Terri Schiavo's parents once again are left to ponder a new strategy in the quest to keep their daughter from having her feeding tube removed.
Once again, a court has said it's time for Terri Schiavo to die.
Mrs. Schiavo, 39, has been in a persistent vegetative state since a 1990 heart attack. For five years her husband Michael - who says he is following her wishes - has been trying to have her feeding tube removed, which would lead to her death. Her parents, Robert and Mary Schindler, have fought him every step of the way.
Last fall, after the highly publicized case had already gone all the way to the U.S. Supreme Court and come back down, Pinellas-Pasco Circuit Judge George Greer ruled that Mrs. Schiavo would never recover. He ordered her tube removed.
But the Schindlers appealed that decision to the 2nd District Court of Appeal in Lakeland - the fourth time they have gone to that court.
On Friday the appeals court again rejected their pleas. In an 11-page ruling that reads like their last word on the subject, three appellate judges ordered Greer to set a new date for removing the tube.
Mrs. Schiavo resides at a Pinellas Park hospice facility, where she is kept alive by twice-a-day feedings of a vitamin-enriched beverage and water. She is not in a coma. Her eyes are open during the day and she sleeps at night.
Her parents say her smiles, laughs, cries and moans show emotional and intellectual activity, but her doctors say those are involuntary reflexes.
Greer's decision last fall came after he heard testimony from five doctors - two picked by Schiavo, two by the Schindlers and one selected by Greer.
In Friday's ruling, the appeals judges noted that three of the five doctors testified that Mrs. Schiavo is either in a persistent or permanent vegetative state. Even the two doctors brought in by the Schindlers could not swear she will ever improve, the appellate judges said.
"The only debate between the doctors is whether she has a small amount of isolated living tissue in her cerebral cortex or whether she has no living tissue in her cerebral cortex," Chief Appeals Court Judge Chris Altenbernd wrote.
The Schindlers could not be reached for comment. Their attorney, Pat Anderson, said the parents were not surprised by the appeals court decision, and are already debating whether it's better to ask for a rehearing at this level or try for the Florida Supreme Court again.
"They remain hopeful that somebody, somewhere, is going to say hey, this is wrong," she said.
The Schindlers and Schiavo have accused each other of trying to control Mrs. Schiavo's fate to get $700,000 she received in 1993 from a malpractice suit, although their ongoing legal battle has largely depleted that fund.
The legal contest has become a bitter struggle. Last year Schiavo, a Clearwater resident, appeared on a CNN talk show, where he mentioned that he has a girlfriend and she recently had a baby. The revelation infuriated the Schindlers, who in court papers accused him of making a mockery of his marriage.
To Schiavo's attorney, George Felos, the whole case "is a real defeat for the court system. It shouldn't take half a decade to carry out end-of-life wishes. This gives a signal to the general public that the judicial system is not the place to resolve these disputes."
Felos predicted that the Florida Supreme Court and U.S. Supreme Court will again refuse to hear the case, and the case will wind up in two months or so.
The Schindlers had asked the appeals court to do more than just review Greer's ruling. They had also asked the appellate judges to look over all the medical evidence as if it were the first time.
Although the appeals judges said Greer had done everything right, Altenbernd said they too watched all the videotapes of Mrs. Schiavo's examinations by the doctors, examined the brain scans and read the doctors' testimony.
They came to the same conclusion as Greer.
Altenbernd sounded a note of sympathy for the Schindlers, noting that each judge "has our own family, our own loved ones, our own children. ... We understand why a parent who had raised and nurtured a child from conception would hold out hope that some level of cognitive function remained. If Mrs. Schiavo were our own daughter, we could not but hold to such a faith."
Nevertheless, he wrote, "this case is not about the aspirations that loving parents have for their children," but about Mrs. Schiavo's "right to make her own decision, independent of her parents and independent of her husband."
Greer said Friday he has not seen the order yet and has not yet set a date for the hearing at which he would tell hospice workers when to stop feeding Mrs. Schiavo. Without the tube, she will die in two weeks.