Lawmakers Expect Broader Review of Right-to-Die Issue

After intervening in the Terri Schiavo controversy, members of Congress are exploring whether to pass more sweeping legislation that would apply to other cases of incapacitated patients who did not leave behind instructions for their medical care.

In the bill approved this week and signed by President Bush that allowed Schiavo’s parents to ask a federal judge to order her feeding tube reconnected, lawmakers expressed their intent to take a broader look at the issue. A congressional hearing on whether additional federal legislation is needed is expected to be held next week.

“Clearly, Congress is interested in the debate over preserving a culture of life,” said Bob Stevenson, a spokesman for Senate Majority Leader Bill Frist (R-Tenn.).

While the push for the Schiavo bill came from Republicans, a prominent Democrat, Sen. Tom Harkin of Iowa, is considering introducing legislation that would allow a federal judge to review cases in which people had written no living will or left other instructions specifying their medical wishes if they became incapacitated and in which there is a dispute about the patient’s wishes.

“The more I looked at the Schiavo case, the more I thought, Wait a minute. There are a lot of people in similar situations -- maybe not in her specific situation -- but because of a disability cannot express themselves or cannot in any way make their desires known,” Harkin said last weekend.

Still, no consensus has emerged on what Congress should do next, if anything, on the issue. The bill approved dealing only with the Schiavo case drove a deep wedge in the ranks of House Democrats, who were almost evenly divided over it.

Also, a broader bill could draw objections from Republicans protective of states’ rights.

“We don’t really have a problem that requires federal action,” said William J. Winslade, a bioethicist and law professor at the Institute for the Medical Humanities at the University of Texas Medical Branch at Galveston. “The state laws have already covered these situations relatively well.”

Winslade said he hoped federal lawmakers would “think carefully about whether to intrude on these very personal and very private matters” before they sought to override state laws.

Social conservative groups pushed for congressional intervention in the Schiavo case, and they plan to lobby Congress for additional legislation.

“I think Congress does have a legitimate role in protecting life,” said Tony Perkins, head of the Family Research Council, a conservative lobbying group. “In [the Schiavo] case ... I think Congress was compelled to act, and I think that there are going to be other cases like this that will need to be addressed.”

Although Perkins has not determined what kind of legislation his group would back, some social conservative groups want to revive a broader bill that passed the House last week but stalled in the Senate. That bill would allow federal courts to review cases similar to Schiavo’s. But in the Senate, some Republicans joined Democrats in objecting that the bill was too sweeping.

Lanier Swann, director of government relations for Concerned Women for America, said she hoped Congress would consider, among other issues, who should be considered a guardian able to determine an incapacitated patient’s care.

She said Schiavo’s husband, Michael, should have no say in Terri Schiavo’s case because he has fathered two children with his girlfriend, with whom he lives.

Congressional Republican leaders were vague Tuesday about their next move.

A spokesman for House Majority Leader Tom DeLay (R-Texas), a leader in moving the Schiavo bill through Congress, said the case had “raised the issue in the eyes of Americans throughout the country. It is an issue that Congress continues to focus on.”

An aide to a senior House Republican, speaking on condition that he not be identified, said he thought lawmakers would move cautiously, mindful of public opinion polls showing disapproval of congressional intervention in the Schiavo case.

“We’ve got to get a sense of what members are hearing back in their districts,” the aide said.