"Medical ethics requires that we apply values to facts," says Kenneth A. Richman, associate professor of philosophy and health care ethics at the Massachusetts College of Pharmacy and Health Sciences. "Terri Schiavo’s case is especially troubling because the parties disagree about both facts and values. The Schiavo case will have some good consequences if it encourages others to think carefully about what they want for themselves at the end of life, talk with their families and document their wishes in a living will."

Family's Painful Decision

Terri Schiavo was in her twenties when her brain injury occurred as a result of a chemical imbalance that deprived it of sufficient oxygen. Although she did not leave written instructions, her husband, Michael Schiavo has testified that she was emphatic in expressing her wishes to him that she would not want to be kept alive in a vegetative state.

Her parents have fought strenuously against Mr. Schiavo's decision to have his wife's feeding tube removed, thus allowing her to die of dehydration. They have argued both that their daughter is not in a persistent vegetative state and has hope of getting better, and that she would have wanted to continue living.

"Terri Schiavo likely never imagined her life would generate legislative interest, but she also likely never imagined she'd end up in a persistent vegetative state," said Glenda Brewer, attorney at Dallas' Cowles & Thompson. "If she had, she may have chosen to craft a directive to physicians, or living will, specifying how she wished to be treated. She can't tell anyone what she wants now, so those closest to her are left to argue her fate."

Political Intervention

Such conflicts can be prolonged and bitter, creating a permanent divide among the surviving family members, a result that the subject of the dispute almost surely would not want to occur. In Terri Schiavo's case, the controversy was played out not only in the courts, but in the halls of the US Congress. Following the removal of her feeding tube, Congress passed emergency legislation that gave her parents additional avenues of legal redress on the federal level.

Although President Bush made a dramatic trip from Texas to Washington, D.C., in order to sign the bill, the majority of Americans' strongly disapproved of the legislative intervention, public opinion polls indicated.

"What is being done to Terri Schiavo is an abuse of power that encroaches on the jurisdiction of the courts, both federal and state, to make these decisions," said Alice Herb, attorney, medical ethicist and faculty member in graduate program in health advocacy at Sarah Lawrence College. "These are laws that so far have been within the purview of the states and protect our personal guarantees of liberty to make decisions without government interfering when it sees a political advantage. Never mind running roughshod over the constitutional right of privacy, invading Mr. Schiavo's personal life and usurping his right to make decisions for his wife."

Despite the frenetic attempts of lawmakers, the federal courts were no more disposed to side with Terri Schiavo's parents than the Florida state courts had been. They persisted in their anguished efforts to have their daughter's feeding tube re-inserted, to no avail. The US Supreme Court declined to consider the case.

Living Will Urged

Terri Schiavo's saga need not be played out again, experts note. The lesson in her tragedy is that the means exist to make an individual's wishes known in such situations.

"A living will enables a person to think through and articulate their specific wishes regarding how they are to be treated if they are seriously ill or reaching end of life," says Nancy Davis, chief nursing officer at the Ochnsner Clinic Foundation. "It helps a person talk with his or her family, friends, and physician about what they want and prevents anyone from having to make these decisions.

"Completing a living will is important to do while you are not ill, not just when you've been diagnosed. This way, you and your significant others have time for real dialogue and understanding. It can be changed at any time if your wishes change. It allows a person to specify what 'life support' means to them so, at the end of life, others are not trying to guess what it means," Davis says.