Supreme Court refuses to hear Schiavo case

By refusing to hear the case of Jeb Bush v. Michael Schiavo, the U.S. Supreme Court may have ended a long legal battle that is believed to have sparked public interest in living wills and advance directives.

The court's Jan. 24 decision upheld the Florida Supreme Court's Sept. 3, 2004, ruling overturning a state law that gave Gov. Jeb Bush specific authority to reinsert the feeding tube for Terri Schiavo, a Florida woman who has been in a persistent vegetative state for 15 years.

The court's decision appears to end the dispute between Schiavo's husband, who argued that she would not want to continue living in her current state, and her parents, who say she is mentally aware. Unable to swallow, Schiavo receives nutrition and water through a tube. In 2001 and 2003, courts allowed Michael Schiavo to discontinue feedings for his wife, only to have others order them reinstated.

Terri Schiavo's parents have other appeals, but a Supreme Court ruling was believed to be their best chance at keeping their daughter's tube in place. It was not immediately known if or when the tube would be removed.

Diane Coleman, president of Not Dead Yet, a national disability rights group based in suburban Chicago, said there is still hope Schiavo's parents will somehow attain custody. She said California's 1990 "Richard S" case established the principle that custody of impaired individuals should go to the party willing to commit to that individual's care.

Both the Florida Medical Assn. and the AMA have remained neutral on the Schiavo case.

"That really is the principle that we think the Florida court should be going on," Coleman said.

Because of the way the case wound through Florida's judicial, legislative and executive branches before ending in the U.S. Supreme Court, Arthur R. Derse, MD, said it offers "a lesson more in civics than medical ethics."

"Most end-of-life cases end with families and physicians on the same page," said Dr. Derse of the Medical College of Wisconsin in Milwaukee's Center for the Study of Bioethics. "This a testimonial that the best way to resolve these issues is by making your wishes known."

Terri Schiavo had no advance directive.