Terri Schiavo collapsed on to the floor of her house in 1990. When she was discovered by paramedics, she was unconscious and had been deprived of oxygen to her brain. She went into a coma, never regained the ability to express her wishes, and did not have a “living will”, which is a document which informs your loved ones and doctors of your wishes if you are incapacitated, cannot take care of yourself, and cannot make medical decisions for yourself.

(A “living will” is not technically a “will” because it is in effect for someone still alive. For this reason, a living will is more accurately called “advance healthcare directive” or “medical power of attorney”, or “healthcare proxy”.)

Terri’s husband, Michael, insisted that she preferred to die rather than remain on life-support. He insisted that she would prefer to be denied water and food rather than be kept alive in such a state. Terri’s parents, Robert and Mary Schindler, objected and argued that Terry wanted to live and would never have consented to death by dehydration and starvation. What resulted were more than a dozen appeals in Florida courts, five federal lawsuits, four denials of appeals to the U.S. Supreme Court, and public awareness of what can happen if you do not write and properly sign a “living will”.

In Michael’s favor in the litigation were the opinions of a number of doctors who said that Terri had no chance of recovery as well as the courts of Florida, which by precedent defer to the spouse if there is no living will.

In the Schindlers’ favor were numerous medical opinions questioning the other doctors’ judgments, the lack of medical knowledge about the sufferings at death of unresponsive but non-comatose people, and the fact that while Terri was hospitalized, Michael was living with another woman who had given birth to his child, yet he refused to divorce her and thereby concede control of her medical care to her parents.

Because of Florida’s strong court precedents in favor of the spouse in these situations, the courts eventually permitted Michael to deny Terri hydration and nutrition, and she died in 2005. Michael claimed that he kept his promise to Terri. Terri’s brother, however, said that no one who saw her die would believe death is what she wanted.

The question still debated vigorously is whether the denial of hydration and nutrition is a cruel thing. Before you sign a living will, you need to consider carefully this subject. On the form document of a living will there is a check box for whether you want your loved ones to deny you hydration and nutrition. Though there are medical opinions that the denial of water and food can lead to a painless death, altered consciousness is not a state well-understood by medical science. Those in a coma sometimes respond to pain but seldom recall the pain later. Coma is often the result of a brain injury, and in some cases, a person comes out of a coma years later.

Like Terri, a person can come out of a coma, be largely unresponsive, but not be “brain-dead”. Thus, those near death are in a medical frontier. A living will is how you can plan for such a terrible thing.

Terri Schiavo’s lack of a living will cost her family untold anguish and caused a titanic legal and cultural battle.

http://www.washingtonpost.com/news/speaking-of-science/wp/2015/01/13/meet-the-man-who-spent-12-years-trapped-inside-his-body-watching-barney-reruns
http://www.nybooks.com/articles/archives/2005/jun/09/the-case-of-theresa-schiavo