Analysis of Terri Schiavo - Case Study Example

Terri Schiavo Case Analysis Terri Schiavo’s case is a of a legal struggle concerning prolonged life supporting in the in the U.S.A. Terri Schiavo sustained a permanent injury on the brain due to lack oxygen after collapsing in the hall of her apartment on 25 February, 1990 at the age of 26 years. She had not prepared a living will, and she did not have a durable attorney’s power. Four months after her injury, she was rendered incompetent and her husband, Mr Schiavo was appointed her lawful guardian without opposition from her parents. The brain injury had rendered her incapable to swallow and to keep her nourished and alive; a feeding tube was placed on her. Later in the year 1990, Mrs. Shiavo was diagnosed with a “Persistent Vegetative State” (PVS). Her husband Mr. Schiavo accepted that her condition was very critical, and her recovery was remote since all healthcare means had failed to revive her. He decided to work on what he assumed his wife would wish. He said my wife would not have chosen to continue being kept on an artificial life-supporting machine. Mrs. Shiavo’s parents strongly opposed her husband’s stand and subsequently one of the most popular ethical dilemmas unfolded (Perry,Churchill and Kirshner, 2005). This case spurred controversy in the legal, medical, ethical, political and social domains. The case threatened to loosen the long-standing legal and ethical positions, which enabled individuals to control medical interventions executed on them. After so many petitions, hearings and numerous appeals, the Florida Supreme Court sanctioned the feeding tube to be removed on 31 of March 2005 in spite of opposition from President George Bush and the Congress but she died on 31 of March 2005. Terri’s case resonated with other cases that obviously influenced the Supreme Court’s decision to have the feeding tube removed, which included, the case of “Karen Quinlan Ann in 1976,” “Paul Brophy in 1986,” and “Nancy Cruzan in 1990” in which the patients who didn’t have written advance directives. In all these cases, the courts viewed the freedom and privacy interest of the patients as supreme and thus, the judge argued that she would not have wished to continue living under life-prolonging measures all her life hence sanctioned the that the feeding tube be remove from her (Perry, Churchill and Kirshner, 2005) A number of legal considerations were put into perspective in the determination of this case. Firstly, she had not made any healthcare directive other than private conversations with her husband in, which she stated, or the husband deduced that she would not want her life to be prolonged if she fell in a PVS. Without such advance health care directive, the decision to terminate the artificial nourishment and hydration had to be made by the husband who was the legal guardian. Being a person who knew her well, he was the best-suited surrogate decision maker for her. On the other hand, the numerous appeals, hearings and petitions on the case that delayed its determination for many years were because, withholding artificial hydration and nourishment of patients in chronic vegetative state is not considered illegal in the state of Florida Judicial systems (Mathes, 2005), Various people and institutions took different positions regarding Schiavos case. The parent’s stand was motivated by their belief that; Terri could recover with hypobaric chamber therapy since she could swallow. However, the most convincing motivation for their stand was that of their emotional belief of “not killing” based on their Catholic Church religious beliefs position, on euthanasia and the desire to keep alive their loved one as parents and hence it was justifiable for the parents to oppose the termination of the artificial life support. As parents, they had the right to maintain her life if they desired to do so (Ditto, 2000). Many taxpayers could have supported the Supreme Courts ruling due to the resources required to keep someone suffering from an irreversible condition alive for fifteen because they bear the tax burden. The governors of Florida’s position to have Terri remain under artificial nutrition and hydration was influenced by the idea of autonomy, or the patient’s preferences. Governor Bush once reordered that the feeding tube be reinserted after its removal through one of the court’s sanctions by signing Terri’s law, which provided for the governor’s discretion to order resumption of Terri’s medical treatment (Perry, Churchill and Kirshner, 2005). The moral justification of the governor’s stand can be justified on his personal beliefs on human life and the custom of not wanting to deviate from the prevailing public opinion on Euthanasia related issues (Preston &Kelly, 2006). The opinion of the outsiders on the case was influenced by characteristics, values, beliefs, economic and social gains or losses of the opposing persons in the case. For instance, the personal religious persuasions of Terri’s parents could have played a major role in wanting her to remain alive. The Relationship of Terri’s loved ones and the outsider’s ability to associate with either the husband or the parents may have influenced their standpoint in this case. In addition, their concern and care not to harm emotions of either the parents or the husband through their personal opinions or perceived personal characteristics of the persons involved in the dispute could have influenced their position in this case. Therefore, their varying positions can be justified on our general human character to consider the impact of our ethical decisions on cultural or religious groups and institutions that we believe will be an influenced by these decisions (Preston and Kelly, 2006). The husband’s position can be attributed to the fact that all attempts to help her recover had failed. He was justified on this situation to propose the feeding tube to be remove from her, putting into consideration that he was convinced, as a husband that Terri would have wished for the same if she were in a capacity to express herself (Ditto, 2006). My ethical position in this case is that the court of Supreme did more harm than good by its final ruling. Although her condition was terminal, authorizing the removal of the tube, and her subsequent death violated the dominant ethical belief of maintaining life. This may give rise to situations where lives are terminated,even when the patient’s case is not irreversible, by using the law that allows courts to determine the incapacitated patient’s best interests or who is suited best to decide for them (Mathes, 2005). Public health consideration arises in Terri’s case. It entails preventing illness, promoting health and prolonging life. The main issue is the actual methods that should be used in prolonging life and what are the exceptional cases where life should not be prolonged (Mathes, 2005). Terri Schiavo’s case is an ideal illustration of how ethics, law, values and beliefs can come into conflict. It places importance on the need for sound decision-making and the framework to deal with legal and ethics dilemmas in order to avoid recurrence of spectacles such as in this case. I now consider implementing my advance directive in the form of a specific statement regarding the types of life-sustaining treatment I would want to receive. This will help to avoid conflicts in decision making among various stakeholders as it happened in Shiavos case (Hook & Mueller, 2005). Vegetative state refers to a situation where a patient loses consciousness because of injury on brain (Fins, 2008). Higher brain death is the stoppage of functioning in brain parts responsible for consciousness and advanced thinking (Wijdicks, 2001). After her death and autopsy had been done, “the coroner implied that Terri was not in a minimally stable state. She had massive brain damage. Her brain weight was approximated to be half the normal weight. Her remaining brain regions showed severe hypoxic injury and neuronal atrophy/loss” (Pence, 2011). Therefore, the autopsy leads me to conclude that her husband made the right decision for her after all. References Ditto, P. (2006). What Would Terri Want? On the Psychological Challenges of Surrogate Decision Making (1st ed.). California: Taylor &Francis Group. Fins, J. (2008). Brain Injury:The Vegetative and Minimally Conscious States. (1st ed., pp. 15-20). Newyork: The Hastings Center. Hook, C. C., & Mueller, P. S. (2005). The Terri Shiavo Saga: The making of a tragedy and Lessons learned. Mayo Clinic Proceedings, 80, 1449-1460. Matthes, M. (2005). Terri Shiavo and End of Life Decisions: Can Law Help Us Out?. Med Nursing, 14(3), 200-202. Preston, T., & Kelly, M. (2006). A Medical Ethics Assessment of the Case of Terri Schiavo (1st ed.). Washington: Taylor &Francis Group. Pence, G. E. (2011). Medical Ethics: Accounts of Ground-Breaking Cases (6th ed.). (M. Ryan, Ed.). New York, NY: McGraw Hill Perry, J. E., Churchill, L. R., & Kirshner, H. S. (2005). The Terri shiavo case: Legal, Ethical and medical perspectives. Annals of Internal Medicine, 143, 744-748. Wijdicks, E. F. (2001). The diagnosis of brain death. New England Journal of Medicine, 344(16), 1215-21 Read More