Terri Schiavo case was in the news for several years before she eventually died from dehydration on March 31, 2005. Admittedly, at the time it was a case that was only marginally on my radar. I was pursuing my undergraduate degree in chemistry when the news was buzzing about it, and I was neck-deep into my master’s degree when she eventually died.
During this time, I had a professor, a no-nonsense slightly abrasive New Englander, who ran an upper-level chemistry laboratory class that met for a grueling eight hours per week. Typically, there was some down time while we waited for the reaction to complete or for the machine to finish its readings. On one particular day, when we had to wait twenty minutes for a sample to run through the NMR, the topic of Terri Schiavo came up.
I had taken a Law and Medicine class my sophomore year that covered the quintessential U.S. Supreme Court cases involving medical issues. It was a pre-law class that involved reading the Court’s opinions and scrutinizing the facts of the cases and the precedents that were set. Among those cases were the Karen Ann Quinlan case and the Nancy Cruzan case. After taking this class, and making an A, I deemed myself an expert on these matters, so when my professor said something about the Schiavo case, I confidently replied, “Well, her husband is her legal surrogate, so what he says goes” which is not exactly what the Cruzan case said, but that was how I applied it anyway. I did not actually know very much about the Schiavo case other than there was some legal wrangle between the husband and the parents. It was quite simple in my wizened twenty-one year old head that whatever the parents were wanting, the husband is the legal surrogate. There was legal precedent. Case closed. My professor replied, “Well, if it was your daughter, you might think differently.”
Having at least the wherewithal to not argue with him, I said okay and got back to more important matters, like checking to see if my sample was done in the NMR and if it was pure product. It turns out his reply had more wisdom in it than I had recognized at the time. I did not see Terri Schiavo as a human being and I did not understand what was wrong with removing a medical treatment from “someone like her.”
I was wrong. I had no compassion for this person, and, I am ashamed to admit that as a college student, it was beyond me that someone with such minimal cognitive function would even know or care what you did to them. I also had no clue about the facts of the case because, at the time, I was too caught up with the stuff of life like coursework, graduation, and my senior thesis to pay attention to the news. I didn’t even know until a couple of years later that her husband had a girlfriend with whom he had two children, or that there was a difference between persistent vegetative state and whole brain death, for that matter.
In the spring of 2006, I took a bioethics class that was not part of my graduate program. At that point, my research was not going so well, and what should have been a two-year master’s degree was well into year three. I was getting pretty depressed about the whole thing, and decided that I needed a change of pace from the lab work. I signed up for a graduate level bioethics class that was being offered in the evening at the university.
I was going to a state university, so this class could have been taught from any number of moral perspectives or worldviews. As it turns out, the professor’s day job was as a practicing cardiologist. My professor was an older, laid back kind of guy who enjoyed leading discussion and encouraging questions. He also brought to the class the doctor’s perspective. He kept the class from getting too theoretical by gently reminding us that these issues involve real patients (and real doctors).
He had us go through the fundamentals of medical ethics like the Hippocratic Oath, and we read many of the quintessential books in the field like Jonsen’s Birth of Bioethics and excerpts from Beauchamp and Childress. It was a solid survey of bioethics. We eventually covered the Terri Schiavo case, which included a detailed timeline of events. At this point in the semester, it was almost year since Terri Schiavo had died.
After all of our readings and class discussions, by the time we got the Schiavo case, it was certainly not very cut-and-dry in my mind. Questions that I had not considered, such as whether it is right to deem some lives not worth living, even if the person is severely mentally disabled? And, what does quality of life even mean? Also, I had never made the distinction between extraordinary measures and ordinary care, and while the Cruzan case called artificial feeding and nutrition a kind of medical technology, which can therefore be stopped if that was the patient’s wish or if there is no perceived benefit, there is some debate as to whether it should actually be considered part of basic care. Additionally, I had not considered the distinction between removing artificial feeding and nutrition from someone who is immanently dying verses someone who is in a persistent vegetative state.
After reading the details, her husband was her legal surrogate by default because she did not have a living will. There were questions of whether he was acting in Ms. Schiavo’s best interest and whether there was evidence of neglect. Furthermore his relationship with another woman called into question his motivations as well as whether he was still legally Terri Schiavo’s surrogate.
This case was far more nuanced than I had thought it was. And the subject matter required more compassion than I certainly had a few years before.
I ended up graduating with master’s degree in chemistry, choosing not to pursue my PhD. But, I did eventually go back to school and received a master’s degree in bioethics from a university with one of the foremost bioethics programs centered on the concept of human dignity. There were several reasons that lead to my decision to major in bioethics, but, admittedly, something that stuck with me was just how naive I was about the Terri Schiavo case and what little regard I had had for her humanity.