Jay Wolfson, DrPH, JD, Guardian Ad Litem for Theresa Marie S
Thu Mar 24, 2005 21:58
64.140.158.56
Jay Wolfson, DrPH, JD, Guardian Ad Litem for Theresa Marie Schiavo
jwolfson@hsc.usf.edu
Contact Information:
Office: CPH 1126
E-Mail: jwolfson@hsc.usf.edu
Voice Mail: (813) 974-6643
FAX: (813) 974-6642
http://hsc.usf.edu/publichealth/eoh/jwolfson/
Jay Wolfson- and the Terri Schiavo Case
... Jay Wolfson is Professor of Public Health and Medicine, Director of the ...
Jay Wolfson told The Associated Press in his first interview on the case ...
A REPORT TO GOVERNOR JEB BUSH
AND THE 6TH JUDICIAL CIRCUIT
IN THE MATTER OF THERESA MARIE SCHIAVO
Pursuant to the requirements of H.B. 35-E (Chapter 2003-418, Laws of Florida) and the Order of the Hon. David Demers, Chief Judge, Florida 6th Judicial Circuit regarding the appointment and duties of a Guardian Ad Litem in the matter of Theresa Marie Schiavo, Incapacitated.
Respectfully Submitted
Jay Wolfson, DrPH, JD, Guardian Ad Litem for Theresa Marie Schiavo
1 December 2003
http://jb-williams.com/ts-report-12-03.htm
Introduction
Sometimes good law is not enough, good medicine is not enough, and all too often, good intentions do not suffice. Sometimes, the answer is in the process, not the presumed outcome. We must be left with hope that the right thing will be done well.
We are, each of us, standing in Theresa Marie Schiavo's shoes. Each of us is profoundly affected by the decisions that have and will be made in this case. Advocates of privacy rights and death with dignity, and advocates of right to life and rights of the disabled provide the compelling definitional parameters of this matter.
On 31 October 2003, pursuant to the requirements of Florida H.B. 35-E (Chapter 2003- 418, Laws of Florida) and the order of the Hon. David Demers, Chief Judge, Florida 6th Judicial Circuit, a Guardian Ad Litem was appointed for a period of thirty days with the following charge:
"…make a report and recommendations to the Governor as to whether the Governor should lift the stay that he previously entered. The report will specifically address the feasibility and value of swallow tests for this ward and the feasibility and value of swallow therapy. Additionally, the report will include a thorough summary of everything that has taken place in the trial court and the appellate court concerning this case."
The legislature instructed the court to appoint a Guardian Ad Litem to report to the court and the Governor. Florida law regarding the duties and powers of the Guardian Ad Litem afford considerable scope and flexibility. The specific court ordered charge is narrowly constructed, particularly with respect to the questions to be addressed.
The recommendations proffered herein are intended for both the Governor and the court, on behalf of Theresa Marie Schiavo.
The Guardian Ad Litem's efforts have been to deduce and represent the best wishes and best interests of Theresa Schiavo. In that no express, written advance directive existed, determining what Theresa's wishes might be require a combination of substituted judgment, reasonable person considerations, and an aggressive, objective assessment of the massive legal and clinical record that has been compiled over thirteen years.
The entire court file of thirteen years, including items of evidence, has been reviewed and studied, with particular attention given to decision points in the case history that are reflected in motions to and orders by the Court. The case review has included clinical and medical records, discussions with members of the family, caregivers, and with medical, legal, bioethical and religious practitioners and scholars and the conduct of independent research into the substantive issues in this case. The GAL has met regularly with Ms. Schiavo, his ward.
Below, the questions posed to the GAL are addressed with recommendations, followed by an introduction to the case, a summary of the case, a summary of legal and medical issues in this case, and an expanded analysis of the recommendations at the conclusion of the report.
Questions and Recommendations
The two questions which the GAL is directed to address, and respective recommendations are:
1. Should the Governor lift the stay that he previously entered relative to Theresa Schiavo's feeding tube?
a. Yes. The Governor should lift the stay, if valid, independent scientific medical evidence clearly indicates that Theresa has no reasonable medical hope of regaining any swallowing function and/or if there is no evidence of cognitive function and no hope of improvement.
b. No. The Governor should not lift the stay if valid, independent scientific medical evidence clearly indicates that Theresa has a reasonable medical hope of regaining any swallowing function and/or if there is evidence of cognitive function with or without hope of improvement.
2. Is there feasibility and value in swallowing tests and swallowing therapy given the totality of circumstances?
a. Yes. There is feasibility and value in swallowing tests and swallowing therapy being administered if the parties agree in advance as to how the results of these tests will be used with respect to the decision about Theresa's future. If the parties do not agree in advance as to how the tests will be used, then the court must be prepared to once again make a final judgment on the matter. Given the history of the case, this would not, in and of itself, assure a resolution, and is not, therefore, deemed either feasible or of value to Theresa Schiavo without prior agreement.
A detailed discussion of these recommendations within the context of the GAL's findings and analyses concludes this report.
CLICK FULL REPORT:>>
http://jb-williams.com/ts-report-12-03.htm
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Jay Wolfson, Dr.PH, JD
... Jay Wolfson, Dr.PH, JD. Health Sciences Center · College of Public Health ·
Environmental and Occupational Health ...
HAS NOT REMARKED ON TERRI'S BONE SCAN.... STRANGE!!
Theresa Marie Schiavo's Bone Scan:
http://www.apfn.org/APFN/TERRI_BONESCAN.HTM
a surprise move the state's social welfare agency asked for an indefinite delay to investigate potential abuse of the severely brain-damaged woman. 02/23/05
http://www.apfn.org/apfn/Terri_stay.htm
State-Funded Agency to Probe Claim of Spousal Abuse in Terri Schiavo Case
http://www.apfn.org/apfn/Terri_abuse.htm
Dr. Wolfson also has a private health law practice.
posted on Tue, Jan. 25,2005
AP Interview: Former Schiavo
guardian calls for definitive
tests
Vickie Chachere
Associated Press
TAMPA, Fla. - Terri Schiavo should undergo a new examination by independent medical experts to put to rest lingering questions on whether she has any hope of recovery, the University of South Florida professor who had been her court-appointed advocate said Tuesday.
But before any tests are done, her warring husband and parents would have to agree to drop their life-or-death legal fight in favor of whichever side the medical evidence supports, Jay Wolfson told The Associated Press in his first interview on the case since serving as Terri Schiavo's guardian ad litem.
His comments come as the legal options of Terri Schiavo's parents have dwindled to two pending matters in state courts which have ruled against them before.
The U.S. Supreme Court refused Monday to consider a legal challenge to "Terri's Law," the measure pushed by Gov. Jeb Bush in October 2003 to keep Terri Schiavo alive after the courts had cleared the way for her death.
Wolfson served as Schiavo's guardian for two months 2003 under the auspices of "Terri's Law." He tried to broker an agreement between the two sides, but was unsuccessful.
Wolfson said it is not too late to revisit the original question in the long-running legal saga - is the 41-year-old woman disabled, or brain dead?
"There is so much at stake here, not just for Terri, but for the issue," said Wolfson, who is both a physician and a lawyer and serves as director of the Health Policy Information Center at USF.
"If we were serious about addressing this, we would say, 'What are the interests of the parties and how can we use science, medicine and good law to take away from the clouding factors in this case?'" he said.
Attorneys for her husband, Michael Schiavo, did not return calls for comment Tuesday. The suggestion of new independent medical review has been suggested, and rejected, by both sides at different stages in the case.
Barbara Weller, an attorney for parents Bob and Mary Schindler, said the offer of an independent medical panel was made by Michael Schiavo as late as the end of last year, but the Schindlers are hesitant to accept such a suggestion.
"The problem is finding truly neutral doctors," Weller said.
The Schindlers, who have been criticized by opposing attorneys for pursuing repeated appeals for their daughter, would prefer to settle the matter out of court, Weller said.
A hearing is scheduled for Friday on a motion in Florida Circuit Court in nearby Clearwater to set aside the decision granting Michael Schiavo permission to tell doctors to disconnect his wife's feeding tube. The Schindlers are arguing, in part, that Terri Schiavo should have had independent legal representation throughout the process.
Terri Schiavo suffered severe brain damage 15 years ago when her heart stopped beating because of a chemical imbalance.
She left no written directive and Michael Schiavo has said his wife would not have wanted to be kept alive artificially. But her parents dispute that she has no cognitive abilities, and say their daughter may be severely brain damaged but communicates with them and reacts to her environment.
Terri Schiavo breatheson her own, but requires a feeding tube for nutrition and hydration to keep her alive.
In 2002, Circuit Judge George Greer considered testimony from five medical experts who examined Terri Schiavo. Two were picked by Michael Schiavo, two by the Schindlers and one was independently selected by the judge.
That independent doctor reported there was no hope for her recovery.
Wolfson said that after examining her medical records, spending time with Terri Schiavo and consulting with experts nationwide, he, too, believes she is ina persistent vegetative state.
But even in his report to the courts, Wolfson wrote of the difficulties in reaching that conclusion, noting Terri Schiavo's "presence" when he was around her.
"Her eyes are not shut, she's breathing on her own and she makes noises," he said. "You want so much to say, 'Terri, give me a sign!' It's not a cucumber lying in a bed.
"The two sides were close to a deal when Michael Schiavo backed out, Wolfson said, saying he couldn't agree to anything Wolfson proposed because it came under the auspices of "Terri's Law," which Michael Schiavo was challenging as unconstitutional.
It was that law that came to its end Tuesday when the U.S. Supreme Court refused to consider it. The Florida Supreme Court had previously struck down the law as an unconstitutional.
Wolfson is not alone among experts in suggesting new, independent reviews of Terri Schiavo's condition.
Arthur Caplan, a director of the Center for Bioethics at the University of Pennsylvania and one of the nation's leading experts on end-of-life care, said last week he too believes a panel of independent doctors should have been asked to evaluate her.
"I don't know why that never happened," Caplan said. "It's been way too long to not have more, independent medical opinions about her diagnosis.
"Wolfson said the Schiavo case has the potential to drag on for years more as the parents continuously reframe their arguments in new legal filings.
"The process has not benefited anybody, it certainly has not benefited Terri,"Wolfson said.
AP Wire | 01/25/2005 | AP Interview: Former Schiavo guardian calls for definitive tests
http://journals.aol.com/justice1949/JUSTICEFORTERRISCHIAVO/entries/409
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