Fight over Florida woman's fate

In a room in a hospice in Pinellas Park, Florida, a woman named Terri Schiavo lies in bed. By various accounts she reacts and even interacts with staff and visitors.

But she has been incapacitated since suffering brain damage after a collapse in 1990 and her husband Michael says it is now time to let her die as she would have wished.

Mrs Schiavo needs no machines to keep her heart, lungs or other organs working but must be fed through a tube to her stomach - without this source of nutrition, she would die.

Her parents, Robert and Mary Schindler, say Mr Schiavo wants to free himself from his wife so he can re-marry. They also say he has spent hundreds of thousands of dollars in a fund for her care on legal costs. Mr Schiavo's lawyer says the money has been spent on medical bills.

The Schindlers have petitioned a federal court to try to overturn a ruling won by Mr Schiavo for the feeding tube to be removed at 1400 local time on 15 October. A hearing has been scheduled for 10 October.

Because of the pending court cases, neither the parents nor Mr Schiavo is giving interviews. But the parents' position is clear from their petition and Mr Schiavo's lawyer, George Felos, speaks for his client.

Mr Felos told BBC News Online that Mr Schiavo had come to the conclusion that his wife could not recover after several years of hoping for rehabilitation. At that time, he decided he needed to follow his wife's wishes - expressed on more than one occasion - that she did not want to be kept alive by tubes.

"The case is not about what Michael wants or the parents want - it's about what Terri wants," he said.

But the Schindlers accuse Michael Schiavo of making up his wife's wishes and say he has denied her rehabilitation treatment they believe could have helped her to learn how to eat again and so live without the feeding tube.

The parents' petition says Mr Schiavo has "generally deprived Terri of her dignity as a human being, and treated her as though she were already dead".

It accuses him of "deliberately and maliciously" abusing the special relationship he has with his wife who also became his ward after her collapse through, among other things, "his decade-long campaign of deliberately degrading Terri's neurological responses by a calculated plan of sensory deprivation; his looting of Terri's guardianship estate for attorney fees in the effort to have her killed, contrary to his promises to the jury about how the money would be used; and his cohabitation with another woman, during which he has fathered two children out of wedlock".

After the petition was filed, however, George Felos said: "I would hope that the federal judge looking at this realises this is just an attempt to rehash what has gone on before.

"I think a federal judge is well aware that he doesn't have jurisdiction. Beyond that, it must be pointed out that so much of what is in this complaint is just an out-and-out lie."

So far, court rulings have swung between the two sides. Mr Schiavo has won orders from a judge that the feeding tube be removed - and it was taken out for two days in April 2001.

But various appeals and stays have also been allowed, though both the Florida Supreme Court and the US Supreme Court have refused to become involved.

Doctors chosen by the two sides to give medical opinions disagree on whether there is any hope of recovery for Mrs Schiavo, though a court-appointed physician agreed with Mr Schiavo's experts that there was none.

Dr Robert Walker, who teaches ethics at the University of South Florida's medical school, said it was a difficult case for all concerned.

"The one question is really making an accurate diagnosis of her brain damage and what her capacity is and whether there is potential for improvement "
Dr Robert Walker, University of South Florida

He told BBC News Online that it was near-impossible to say who was right and who was wrong given the fact that Mrs Schiavo - who was only 26 when she collapsed - had made no living will saying exactly what treatment she would want.

"It would be wrong to treat someone in her condition against her will but it would be wrong to discontinue treatment if she wanted it to be continued," he said.

Dr Walker said Florida state law did not differentiate between not starting medical procedures - which by its standards includes the use of a feeding tube - and stopping them.

But he said there was a great emotional difference for patients, their relatives and doctors between deciding not to do something - such as shocking a patient's arrested heart - which might prolong life, and withdrawing treatment which would lead to death.

In this case, however, he believed that the manner of death need not be a factor.

Cortex 'destroyed'

Mr and Mrs Schindler say their daughter would die slowly and painfully from starvation. Such a death would be a graphic and horrifying thought to most people, but Dr Walker said Mrs Schiavo simply does not feel hunger or thirst.

Mrs Schiavo's brain scans have not been made public but Dr Walker has followed the case closely through media reports and court records.

"The majority of her cerebral cortex - the part of the brain that thinks and feels - has been destroyed and replaced by fluid," he said.

"She doesn't have any perception, there is no reason to believe she can suffer."

Unlike a patient in a coma, Dr Walker believes there is no hope for recovery for someone in Mrs Schiavo's condition - known as permanent vegetative state - because the cerebral cortex does not regrow once destroyed.

Despite the medical term, however, video of Terri Schiavo on a website run by her parents' supporters shows her more like a baby. But this is misleading as the movements are purely reflexes, Dr Walker says.

"The hard part of it is when you look at her, her eyes open, she blinks, she moves her head. If you do things that seem to be uncomfortable she will recoil from that but all of these things are known to be reflexive," he said.

"Terri Schiavo is very much alive, she is not in any sense dead, but she is severely brain damaged.

"The one question is really making an accurate diagnosis of her brain damage and what her capacity is and whether there is potential for improvement. These are matters for medical experts - that's a proper role for physicians.

"What's not proper for physicians is to be deciding whether Terri Schiavo continues in this way or not. That should be going by her wishes... it's not what others would want for her but what she would want for herself."

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