When the Florida Legislature passed "Terri's Law" empowering Gov. Jeb Bush to reinsert Terri Schindler-Schiavo's feeding tube, one of the provisions was the appointment of a guardian ad litem. This individual would not replace Terri's legal guardian, her husband, but would review Terri's situation and make recommendations.

On Tuesday, the 40-page report of University of South Florida Professor Jay Wolfson was made public. The emphases of today's newspaper stories are that Wolfson concluded that Terri is "in a persistent vegetative state (PVS) with little hope of recovery," as the St. Petersburg Times put it, and that he "also recommended a new set of swallowing tests to see if Mrs. Schiavo can eat and drink on her own. If so, he said, it might be presumed Mrs. Schiavo would want to live." (Although Wolfson does not say so in exactly so many words, the clear implication is that if Terri can swallow on her own, she is not in a persistent vegetative state.)

I have no reason to doubt Prof. Wolfson's competence, motives, or sincerity.  Having said that, there are still issues he left unaddressed (perhaps because of the mere 30 days he was given to report). In his response, Gov. Jeb Bush hit on some of the most important. His statement is reproduced below in full.

"I appreciate Dr. Wolfson's time and effort in this endeavor. I also respect the tremendous challenge of preparing an accurate, independent and thorough review of nearly 10 years of information in only 30 days. That Dr. Wolfson recognizes the continued need for an independent third party Guardian Ad Litem is encouraging, as is his recommendation that Mrs. Schiavo undergo swallowing tests and therapy.  Based on this third party analysis, I am hopeful that Mr. Schiavo and his attorney will no longer prevent this vital testing from taking place.  This would be a first step in the fresh, clean-hands start that Dr. Wolfson recommended at the end of his report.

"Taken as a whole, however, I am concerned that too many open questions still remain. Chief among them is the issue of Mrs. Schiavo's wishes, and whether or not there is clear and convincing evidence as to what those wishes were.  The current court proceedings have not addressed this issue, or her current guardian's conflicts of interest, nor have I been given the opportunity to develop evidence, or test the accuracy of Mr. Schiavo's assertions on this matter.

"I am also concerned we do not know the expertise of the individuals who provided the 'answers' to the questions that are addressed in the report. I am sure that Dr. Wolfson, who indicated his reliance on 'good science-based medicine,' understands the importance of knowing which good scientists and good doctors he relied on to reach certain conclusions.

"As I have said from the beginning, the state must protect every Floridian's right to life, and in so doing, err on the side of life. As Governor, I will continue to do just that. Nothing in Dr. Wolfson's report leads me to believe the stay should be lifted at this time, or that Mrs. Schiavo should be deprived of her right to live."

In short: (1) Terri's alleged desire not to live "artificially" is based on hearsay evidence from her husband, her husband's brother and his wife. These alleged remarks did not surface, according to Newsweek, until after Terri's husband won a $1 million medical malpractice settlement.

(2) There is a difference of expert medical opinion over whether Terri is in a so-called "persistent vegetative state." As was pointed out to me, Florida's definition of PVS requires an "absence of voluntary action or cognitive behavior of any kind."   Yet those doctors who concluded Terri was in a PVS appeared to have based this diagnosis not on the "absence of voluntary action or cognitive behavior of any kind," but because her responses were "not repetitive or consistent," as Wolfson described his own assessment of Terri's reactions.

(3) It is the duty of the state to err on the side of life.

According to the Chicago Tribune, Wolfson nearly succeeded in hammering out an agreement over the weekend between Bob and Mary Schindler (Terri's parents), her husband, and Gov. Bush. "The tentative agreement, arranged by Wolfson, called for independent medical testing of Schiavo and a private resolution to the matter," the Tribune reported. "But [Robert] Schindler said George Felos, the lead attorney for Schiavo's husband, backed out of the deal."

One other thought for today. After insisting that Terri is in a PVS, Wolfson wrote this:

"This having been said, Theresa has a distinct presence about her...It would be easy to detach from her if she were comatose, asleep with her eyes closed and made no noises. This is the confusing thing for the lay person about persistent vegetative states."

Maybe it's not so confusing. Maybe it's clearer than Wolfson thinks.  Maybe if there is a difference of opinion, and one party to the debate wishes to starve a patient to death while the other offers to care for the patient, then the choice should be for life!

By: Dave Andrusko
Source: Today's News and Views (NRLC)
Publish Date: December 3, 2003
Online at: http://nrlc.org/News_and_Views/December03/nv120303.html

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