Terri Schiavo: Rest in peace
============================

* William J. Sullivan

[The following letter concerns the death of Terri Schiavo in 2005. Because of an editorial oversight, this letter was not published last year, and it seemed appropriate to include it here.]

The analysis by Glenys Godlovitch and associates1 of discontinuing life support is well done. It is, however, important to remember that under the Canadian Constitution, it is the provinces (not the federal government) that have jurisdiction with regard to substitute health care decision-making. Therefore, readers should be aware that the Alberta court decision discussed by these authors may not apply in other provinces, where the laws may be different.

Although the common law2 has long recognized the legal validity of living wills (instructional advance directives), the statutory enactments in some provinces may require that certain procedural steps be taken before they become enforceable. Even without these steps, the instructional advance directive is evidence of the person's wishes. Although, as Weijer3 rightfully points out, the instructional advance directive is not a panacea, such a directive is worth writing to provide guidance to surrogate decision-makers in situations such as the withdrawal of life support if the patient becomes comatose.

## REFERENCES

1.  1. Godlovitch G, Mitchell I, Doig CJ. Discontinuing life support in comatose patients: an example from Canadian case law. CMAJ 2005;172(9):1172-3.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMDoiMTcyLzkvMTE3MiI7czo0OiJhdG9tIjtzOjIyOiIvY21hai8xNzUvNi82MjEuMi5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

2.  2. *Malette* v. *Shulman* (1990), 72 O.R. (2d) 417.
    
    

3.  3. Weijer C. A death in the family: Reflections on the Terri Schiavo case [editorial]. CMAJ 2005;172(9): 1197-8.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMDoiMTcyLzkvMTE5NyI7czo0OiJhdG9tIjtzOjIyOiIvY21hai8xNzUvNi82MjEuMi5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=)