On the Subject of Terry Schaivo

Congressional Record - House

March 20, 2005 (H1723)

Mr. CARDIN. Mr. Speaker, I rise in opposition to the legislation.

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Mr. Speaker, I rise first to extend my thoughts and prayers to the loved ones of Teresa Marie Schiavo at this extraordinarily difficult time.

America has seen the anguish in the faces of Ms. Schiavo's family members. The legislation we are considering will determine whether we will send to federal court one case that has been adjudicated in Florida's state courts for nearly a decade.

For the past seven years, this particular case has traveled through Florida's state court system. The Florida courts determined through a review of testimony that, as her husband has testified, Terri Schiavo would not have wanted her life continued by artificial means. This Congress has chosen to disregard the ruling of the state court, the appeals court and Florida's Supreme Court. This bill stands in stark contrast to the principles of federalism, and it is the wrong direction for this Congress to take.

But as this debate is carried out before the entire world, it is clear that the issue is far more fundamental than state versus federal jurisdiction. The issue before us involves one of the most personal and controversial matters we face as humans: how do we deal with end-of-life care decisions for patients who cannot speak for themselves? Certainly not through this unprecedented act of intrusion into a personal family matter.

I believe the authors of this bill know that this is not the correct approach. Section 9 of this bill includes a ``Sense of Congress that the 109th Congress should consider policies regarding the status and legal rights of incapacitated individuals who are incapable of making decisions concerning the provision, withholding or withdrawal of foods, fluids, or medical care.''

When to stop life support when a person has no chance of recovery is an arduous decision. It is for that reason that Congress passed in 1990 the Patient Self-Determination Act as part of OBRA '90, which requires all hospitals, long term care facilities, home health agencies, hospice programs and HMOs that receive Medicare and Medicaid dollars to recognize a patient's living will and power of attorney for health care as advance directives. Health care organizations must provide patients with written information about establishing an advance directive and document if the patient has an advance directive that is placed in the patient's medical record. Patients are then able to decide in advance what medical treatment they want to receive if they become physically or mentally unable to communicate their wishes.

This piece of legislation gives patients the right to make choices and decisions about the types and extent of medical care they wish for themselves. With this act, patients can specify if they want to accept or refuse specific medical care. They can also identify a legal representative for urgent health care decision purposes. Then if they become unable to make decisions due to illness, the patients' wishes have been clearly documented at an earlier point of time.

Unfortunately, Ms. Schiavo did not execute an advance directive. There is conflicting information as to her wishes as expressed by her husband and parents. That conflict was resolved by the appropriate Florida court. It is not appropriate for Congress to pass special legislation for this one case.

Fifteen years after the passage of the Patient Self-Determination Act, the vast majority of Americans have not completed an advance directive. My colleague in the Senate, Bill Nelson, has introduced legislation that would improve compliance with the 1990 legislation and provide a benefit under Medicare for end-of-life consultation. That is the bill Congress should move as we debate this complex issue, not the bill that's currently before us.

If we enact this bill, it could very well result in an avalanche of cases in federal court. According to medical experts, as many as 35,000 Americans--nearly one-third of them children--are in a condition similar to that of Terri Schiavo . Their families face the same difficult decision-making process that Ms. Schiavo's parents and husband are contending with. I believe most Americans would agree that the last thing we want to do is encourage more divisive court cases and bills of this nature.

Regardless of the outcome of this vote, there will be no clear winners at the conclusion of this debate. Our judicial system and the rights of patients and their next-of-kin to make end-of-life decisions with their providers will be clear losers. Congress should never have considered this legislation.

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