Schiavo case: Speculations About Bulimia and Dysfunctional Family

The Schiavo case will go down in bioethical history just as Quinlan and Cruzan have. Whether Schiavo will be the beginning of a change in bioethical and legal thinking with regard to surrogacy and autonomous decisions to terminate life support remains to be seen. Beyond this, the case, as suggested by others, has opened speculation regarding the psychodynamics involving Terri Schiavo and her parents. It has been suggested that it is more than coincidental that food and fluid has played a significant role in both the start and conclusion of Terri's illness. One may speculate that the bulimia of over-eating and purging through vomiting which precipitated the immediate near-fatal electrolyte imbalance may have had as its etiology a severe emotional disturbance related to a need to demonstrate self-control as a reaction to life in a possible dysfunctional family. We don't know this as a fact but certainly there are long established theories regarding such reaction as well as some surveys, self-reported, by bulimic patients. If this was the case with Terri, one might speculate about an apparent controlling behavior of Terri's parents with regard to their response over the years to override her request to terminate her life support and perhaps another control issue which led to the bulimia response itself. If the facts about this daughter-parent relationship, in this already widely publicized personal case, could be investigated, it might contribute to a better understanding of the nature of the bulimic illness. ..Maurice.