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The Guardian

In 1998, Terri Schiavo's first guardian ad litem filed a report on her case. It makes for interesting reading today.

6:40 AM, Nov 4, 2003 • By WESLEY J. SMITH
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THE TERRI SCHIAVO CASE continues to take dramatic twists and turns. Even as Michael Schiavo attempts to have Terri's Law declared unconstitutional, pursuant to the law's requirements, a judge has appointed a guardian ad litem--Professor Jay Wolfson, of the College of Public Health at the University of South Florida in Tampa--to represent Terri's interests.

There has been some confusion as to whether Wolfson replaces Terri's quasi-estranged husband Michael Schiavo as guardian of Terri's person. (I use the term "quasi-estranged" because Schiavo effectively shattered the sanctity their marriage years ago by entering a committed relationship with another woman and starting a family with her.) He does not. Wolfson's sole responsibilities are to determine whether Terri should be allowed a swallow test, whether she should be provided rehabilitation, and to write a report with his recommendations about these matters--all within 30 days. In the meantime, Schiavo remains fully in control over Terri' life and care (or the lack thereof)--with the exception that he cannot, for now, remove her tube-supplied food and water.

A little known but interesting facet of this case is that Wolfson is not the first guardian ad litem appointed to represent Terri's interests. When Schiavo first petitioned the court for permission to dehydrate his wife in 1998, he properly admitted that he had two significant conflicts of interest: He was likely to want to remarry and if Terri died, he would inherit the more than $700,000 then on deposit in her trust account. (For those who have not followed this case, Terri received the money in a medical malpractice lawsuit.)

Because of these conflicts of interest, the Probate Court appointed Richard L. Pearse Jr. of Clearwater, Florida, as Terri's guardian ad litem and instructed him to investigate the matter and report back with a recommendation. Pearse filed his report with the court on December 28, 1998 urging that the court deny the petition to remove Terri's food and water.

Considering that the Pearse's report was written long before the Schiavo case became an international cause celebre, it makes interesting reading. The guardian ad litem supported Schiavo's position on some points and the Schindlers on others. The following are its pertinent portions:

*Pearse unambiguously accepted the diagnosis that Terri is in a persistent vegetative state (PVS) based on the opinions of two doctors, one who treated her and one who consulted on the case. This diagnoses was--and remains-- disputed by Terri's parents, Bob and Mary Schindler. Indeed, subsequent to Pearse's report, the Schindlers energetically attempted to garner evidence that she is conscious. To some degree, they have succeeded: Four board certified neurologists, two board certified internists, one neuro-psychologist, and two speech pathologists have testified in person or by affidavit that Terri is not PVS. These opinions were reinforced by the affidavits of three nurses who cared for Terri in the mid-1990s and who claim to have observed her being interactive. Moreover, millions have viewed videos of Terri and been shocked by the extent to which she appears to aware and awake. (The courts have ruled consistently that Terri is PVS.)

*Pearse claimed that Terri has muscle contractures despite receiving "regular physical therapy." He may have assumed that she received such care--it is routine for bedridden patients, after all. Yet, according to Patricia Anderson, the Schindler's attorney, there are no entries indicating that PT was ever performed in Terri's chart after 1992. Indeed, in 1998, when a new doctor urged Schiavo to approve an evaluation of Terri so that a plan of physical therapy could be developed, he refused to permit it.

*Pearse confirmed the charge by the Schindlers that once the medical malpractice money was in the bank, Schiavo began to refuse medical treatment for Terri, writing:

After February 1993, Mr. Schiavo's attitude concerning treatment for the ward apparently changed. Early in 1994, for example, he refused to consent to treat an infection from which the ward was then suffering and ordered that she not be resuscitated in the event of cardiac arrest. The nursing home where she resided at that time sought to intervene, which ultimately led the ward's husband to reverse his decision and authorize antibiotic treatment.

Perhaps because of the intervention by the home, Schiavo soon moved Terri to a different nursing facility.