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Last Updated: Friday, 31 March 2006, 08:35 GMT 09:35 UK
Schiavo controversy still rages
By Matthew Davis
BBC News, Washington

A younger Terri Schiavo
Schiavo's husband and parents fought over her fate

The controversy over the fate of brain-damaged Terri Schiavo began as a row between her husband and her family, but ended in a political and ethical debate that engaged the whole of America. A year after her death, the recriminations and rows continue.

Terri Schiavo died 13 days after her feeding tube was removed, with the authority of a legal order granted to her husband Michael but opposed by her parents, America's religious right, Republicans in Congress, President Bush, and even the late Pope John Paul II.

She had been in what her doctors said was a persistent vegetative state since 1990, when her heart had stopped beating for several minutes, starving her brain of oxygen.

Michael Schiavo and Robert and Mary Schindler fought a bitter legal battle for seven years. He said Terri had told him she would not want to live on in such a state. They believe she did not want to die and could improve with treatment.

Towards the end, fuelled by political interest groups and the media, this personal tragedy became one of the most litigated medical cases in US history and sparked a national debate about death and dying, law and the family.

Battle of the books

Today the bitter feud between Michael Schiavo and his 41-year-old wife's parents has not abated.

By defaming our family, Michael Schiavo is somehow trying to vindicate himself and justify what he did to Terri
Bobby Schindler

Both sides have just released books attacking each other over the death and continuing the recriminations.

In Terri: The Truth, Michael Schiavo chronicles his legal fight with the Schindlers and recalls the death threats and other pressures that illustrate the passions the case aroused.

"A religious zealot put a $250,000 bounty on my head, urging that I be tortured before I'm killed.

Terri Schiavo's father Bob Schindler at a memorial service
Terri Schiavo's parents accuse Mr Schiavo of abusing her

"I was condemned by the president of the United States, the majority leaders of the House and Senate, the governor of Florida, the Pope, Jesse Jackson and the right-wing media," Mr Schiavo said in an excerpt.

Meanwhile, in A Life That Matters: The Legacy of Terri Schiavo - A Lesson for Us All the Schindlers again accuse Mr Schiavo of abusing Terri - an allegation not supported by the autopsy - and say she would not have wanted her feeding tube removed.

"By defaming our family, Michael Schiavo is somehow trying to vindicate himself and justify what he did to Terri," Terri Schiavo's brother, Bobby Schindler told the Associated Press.

"Unfortunately, nothing he says will change the fact that because of his selfish actions Terri is no longer with us. His book does not honour Terri or her life."

Judges 'fear litigation'

While the recriminations continue, so too does the debate over right to life issues.

TERRI SCHIAVO CASE
File photo of Terri Schiavo
Feb 1990: Terri Schiavo collapses
May 1998: Mr Schiavo files petition to remove feeding tube
Oct 2003: Florida lower house passes "Terri's Law", allowing governor to order doctors to feed Mrs Schiavo
Sept 2004: Florida Supreme Court strikes down law
18 Mar 2005: Florida court allows removal of tube
22 Mar 2005: Federal judge rejects appeal
23 Mar 2005: Appeals court backs federal ruling
29 Mar 2005: Federal court grants parents leave to appeal
30 Mar 2005: Federal court and Supreme Court reject parents' appeal
31 Mar 2005: Terri Schiavo dies

In the wake of the Schiavo case, dozens of states considered new laws to address end-of-life issues pushed, critics say, by religious and social conservatives fighting to change laws and elect right-wing judges.

Dr Kenneth Goodman, an ethics professor at the University of Miami, says that much of the legislation aimed at making it difficult to withdraw care in end-of-life cases had failed to make it onto the statute books.

Yet he believes there has been a more sinister trend of doctors "over-treating" patients in such cases because of fears over litigation.

"Families disagree about end-of-life care all the time," he told the BBC. "But in those kinds of disputes the path of least resistance is often to continue aggressive treatment.

"There is a lot of anecdotal evidence to suggest that decisions are not being made in the best interests of the patient, but through fear of being targeted by lawsuits."

A more positive legacy of the case is an increase in the number of Americans making "living wills", end-of-life directives or simply discussing the what-ifs with their loved ones.

Visits to the US Living Will Registry increased from 500 per day to 50,000 per day during the height of the Schiavo controversy.

They have levelled off to about 2,500 daily, but there has been a fourfold increase in the number of registered documents on the site.

Political stakes

The lasting political effects of the case may be harder to measure.

Political analyst Professor Stephen Hess told the BBC: "This case was very emotionally charged, very dramatic - and very badly handled.

"The fact that it became more and more central to the public debate had to do not just with the agenda of social conservatives, but also because the media picked it up to such an extent that everyone had to take a position on it.

"Sometimes in politics it is not what you gain by doing something, but what you lose by not doing something that becomes important.

"The fact that so many politicians were drawn into the debate shows how high the stakes were."




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