Terri Schiavo: 20 years after her death, her case still shapes end-of-life debates

CLEARWATER, Fla. - Twenty years have passed since the death of Terri Schiavo, the Florida wife who had been in a persistent vegetative state for 15 years before her feeding tube was removed in March of 2005.

Her husband insisted that Terri told him she'd never want to be on life support. But her family disagreed.

Terri died on March 31, heading into her 14th day without food and water amid what was the final legal setback for her parents after the U.S. Supreme Court again refused to hear their plea to reinsert her feeding tube.

Terri's life and death captivated the country and fueled conversations about end-of-life care and the necessity of the documents, known as advance directives or living wills. 

Who was Terri Schiavo? 

The backstory:

Terri Schiavo was born Theresa Marie Schindler to Robert and Mary Schindler on December 3, 1963, according to terrischiavo.org. She was the first of three children the Schindlers would have.

In 1983, Terri met Michael Schiavo. The couple married a year later and later moved from Pennsylvania to Florida. 

What happened to Terri Schiavo?

Dig deeper:

In 1990, at 26 years old, Terri collapsed at her home in Florida. Paramedics responded, and she was admitted to a local hospital. 

Heart attack and drug involvement were ruled out. Doctors never determined the underlying cause of her collapse but she was diagnosed with hypoxic encephalopathy – a neurological injury caused by lack of oxygen to the brain.

She was placed on a ventilator and eventually had to have a feeding tube. 

Days after her feeding tube was removed, she died on March 31, 2005. 

Schiavo's case divides public opinion 

Big picture view:

Terri's case divided her family and the country over the right to die and sparked end-of-life debates. 

The battle went through several courts and even to the White House after her husband declared that his wife stated she did not want to ever be on life support. Her parents refuted that claim, making every effort to keep her alive. 

"Schiavo was huge landmark in maintaining the rights of spouses to stop any and all medical interventions," Arthur Caplan of New York University told ABC News in 2015. "But it raised all sorts of uncomfortable questions about when it becomes acceptable to remove someone from life support, even when the law makes it clear."

A 2005 USA TODAY/CNN/Gallup poll showed that after Terri's death, 52% of Americans believed the feeding tube should've been removed, while 42% believed it should've remained. 

Timeline of Schiavo's case 

Timeline:

The court battle over Terri's condition, care, and preferences lasted for over a decade.

• 1990: Terri collapses at home on February 25. She's admitted to Northside Hospital in St. Petersburg, Florida. Doctors diagnose her with a brain injury.
• 1991: Terri is transferred to Sable Palms Nursing Facility in Largo, Florida, for physical rehabilitation.
• 1993: Terri's husband and her family become at odds over the course of her treatment. Michael's guardianship is challenged in court by Terri's family.
• 1998: Michael's attorney files a petition to withdraw life support.
• 2000: Judge George W. Greer in Pinellas-Pasco’s Sixth Judicial Circuit hears the petition to withdraw life support and orders Terri's feeding tube to be removed. Terry is transferred to the Hospice of the Florida Suncoast. Terry's family tries to appeal the ruling, but the Florida Supreme Court and the U.S. Supreme Court decline to hear the case.
• 2001: Terri's feeding tube is removed, but the judge issues an injunction allowing the tube to remain.
• 2002: A medical evidentiary trial is held where the judge ultimately rules that Terri is in a peristent vegetative state and orders the feeding tube to be removed.
• 2003: The Florida Legislature holds a special session and passes "Terri's Law", giving authority to then-Governor Jeb Bush to reinsert Terri's feeding tube. The law is ultimately ruled unconstitutional.
• 2005: The U.S. Supreme Court declines to hear the case. After more legal back-and-forth and commentary from Congress and Gov. Bush's brother, President George W. Bush, a judge rules for Terri's feeding tube to be removed. She dies nearly two weeks later.

Schiavo's impact on end-of-life care

Why you should care:

Twenty years after her death, it seems that most Americans don't document how they would like to handle their own end-of-life care. 

According to Hospice News, many Americans know the types of end-of-life care they wish to receive, but only 22% have documented their wishes. The outlet also reported that about 25% of those who have documented their wishes are white. African Americans represented 22%, Hispanics 21% and Asians 7%.

"Advance care planning is something that can benefit all people. Unfortunately, there is a gap between thinking about end-of-life planning and actually documenting those wishes," Dr. Joseph Shega, executive vice president and chief medical officer at VITAS, told the outlet. "I can’t stress enough how valuable advance care planning is for all Americans. It allows patients to make their preferences known early and is useful as they become seriously ill and enter advanced disease stages."

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