End-of-life issue not new; attention was


Mary Schindler is lead into the Woodside Hospice where her daughter Terri Schiavo has been a patient shortly after being informed of her daughter's death Thursday, March 31, 2005, in Pinellas Park, Fla. Schiavo, the severely brain-damaged woman who spent 15 years connected to a feeding tube in an epic legal and medical battle died Thursday, 13 days after the tube was removed. She was 41.

The Associated Press
Published: Friday, April 1, 2005 at 6:01 a.m.
Last Modified: Friday, April 1, 2005 at 12:13 a.m.
The medical and ethical issues, local experts said, aren't new.
Long before Terri Schiavo became a household name, families were debating end-of-life issues for their loved ones and making tough decisions about how best to honor their wishes.
Schiavo, who died Thursday, simply made death a topic of national debate.
"The underlying medical issues have been repeated thousands of times around country," said Barbara Noah, a research associate at the Levin College of Law at the University of Florida. "In many families, conflicts need to be resolved by a court or through intervention committees at hospitals. What's different about this case is that it became a public debate."
Noah and other local experts said the legacy of that debate could spur new standards for judicial nominations, as end-of-life issues become as political as abortion and stem cell research.
Noah also said the state Legislature could consider setting stricter standards for determining end-of-life wishes, such as requiring advance written notice or a comment that explicitly describes the medical circumstances in which a person wouldn't want to be kept alive.
"There are some states that say that, absent a written advance directive, the presumption is of continuing all life support," Noah said. "The state Senate appears to be fairly resistant to radical changes, but we can't rule out the possibility that legislators will consider moderate reforms."
Noah said in a similar case in Virginia in the 1990s, state legislators became involved in an end-of-life dispute between a man's spouse and his parents.
Still, Bill Allen, the director of the bioethics program at the UF's College of Medicine, said he and many of his colleagues were shocked to see the Schiavo case hit the Legislature.
"I never would have predicted that the governor and the Legislature would jump into something like that, on the basis of not having any real knowledge of the medical issues surrounding the case, but they did," Allen said. "There are some things here that lend some unpredictabilty to the situation, though, and it has to do with our culture's fear of death."
Allen and Noah both said it's hard to say whether legislators would intervene in a similar case in the future.
Representatives from the Hospice of North Central Florida said they were encouraging people to put their end-of-life wishes in writing long before the need arises, and Allen said he wouldn't be surprised to see an increase in written notices.
But Allen also said he wouldn't be surprised if that increase leveled off after the Schiavo case faded from the national spotlight.
"My experience in this field for over 15 years has convinced me that there's enough reluctance for people to face death that, even if they are faced with an issue that makes them say, 'I should write down my wishes,' it tends to fly back down the priority list soon," Allen said.
William H. Donnelly, the former chief of autopsy services at the UF College of Medicine, said an autopsy would show what Schiavo's brain looked like when she died, but would not lend any insight into what her functional levels were.
"There's no way we can explain that," Donnelly said. "The autopsy may not answer all the questions people have, which is going to be difficult."
Amy Reinink can be reached at (352) 374-5088.

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