Whistling past the graveyard there Guest 9:08/9:12?

Here is some more information on how these family feuds end up in court battles like this (again, from ABC News):

"There is a certain routine-ness to withholding care," said Lefrak, adding that these decisions rarely involve lawyers or court cases. "Ninety-nine-point-five percent of the time these things get ironed out."

Then why do a handful of these cases plunge the nation into a lengthy, complex legal and political morass?

"They will get there usually when there's significant family dysfunction," said Lefrak. Long-smoldering family tensions often reach a flash point when terminal care decisions need to be made, he adds. "It's a very trying time."

"There are a lot of families out there who have a hard time accepting a case of persistent vegetative state," said Cranford "They look like they're perfectly normal in a way, but they're not. In those cases, we don't usually push it."

In almost all situations, medical professionals and families strive to keep PVS cases away from lawyers and courtrooms.

"You try to do the right thing. You try not to get the courts involved. Lawyers and judges have their own point of view," said Lefrak.

"These cases are hard for judges," said Cranford, "because there's a lot of sympathy for both the parents and for the spouse."

There are some strategies medical professionals have developed for keeping PVS and other end-of-life cases out of court.

"Number one is to get the medical facts. Sometimes the medical facts are sort of gray," said Lefrak. "For example, does Terri Schiavo have persistent vegetative state or not?"

"Number two are any hints of what the patient would have wanted," he said.

And Lefrak highlights the importance of working toward a consensus of agreement in every PVS case. This involves bringing in as many people as necessary, including clergy, social workers, ethical consultants and every member of the medical team, including all nurses and doctors.

"I will ask, 'Do you have a minister or would you like to use one of our spiritual care providers?' " said Lefrak. "The whole process has to be transparent. It means more work, and more people have to get involved.

Family members who feel left out of the decision-making process are usually the ones who go to lawyers, he said. "It's when somebody's out of the loop that they go and seek outside help."

"We're going to have lots of Terri Schiavos," said Lefrak. "But the family is going to only have one."

Even though cases like Schiavo's are rare, they will continue to come up, Lefrak believes, since the death of a family member is always a milestone in that family."