Terri Schiavo case

===''Schiavo III and IV'': PVS diagnosis challenge===
[[File:schiavo catscan.jpg|frame|right|Left: [[CT scan]] of normal brain; Right: Schiavo's 2002 CT scan provided by [[Ronald Cranford]], showing loss of brain tissue. The black area is liquid, indicating [[hydrocephalus|hydrocephalus ex vacuo]].<ref>{{cite journal|url=http://www.medscape.com/viewarticle/511647|title=In Brief: The Afterlife of Terri Schiavo|last=Fins|first=Joseph|author2=Nicholas Schiff|journal=The Hastings Center Report|publisher=The Hastings Center|volume=35|issue=4|page=8|date=September 1, 2005|access-date=October 1, 2005|doi=10.1353/hcr.2005.0038|pmid=16225295|s2cid=44800298|archive-url=https://web.archive.org/web/20121211012736/http://www.medscape.com/viewarticle/511647|archive-date=December 11, 2012|url-status=live|df=mdy-all}} Quote: "She had developed hydrocephalus ex vacuo, a condition marked by enlarged ventricles filled with cerebrospinal fluid, because of this profound loss of cortical volume."</ref> The small white piece in the right image is the [[thalamic stimulator]] implanted in her brain.]]
On August 10, 2001, on remand from the [[Florida Second District Court of Appeal]], Judge Greer heard a motion from the Schindlers claiming that new medical treatment could restore sufficient cognitive ability such that Terri Schiavo herself would be able to decide to continue life-prolonging measures. The court also heard motions from the Schindlers to remove the guardian (Michael Schiavo) and to require Judge Greer to [[recuse]] himself. Judge Greer denied the motions and the Schindlers appealed to the Second District Court of Appeals. On October 17, 2001, the Court of Appeal affirmed the denials of the motions to remove and recuse. The Court of Appeals acknowledged that their opinion misled the trial court, and they remanded the question of Terri Schiavo's wishes back to the trial court and required an evidentiary hearing to be held. The court specified that five board certified neurologists were to testify. The Schindlers were allowed to choose two doctors to present findings at an evidentiary hearing while  Schiavo could introduce two rebuttal experts. Finally, the trial court itself would appoint a new independent physician to examine and evaluate Terri Schiavo's condition. These decisions, all published in a single order by the Florida Second District Court of Appeal,<ref>{{cite web|url=http://www.2dca.org/opinion/October%2017,%202001/2d01-3626.pdf|title=In re: Guardianship of Theresa Marie Schiavo, Incapacitated. Robert Schindler and Mary Schindler, Appellants, v. Michael Schiavo, as Guardian of the person of Theresa Marie Schiavo, Appellee, Case Number: 2D01-3626|author=Altenbernd, Chris W. Judge (for The Court)|publisher=Florida Second District Court of Appeal|date=October 17, 2001|page=12|access-date=February 22, 2006|archive-url=https://web.archive.org/web/20060311110308/http://www.2dca.org/opinion/October%2017,%202001/2d01-3626.pdf|archive-date=March 11, 2006|url-status=live|df=mdy-all}}</ref> came to be known by the court as ''Schiavo III'' in its later rulings. In October 2002, on [[remand (court procedure)|remand]] by the Second District Court of Appeal, an evidentiary hearing was held in Judge Greer's court to determine whether new therapy treatments could help Terri Schiavo restore any cognitive function. In preparation for the trial, a new [[computed axial tomography]] scan (CAT scan) was performed, which showed severe [[cerebral atrophy]]. An [[Electroencephalography|EEG]] showed no measurable brain activity. The five physicians chosen were William Maxfield, a [[radiology|radiologist]], and four [[neurology|neurologists]]: William Hammesfahr, Ronald Cranford, Melvin Greer and Peter Bambakidis.<ref>{{cite news|url=http://www.sptimes.com/2003/11/10/Tampabay/Schiavo_tapes__snippe.shtml|title=Schiavo tapes: snippets, then not much|last=Nohlgren|first=Stephen|work=St. Petersburg Times|date=November 10, 2003|access-date=April 5, 2008|archive-url=https://web.archive.org/web/20080111053415/http://www.sptimes.com/2003/11/10/Tampabay/Schiavo_tapes__snippe.shtml|archive-date=January 11, 2008|url-status=live|df=mdy-all}}</ref>

The five doctors examined Terri Schiavo's medical records, brain scans, the videos, and Terri herself. Cranford, Greer, and Bambakidis testified that Terri Schiavo was in a persistent vegetative state (PVS). Drs. Maxfield and Hammesfahr testified that she was in a [[minimally conscious state]]. As part of the court-ordered medical exam, six hours of video of Terri Schiavo were taped and filed at the Pinellas County courthouse. The tape included Terri Schiavo with her mother and neurologist William Hammesfahr. The entire tape was viewed by Judge Greer, who wrote, Terri "clearly does not consistently respond to her mother". From that six hours of video, the Schindlers and their supporters produced six video clips intended to support their case, totaling less than six minutes, and released those clips to public websites.<ref name="tbo">{{cite news|url=http://news.tbo.com/news/MGBQ67CTI6E.html|title=Schiavo Videotapes Offer Powerful But Misleading Evidence|last=Smith|first=Brad|work=Tampa Tribune|date=March 20, 2005|access-date=February 17, 2006 |archive-url=https://web.archive.org/web/20050320120815/http://news.tbo.com/news/MGBQ67CTI6E.html |archive-date=March 20, 2005 |url-status=dead}}</ref> Judge Greer ruled that Terri Schiavo was in a PVS, and was beyond hope of significant improvement. The trial court order was particularly critical of Hammesfahr's testimony, which claimed positive results in similar cases by use of [[vasodilation]] therapy, the success of which is unsupported in the medical literature.<ref>{{cite web|url=http://abstractappeal.com/schiavo/trialctorder11-02.txt|title=In re: The guardianship of Theresa Marie Schiavo, Incapacitated. Michael Schiavo, as Guardian of the person of Theresa Marie Schiavo, Petitioner, v. Robert Schindler and Mary Schindler, Respondents, File No. 90-2908-GB-003|author=Greer, George W. Circuit Judge|publisher=Florida Sixth Judicial Circuit|date=November 22, 2002|access-date=February 4, 2006|archive-url=https://web.archive.org/web/20110709123342/http://abstractappeal.com/schiavo/trialctorder11-02.txt|archive-date=July 9, 2011|url-status=live|df=mdy-all}}</ref> This ruling was later affirmed by Florida's Second District Court of Appeal, which stated that "this court has closely examined all of the evidence in the record", and "we have&nbsp;... carefully observed the video tapes in their entirety." The court concluded that "if we were called upon to review the guardianship court's decision ''[[Trial de novo|de novo]]'', we would still affirm it." This decision by the Second District Court of Appeals<ref>{{cite web|url=http://www.2dca.org/opinion/June%2006,%202003/2D02-5394.pdf|archive-url=https://web.archive.org/web/20040726042921/http://www.2dca.org/opinion/June%2006,%202003/2D02-5394.pdf|url-status=dead|archive-date=July 26, 2004|title="In re: Guardianship of Theresa Marie Schiavo, Incapacitated. Robert Schindler and Mary Schindler, Appellants, v. Michael Schiavo, as Guardian of the person of Theresa Marie Schiavo, Appellee", Case Number: 2D02-5394|author=Altenbernd, Chris W. Judge (for The Court)|publisher=Florida Second District Court of Appeal|date=June 6, 2003|pages=9–10|access-date=February 22, 2006|df=mdy-all}}</ref> came to be known as ''Schiavo IV'' in later rulings.

Around the start of 2003, the Schindlers began to create more publicity by lobbying for their case to keep their daughter alive.  On September 11, 2003, the Schindlers petitioned the court to forestall removal of the feeding tube in order to provide for "eight weeks' therapy". Accompanying the petition were four affidavits from members of the Schindler family and one from Dr. Alexander T. Gimon. At the hearing, the Schindlers' counsel read into the record additional affidavits from three speech professionals and two nurses. In particular, nurse Carla Sauer Iyer asserted that she was able to feed Terri Schiavo orally but that Michael characterized any such interaction as "therapy" and ordered her not to do so. Iyer claimed in her affidavit that her initial training in 1996 consisted solely of the instruction, "Do what Michael Schiavo tells you or you're terminated", and that standing orders were not to contact the Schindler family, but that she "would call them anyway".<ref name=":0" />

On September 17, 2003, Judge [[George Greer]] denied the petition, and wrote that "the Petition is an attempt by Mr. and Mrs. Schindler to re-litigate the entire case. It is not even a veiled or disguised attempt. The exhibits relied upon by them, clearly demonstrate this to be true." Regarding Iyer's<ref name=Iyer>{{cite web|url=http://treyjackson.typepad.com/junction/2005/03/carla_sauer_i_w.html|title=Fox interview of Carla Sauer Iyer|publisher=Fox News via American Patriot Friends Network (APFN)|date=March 25, 2005|access-date=July 25, 2007 |archive-url=https://web.archive.org/web/20050326040947/http://treyjackson.typepad.com/junction/2005/03/carla_sauer_i_w.html |archive-date=March 26, 2005 |url-status=dead}}</ref> statements,<ref name=":0">{{cite web|url=http://www.apfn.org/Schiavo/CIyerAffidavit090203.htm|title=Affidavit|date=March 2, 2005|author=Carla Sauer Iyer|access-date=July 25, 2007|archive-url=https://web.archive.org/web/20070927202855/http://www.apfn.org/Schiavo/CIyerAffidavit090203.htm|archive-date=September 27, 2007|url-status=live|df=mdy-all}}</ref><ref>{{cite news|url=http://www.ocregister.com/ocr/sections/news/news/article_456712.php|title=Michael Schiavo's character is mixed portrait|last=Breed|first=Allen G.|publisher=Orange County Register|date=March 25, 2005|access-date=March 1, 2009 |archive-url=https://web.archive.org/web/20090706204126/http://www.ocregister.com/ocr/sections/news/news/article_456712.php |archive-date=July 6, 2009 |url-status=dead}}</ref><ref>{{cite web|url=http://www.hospicepatients.org/heidi-law-09-03-affidavit-re-terri-schiavo-michael.html|title=Heidi Law Affidavit|author=Heidi Law|publisher=self|date=January 1, 2002|access-date=January 1, 2007|archive-url=https://web.archive.org/web/20061027174433/http://www.hospicepatients.org/heidi-law-09-03-affidavit-re-terri-schiavo-michael.html|archive-date=October 27, 2006|url-status=live|df=mdy-all}}</ref> Greer wrote that they were "incredible to say the least" and that "Ms. Iyer details what amounts to a 15-month cover-up from April 1995 through July 1996, which include the staff of Palm Garden of Largo Convalescent Center, the Guardian of the Person, the guardian ''ad litem'', the medical professionals, the police and, believe it or not, Mr. and Mrs. Schindler&nbsp;... It is impossible to believe that Mr. and Mrs. Schindler would not have subpoenaed Ms. Iyer for the January 2000 evidentiary hearing had Iyer contacted them in 1996 as her affidavit alleges."<ref>{{cite book|url=http://abstractappeal.com/schiavo/trialctorder0903.pdf|title=In re: The guardianship of Theresa Marie Schiavo, Incapacitated. Michael Schiavo, as Guardian of the person of Theresa Marie Schiavo, Petitioner, v. Robert Schindler and Mary Schindler, Respondents, File No. 90-2908GD-003|author=Greer, George W. Circuit Judge|publisher=Florida Sixth Judicial Circuit|date=September 17, 2003|access-date=July 25, 2007|archive-url=https://web.archive.org/web/20070710115626/http://abstractappeal.com/schiavo/trialctorder0903.pdf|archive-date=July 10, 2007|url-status=live|df=mdy-all}} Direct quote from pages 5–6 of this 9-page Order.</ref>