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Terri Schiavo, one year later

A conference looks for lessons learned

March 31 marks the one-year anniversary of the death of Terri Schiavo, the severely brain damaged 41-year-old woman who was at the center of a bitter legal battle and right-to-die debate. That debate will be rekindled on Friday, March 31, at the second annual Health Law Program conference, an all-day event in the George Sherman Union auditorium organized by BU’s School of Law and School of Public Health. The Terri Schiavo Case: One Year Later will examine what, if any, legal, medical, ethical, and political lessons were learned from this highly publicized case. Speakers will include lawyers, health law scholars, and medical experts, among them Ronald Cranford, a physician who examined Schiavo in 2002. Trial court judge George Greer, who ruled that Schiavo’s feeding tube should be removed, will be awarded the School of Law’s N. Neal Pike Prize for Service to People with Disabilities.

After Schiavo suffered brain damage from a 1990 collapse that deprived her of oxygen, her husband, Michael Schiavo, claimed that she had stated that she would not want to be kept alive in such circumstances. In 1998, he petitioned the courts to have her feeding tube removed. The courts consistently sided with Michael Schiavo, who was deemed his wife’s legal guardian, and against Terri Schiavo’s parents, who fought to keep her alive. Their fight reached the levels of the federal government.

Rep. Barney Frank (D-Mass.), who led the Democratic charge against the emergency federal statute giving the federal courts jurisdiction to review the Schiavo case, will deliver a keynote address focusing on whether the government should be involved in personal medical decisions.
 
Conference organizer Wendy Mariner, a professor at BU’s schools of Law, Medicine, and Public Health and a speaker at the conference, says that end-of-life issues pose a recurrent problem and that because the circumstances are so heartrending, the law can be overlooked by the families involved.

“The law has always been that the patient can make decisions about her own treatment and can refuse treatment, even if refusing treatment means she wouldn’t get lifesaving or life-sustaining treatment and would eventually die,” says Mariner, an international authority on health law. “That has always been the easy part of the law. The hard part is the factual one — what does the patient want if the patient is incompetent and unable to speak for herself. Then it’s the guardian’s obligation to do what the patient would want.”

Mariner’s talk, titled Federalism at the Bedside, will examine whether health-care decisions should remain with the individual patient or whether the legislature should set standards for what care must be received.

“I think Congress has recognized that the public does not want them to intervene,” she says. “On the other hand, this case may be emblematic of an increasing willingness on the part of some interest groups to pressure the legislature to make specific changes in the law, which could perhaps have more serious long-term implications for the rule of law and the structure of the relationship between the individual and government.”

The Schiavo case has prompted some people to discuss right-to-die issues with their families, to draft living wills, or to appoint health-care proxies. Speakers at the conference will talk about how well these directives work, who is the best person to speak for an incapacitated patient, how the diagnosis of persistent vegetative state plays out in the courtroom, differences between the legal and personal conceptions of disability, and how the media portrays these cases to the public.  

The conference, from 8:30 a.m. to 5 p.m., is free and open to the public, but advance registration is recommended. To register and to view a complete list of participants, click here.