Fighting for Dear Life (37 page)
If any one of these named individuals refuses to consent, the action that
will result in my death may not be taken.
In the event that my Health Care Surrogate is unable or unwilling to act in said capacity or is determined to have a conflict of interest, whether moral, financial, or any other, by a majority of the following named individuals:
I designate as my alternate surrogate for health care decisions:
Name, Address, and Telephone Number of Alternate Surrogate:
I fully understand that this designation will permit my Health Care Surrogate to make health care decisions for me and to provide, withhold, or withdraw consent to medical procedures on my behalf; to apply for public benefits to defray the cost of health care; to authorize my admission to or transfer from a health care facility; and to have access to medical records pertaining to me and to authorize the release of medical information and medical records to third parties as directed by my Surrogate.
I understand the full import of this declaration, and I am emotionally and mentally competent to make this declaration.
Signed this_________day of _______________, 20_____________.
STATEMENT OF WITNESSES
We declare, under penalty of perjury, that the Declarant is personally known to us, or has produced a driver's license as identification, that the Declarant signed or acknowledged this Designation of Health Care Surrogate in our presence, that the Declarant appears to be of sound mind and under no duress, fraud, or undue influence, and that we are not the person appointed as Health Care Surrogate by this document or related to the Declarant by blood or marriage.
The foregoing instrument was acknowledged before me this day of , 20 , by , who personally appeared before me at the time of notarization, and who is personally known to me or who has produced a driver's license as identification and who did take an oath.
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Permission to photocopy granted.
EXECUTIVE ORDER NUMBER 03-201
WHEREAS, on October 21, 2003, the Florida Legislature passed House Bill 35-E (to be published as Public Law 03-418), signed this date by me, authorizing the Governor to issue a one-time stay in certain cases where, as of October 15, 2003, the action of withholding or withdrawing nutrition or hydration from a patient in a permanent vegetative state has already occurred and there is no written advance directive and a family member has challenged the withholding or withdrawing of nutrition and hydration; and
WHEREAS, under House Bill 35-E a person may not be held civilly liable and is not subject to regulatory or disciplinary sanctions for taking any action to comply with a stay issued by the Governor pursuant to House Bill 35-E; and
WHEREAS, in the case of Theresa Marie Schindler Schiavo, Robert Schindler and Mary Schindler, the parents of Theresa Marie Schindler Schiavo, have requested that the Governor enter a stay prohibiting further withholding or withdrawing of nutrition or hydration; and
WHEREAS, a court has found that Theresa Schiavo is in a persistent vegetative state as of October 15, 2003; and
WHEREAS, Theresa Schiavo had no written advance directive as of October 15, 2003; and
WHEREAS, nutrition and hydration have been withdrawn from Theresa Schiavo, and continues to be withheld as of October 15, 2003; and
WHEREAS, the Schindlers have challenged the withdrawal and withholding of nutrition and hydration as of October 15, 2003; and
WHEREAS, an immediate and urgent need has arisen to address the removal of nutrition or hydration, because death due to lack of nutrition and hydration is imminent;
NOW THEREFORE, I, JEB BUSH, Governor of the State of Florida, by the powers vested in me by the Constitution and laws of the State of Florida, specifically House Bill 35-E, do hereby promulgate the following Executive Order, effective immediately:
Section 1
A. Effective immediately, continued withholding of nutrition and hydration from Theresa Schiavo is hereby stayed.
B. Effective immediately, all medical facilities and personnel providing medical care for Theresa Schiavo, and all those acting in concert or participation with them, are hereby directed to immediately provide nutrition and hydration to Theresa Schiavo by means of a gastronomy tube, or by any other method determined appropriate in the reasonable judgment of a licensed physician.
C. While this order is effective, no person shall interfere with the stay entered pursuant to this order.
D. This order shall be binding on all persons having notice of its provisions.
E. This order shall be effective until such time as the Governor revokes it.
F. The Florida Department of Law Enforcement shall serve a copy of this Executive Order upon the medical facility currently providing care for Theresa Schiavo.
IN TESTIMONY WHEREOF, I have hereunto set my hand and have
caused the Great Seal of the State of Florida to be affixed this 21st day
of October, 2003.
109TH CONGRESS
    1ST SESSION
S. 686
For the relief of the parents of Theresa Marie Schiavo.
IN THE SENATE OF THE UNITED STATES
MARCH 20, 2005
Mr. FRIST (for himself, Mr. MARTINEZ, and Mr. SANTORUM) introduced the following bill; which was read twice, considered, read the third time, and passed
AN ACT
For the relief of the parents of Theresa Marie Schiavo.
1
Be it enacted by the Senate and House of Representa-
2
tives of the United States of America in Congress assembled,
3
SECTION 1. RELIEF OF THE PARENTS OF THERESA MARIE
4
SCHIAVO.
5 The United States District Court for the Middle Dis-
6 trict of Florida shall have jurisdiction to hear, determine,
7 and render judgment on a suit or claim by or on behalf
8 of Theresa Marie Schiavo for the alleged violation of any
9 right of Theresa Marie Schiavo under the Constitution or
10 laws of the United States relating to the withholding or
1 withdrawal of food, fluids, or medical treatment necessary
2 to sustain her life.
3
SEC. 2. PROCEDURE.
4 Any parent of Theresa Marie Schiavo shall have
5 standing to bring a suit under this Act. The suit may be
6 brought against any other person who was a party to State
7 court proceedings relating to the withholding or with-
8 drawal of food, fluids, or medical treatment necessary to
9 sustain the life of Theresa Marie Schiavo, or who may act
10 pursuant to a State court order authorizing or directing
11 the withholding or withdrawal of food, fluids, or medical
12 treatment necessary to sustain her life. In such a suit, the
13 District Court shall determine de novo any claim of a vio-
14 lation of any right of Theresa Marie Schiavo within the
15 scope of this Act, notwithstanding any prior State court
16 determination and regardless of whether such a claim has
17 previously been raised, considered, or decided in State
18 court proceedings. The District Court shall entertain and
19 determine the suit without any delay or abstention in favor
20 of State court proceedings, and regardless of whether rem-
21 edies available in the State courts have been exhausted.
22
SEC. 3. RELIEF.
23 After a determination of the merits of a suit brought
24 under this Act, the District Court shall issue such declara-
25 tory and injunctive relief as may be necessary to protect
1 the rights of Theresa Marie Schiavo under the Constitu-
2 tion and laws of the United States relating to the with-
3 holding or withdrawal of food, fluids, or medical treatment
4 necessary to sustain her life.
5
SEC. 4. TIME FOR FILING.
6 Notwithstanding any other time limitation, any suit
7 or claim under this Act shall be timely if filed within 30
